I've been dealing with some pain near my heart, left shoulder, and back for the past three years. Theres a mild problem at C5 C6. I've had a bunch of ECGs and they always come back normal. With these results, do you think I still need an ECO or TMT? I'm just trying to figure out what should be my next steps.

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Dr Shubham Chauhan

General Practitioner

MBBS
4+ Yrs

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From last 3 years, you have been experiencing pain near the heart, left shoulder pain, and back pain. You mentioned there was a mild disc prolapse in C5-C6. Despite undergoing multiple ECGs, they have all been normal. You are now wondering if an ECO (Echocardiogram) or TMT (Treadmill Test) is necessary. Given your symptoms and history of normal ECG results, it would be advisable to undergo an ECO to further evaluate the structure and function of your heart. An ECO can provide more detailed information that may not be captured by an ECG alone, especially in cases of suspected cardiac issues. Additionally, considering your persistent symptoms and the need for a more comprehensive assessment, a TMT may also be beneficial to assess your heart's response to physical activity. For your situation, I would recommend an ECO to assess your heart's structure and function, and a TMT to evaluate your heart's response to exercise. These tests can provide valuable insights into the cause of your symptoms and help guide further management.

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Answered 04/07/2025

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Understanding Your Symptoms
- Pain in the chest, left shoulder, and back can be concerning and warrants thorough evaluation to rule out cardiac and non-cardiac causes.
Role of ECG in Diagnosis
- A normal ECG suggests no immediate electrical heart issues but may not detect all heart conditions.
Purpose of Echocardiogram (ECO)
- An ECO provides detailed images of heart structure and function, identifying issues not visible on an ECG.
Purpose of Treadmill Test (TMT)
- TMT evaluates heart performance under physical stress, revealing exercise-induced problems.
When to Consider ECO or TMT
- Consider these tests if symptoms persist, especially with risk factors like family history or lifestyle concerns.
Next Steps and Medical Consultation
- Consult a cardiologist for a personalized evaluation to determine the necessity of ECO or TMT.
Additional Considerations
- Explore other potential causes of symptoms with a comprehensive assessment, possibly involving other specialties.

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Answered 10/09/2025

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