One thing that causes intense chest pain mimicking heart attack like symtoms is esophogeal spasm.... it hurts like heck - can last for hours - and I ended up in urgent care once with those symtoms to rule out heart problems... they were able to do that and it it turned out it was "just" my esophogeous kinda tied in a knot...... was ok the next day and I get flare ups occasionally but at least I know what I'm dealing with...
Hope its nothing major there! (I do have heart rythm problems I take meds for - but they dont cause pain)

When I first started with the autonomic problems, I had high BP episodes....210/104ish.....but my pulse would be sitting at 40BPM...it is called 'Disassociation'. Then after a while the BP dumped down to 70/40 and THAT stayed like that mostly...with the pulse around 40. It has been better lately...I stay in the 'normal range' for the most part, but the pulse can get real low. Any stress physical or emotional, can make the blood pressure go down quite low. I just had a stress test and my BP dropped 35 points at max exertion...so they stopped me there. I don't think I was quite up to the max heart rate for my age, but close....I had to break into a run, so that is not fun for me on a treadmill on an angle....felt like I could fly off the back---then my foot flop kicked in---so it was a good thing they stopped it, or I would have a a Youtube moment.

I think if you have small fiber neuropathy, it would be good to have an autonomic battery. I learned a lot.....like I don't sense external heat and do not sweat, at all....emerged totally orange from the sweat box. I was supposed to emerge a purple Barney. I believe that was an accurate result...

I did the 'stupid thing' last night....you know, it is cold in my part of the country....so I used one of those 'hot hands' things in my mukluk....well, good thing I checked it...I had two toes that looked like they had been baked to medium rare...I felt---nothing. I thought the darn 'hot hands' thing was not working. So what is a person to do, when they feel cold all the time---but can't feel warm??? Toes are fine...the red faded in a half an hour....

Anyway labile hypertension was the first real abnormality I had....and it wasn't really hypertension, it was autonomic neuropathy. Good to get diagnosed, because then they watch for other stuff like gastroparesis and other autonomic dysfunction.

My GP is pretty sharp and at this mornings appointment brought up that it could be from autonomic pn. I hadnt mentioned it yet. Three days in the ccu and the cardiologist who treated me there told me to come back next week, his office told me today that they couldnt take me till mid march even though i had just come out of ccu. I told them have that doctor call me as to wether he wanted me to go to another doctor or get me an appointment. Meanwhile GP's office then called later when i went there and also was told same thing, took them awhile to get me an appointment for next week. Cardio office finally told them would have to get asap appointment only with doctors approval so they told them so go get it. Ill make sure i mention this to that doctor when i go in for my appointment after the business at hand is over with. You have to fight for every inch sometimes and it does get tiring after a while.

I dont know if this is a clue or not but 3 treatments of nitroglycerin did nothing while one treatment of 5 mg of morphine relaxed the constriction out of my chest in the heart area. The constriction actually felt like what asthma constriction feels like only in heart area not lungs. A while later i started to get aching pains in the area of the chest where the heart is, but that subsided in less time.

thanks for the replies, i really appreciate it, and i look forward to turning purple and taking a whirl on the tilt table.

KMEB how did you find out it was esophogeal spasm? What did they do to find out.

I HATE that blather about see me next week and then you can't get in for 6 weeks!
I called my GP when I'd encountered this after my onset...and let the DOCS and their egos slug it out! I won't go into it, as I could say LOTS of very bad and words that would be offensive to many....BUT I WAS THINKING THEM! LOTS OF THEM! You would think docs 'on call' in the ER could have a way to fast-track patients from there to their own offices! Enough of rant.
We both have earned tee-shirts on the issue!
Joe? What ever color you turn on a tilt-table, I'll still ALWAYS like you. Just the way you happen to BE! I just hope should you turn color? It's a GOOD one.
I truly also hope tho, that it was one of those quirks [NOT IDEOPATHIC, Just a QUIRK, mind you] and that testing can eliminate the other what-IFs.
Bad enough dealing with the what ARE's! That you get the ubiquitious 'baseline' in this new area, and don't have to worry about it in the future.... Lots of these: 's to you and to your family...Bet they aren't having fun either? They understand less than you do, and are probably more scared with all the unknowns, use that sympathy wisely. You know what I mean. Best ever - j

Sorry I spelled your name wrong before! Thats exactly what they did to me - nitro (did you get a roaring headache with it?) - some bloodwork - EKG - all ok - then IV valium which slowly got rid of the pain.....

My poor mom would have to carry Nitro,and she said the headacke was
worst then the chest pain..My brother who never gets sick,same thing
as Joe,they took every test under the sun,came up with nothing.
Really scared him though,called me and said i'm sorry your sick,
it was sweet..Hey Joe I'm sorry your going throug this,but better to
take tests,it may never happen again,hope not.
Sue PS Just smile and look preety in May C,,your son i'm sure
is very proud of you,just the way you are...But 300 people

surprisingly no headache and i didnt feel the morphine except it relieved the tightness. i either dont react or over react to medications. makes life fun. thanks for the replies kmeb and sue

Well you can't fool around with chest pain like that....just call 911, and let them sort stuff out....and yes, they DO make a big deal out of it...just the way the cookie crumbles.

You can't really differentiate between an esophageal spasm or heart attack...I get esophageal spasms....and I had a few that I swear felt like I thought a heart attack would feel....

Sounds like you will have to endure more docs, more tests and more drudgery....and more self advocacy......

turning purple won't be bad....think of a day on the beach....purple is good.

the tilt table isn't really bad, unless you get sick at that angle...if you get sick at that angle, which is around 70 degrees if I remember correctly (90 being strait up and down I assume)...anyway, if your body adjusts, it is fine....if it decides to dump on you, you just get nauseated and feel like passing out and it comes quick and you do....and they tip you down and then you come around....been there done that. I don't like being moved around on moving tables...Amusement rides were never my thing.

If you have had pulmonary function testing then the Valsalva test won't be new....they make you blow thru all kinds of things at different rates....they make you hyperventilate, and also blow against pressure...then they do these skin thingies, with acetylcholine in these little sucker things (that is what they looked like to me) they stick them on your skin...and it records things on a computer....how much you sweat I think....I don't know, I just do it....heh heh...'just do it.'

Anyway having autonomic neuropathy does not by any means rule out a heart attack....problem with AN, is folks do not know they are having a heart attack....

The more I learn about the nervous system, the less I want to know, because I realize what medicine does not know.

Besides, I am not firing on all synapses lately.

It was a small amount of morphine,but it helped. Bob is the same way
with meds. Sue