Symptoms are similar to angina , tests all OK, doctors are stumped could it be Coronary Microvascular Disease?

I am 20 years old, Male. I am athletic. My symptoms are similar to angina (chest tightens, dizziness, heart throbbing) My heart rate is abnormally high during physical exertion, (209 bpm)

These symptoms started 3 months ago in the summer. It has progressively gotten worse.

I have done blood work, echo-cardiogram, ECG, Stress test.

Results of blood work: Nothing abnormal
Results of Echo-cardiogram: No plaque buildup, Nothing abnormal
Results of ECG: No arrhythmia detected, Nothing abnormal
Results of Stress test: Heart rate quickly spiked to 209 bpm despite fitness level. Symptoms of chest pain started at 190 bpm. No arrhythmia detected.

Doctors are stumped as to why I have these symptoms. Need advice on what to do next. (What possibilities can it be? What tests should I take next?)

These tests, to my knowledge, have ruled out pretty much everything common. Could it be Coronary Microvascular Disease?

Its been 3 months since all this started, I can’t work, I can’t exercise. I just want my life back.

I have had no medical problems until this, I do not take medications, I do not have known allergies.





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MAHAVEER PATIL
6:18 am

hi
as all the cardiac tests are normal,it doesnt seem to be cardiac related. Some diseases like pheochromocytoma may cause such increased heart beats. You should talk to your doctor about this and get the necessary investigations done.
thanks

shw12
7:50 am

HI
YES,THIS CAN BE CORONARY MICRO-VASCULAR DISEASE. BUT OTHER HORMONAL OR SYSTEMIC DISEASES THAT HAVE EFFECTS ON THE CARDIAC FUNCTIONING SHOULD BE KEPT IN MIND. AFFECTION OF HYPOTHALAMO-PITUITARY AXIS CAN CAUSE THESE SYMTPMS. CONSULT A NEUROLOGIST AND A ENDOCRINOLOGIST.

shalini p
8:19 am

hello there
heart rates over 190 are dangerous. Being a young athelete you are expected to have low heart rate compared to normal people. but there should be some reason for such grossly increased heart rate. consult a endocrinologist to see for adrenal insufficiency

Ayman Darrag
11:57 am

Hi and welcome to question doctors.com
Have you tried anaemia test? If it is not due to cardiac or anaemia you can do a lipid profile to check for cholesterol levels..otherwise it would be anxiety disorder…
You should try exercising at low to medium impact for long time and work to you Maximum heart rate which should be 220-your age
Practice yoga and deep breathing exercises…