I am 28 years old. For a couple years now I have had mild chest pain off and on. I've seen cardiologists and no one had ever found anything. In July of 2009 I started having moderate chest pain, chest pressure and shortness of breath. My o2 was always 100% and I had a sinus rhythm but starting having bradycardia. My heart rate was running 30-40 while I was awake and 20s at night. My cardiologist ran all the tests including stress tests, ekg,chest x-ray but could find no reason for it. I had a pacemaker put in in October of 2009. A month after having it put in I noticed that I could not exert any energy and my heart rate was 180-190, but again still had a sinus rhythm. I thought my pacemaker needed adjusted, but after my exam the cardiologist found that it wasn't my pacemaker causing it. My heart was just doing it. He then decided to put me on atenolol in January to help lower my heartrate. It is working and I'm feeling a lot better than I did. Im able to now play with the kids. However, I have noticed that my chest pain has gotten more frequent and also the chest pressure. When I ask my dr. what is causing this, he has no answers for me. There has to be a reason for it,right? In October I was using my pacer 1/4 the time. Now I use it about every beat and imtold my pacemaker is working normal. Can you help explain to me what may be going on!!

Yipes! Here is a reference that may help: Bradycardia - Wikipedia, the free encyclopedia Look in the causes section.

I'd like to suggest seeing an endocrinologist to rule out thyroid, electrolyte imbalances, autonomic nervous system damage etc.
So, you should have a thyroid panel and an electrolyte panel done at the very least.

There is an autonomic nervous system test where you have EKG electrodes and you do breathing at the same time. There is also another one where your tilted 90 deg.

You seem to have had initially a heart rate lower than normal and when your tilted it goes even lower.

Since it has a relation to sleeping, I'd ask about a sleep study.

Also rule out asthma. You could easily check you're your peek flow with one of these: AirZone Personal Peak Flow Meter | National Allergy There is a reference value based on age, weight and sex.

There is a nuclear medicine test that can look for bleeding inside the body. Not sure if that's relevant.

Your cardiologist did the correct thing by putting in a pacemaker and starting you on altenalol. If you don't feel as if he is helping you any further I suggest you have your primary care physician consult a second cardiologist for a second opinion. Its difficult to say exactly what you would need without a lot of history and information. There is a possibility you might need a cardiac cath with ongoing chest pain and shortness of breath. Have you had a Echocardiogram?

Yes I've had an echo done, but it doesn't show anyhting. This however was before I had the pacemaker put in in October 2009 and I have had some cardiac changes since then. Do you think I should ask for another one to be done.

Have you worn a Holter Monitor? This might be a first step.

Yes, but again that was back in January or February of2009 before the pacemaker and I've had cardiac changes even since the pacemaker. That is why I take the atenolol now. I started it in Feb. 2010. Do you think I should have these tests done again.

We are not doctors here and we provide only opinions.

Personally, as a nurse, I believe pain always warrants a visit to a doctor. Pain is an indicator that there is something wrong.

Have you gotten a second opinion from a different cardiologist? Could this be anxiety related?