Which tests are recommended in an ex-smoker with chest pain?
I have been getting random chest pains over the last 3 months. I was an ex-smoker for 10 years who has quit smoking for 1 month. The doctor has said that my resting ECG and exercise ECG are normal. Are there any other recommended tests in an ex-smoker with chest pain?
Great question, and congratulations on giving up smoking! I'm sure this is a question on many smokers minds too.
First of all, chest pain should never be viewed trivially.
Do follow up closely with your doctor on what to do next for your chest pain. Even though your ECG and exercise tests are normal, there are other cardiac screening tests that he may recommend, such as:
- Cardiac MRIs to look at blood vessels
- Echocardiograms (an ultrasound scan of your heart)
- Blood tests to rule out an on-going heart attack
The gold standard test for a patient with chest pain is an angiogram/angioplasty - this is an invasive test to determine if there are any significant blockages in your arteries. It involves putting a needle in your wrist, and injecting some dye into the blood vessels supplying your heart.
Significant blockage of these important blood vessels can cause chest pain, and a sudden heart attack. This remains one of the biggest killers of ex-smokers.
An angiogram is the most definitive way for a doctor to tell you that your chest pain is not likely to be of a concerning nature.
Here are some other health screening tests that your doctor may consider, given that you are an ex-smoker:
1. Lung function tests, eg. spirometry
Most doctors would request for lung function tests to check how well or poorly your lungs are performing.
These can be performed at your annual check ups, and is the best way to diagnose COPD (chronic obstructive pulmonary disease). Spirometry requires you to blow into a machine so that doctors can determine how well air flows into and out of your lungs.
When you quit smoking, your lung function will stop deterioriating. Some – but not all – of the damage will also begin to heal.
2. Chest X-ray or CT Scan
X-rays and CT scans are imaging tests that can reveal problems in your heart, lungs, or blood vessels supplying your heart.
3. Diabetes screening
Smokers are at an increased risk for Type 2 Diabetes.
People who smoke less than a pack of cigarettes a day have about a 44% increased risk of developing diabetes compared to nonsmokers, according to a 2007 Swiss study published in the JAMA.
Diabetes tests include:
- Fasting blood glucose level, which measures blood sugar when you haven’t eaten in 8 hours
- Oral glucose tolerance, which measures blood sugar levels 2 hours after you drink a sugary liquid
- Hemoglobin A1c (HbA1c), which shows average blood glucose levels over 3 months
4. Dental check-ups
Smokers are more likely to suffer from tooth loss; however, your risk reduces within 10 years of quitting.
Because mouth and throat cancers are also associated with cigarette use, ex-smokers should see their dentist at least 2 x a year for checkups.
5. Vitamin D blood test
Cigarette smoking can also result in bone loss and a higher risk of leg and hip fractures.
Regular exercise and sufficient calcium and Vitamin D levels can reduce these risks.
Advice to improve your health after quitting smoking
Paying extra attention to other heart disease risk factors can help to prevent problems down the road.
- Improving your blood pressure
- Improving cholesterol levels, and
- Controlling blood sugar levels
- Lowering saturated fat in your diet
- Exercising regularly and losing excess weight
Hope this helps!