Hypovitamanosis D and non cardiac chest pain

Authors

  • B. V. Nagabhushana Department of Medicine, Queens NRI Hospital, Visakhapatnam, Andhra Pradesh, India
  • G. Mahesh Department of Cardiology, Queens NRI Hospital, Visakhapatnam, Andhra Pradesh, India
  • P. S. S. Subramanyam Department of Cardiology, Queens NRI Hospital, Visakhapatnam, Andhra Pradesh, India
  • A. Rekha Department of Cardiology, Queens NRI Hospital, Visakhapatnam, Andhra Pradesh, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20202268

Keywords:

Coronary artery disease, Osteomalacia, Recurrent chest pain, Sunlight, Vitamin D deficiency

Abstract

Background: Recurrent atypical chest pain not due to cardiac illness is a very common condition in medical outpatient departments. Authors found that people consulting for atypical chest pain often have significant Vitamin D deficiency and correction of Vitamin D deficiency relieved patient symptoms. Hence authors carried out this study.

Methods: Persons aged below 50 years were taken up for study. Those attending medical clinics with complaints of chest pain occurring more than two times were taken up for study. Cardiac illness was excluded by clinical examination and investigations. Those found to have low Vitamin D were taken up for study. 60,000 international units Vitamin D was administered orally weekly for 8 weeks. They were followed up twice weekly for three months and once monthly for three months.

Results: Results were analyzed and charted. 120 subjects were taken up for study and duration of study was three years. Average age of the study group was 37.50 years and the average Vitamin D level was 15.75 nanogram/ml (ngm/ml). Duration of chest pain ranged from one week to one year. Most of the patients had migratory chest pain.

Conclusions: As Vitamin D deficiency is a treatable medical condition it may be prudent to check Vitamin D levels in the patients presenting with recurrent atypical pain in the chest. It reduces the burden on the health care system and relieves the suffering of the patient. It may not be futile to check Vitamin D levels even in the patients with coronary artery disease who are suffering from atypical chest pain.

References

Prentice A. Vitamin D deficiency: a global perspective. Nutr Rev. 2008;66(10 Suppl 2):S153.

Webb AR, Kline L, Holick MF. Influence of season and latitude on the cutaneous synthesis of vitamin D3: exposure to winter sunlight in Boston and Edmonton will not promote vitamin D3 synthesis in human skin. J Clin Endocrinol Metab. 1988;67(2):373.

Mousavi SE, Amini H, Heydarpour P, Chermahini FA, Godderis L. Air pollution, environmental chemicals, and smoking may trigger vitamin D deficiency: Evidence and potential mechanisms. Environm Int. 2019 Jan 1;122:67-90.

Frieling T. Non-cardiac chest pain. Viscer Medi. 2018;34(2):92-6.

Eslick GD. Classification, natural history, epidemiology, and risk factors of noncardiac chest pain. Dis Mon. 2008 Sep;54(9):593-603.

Katon W, Sullivan M, Walker E. Medical symptoms without identified pathology: relationship to psychiatric disorders, childhood and adult trauma, and personality traits. Ann Intern Med. 2001 May;134(9 Pt 2):917-25.

Mahdavi K, Amirajam Z, Yazdankhah S, Majidi S, Adel MH, Omidvar B, et al. The prevalence and prognostic role of vitamin D deficiency in patients with acute coronary syndrome: a single centre study in South-West of Iran. Heart, Lung Circulat. 2013 May 1;22(5):346-51.

Capitanio S, Sambuceti G, Giusti M, Morbelli S, Murialdo G, Garibotto G, et al. 1, 25-Dihydroxy vitamin D and coronary microvascular function. Euro J Nucle Medi Molec Imag. 2013 Jan 1;40(2):280-9.

Le AR, Degerud E, Nyg O, Vogel SD, Hoff R, Frodahl G, et al. Plasma 25-Hydroxyvitamin D and Mortality in Patients With Suspected Stable Angina Pectoris. J Clin Endocrinol Metab; 2018;103(3):1161-70.

Alkhatatbeh MJ, Amara NA, Abdul-Razzak KK. Association of 25-hydroxyvitamin D with HDL-cholesterol and other cardiovascular risk biomarkers in subjects with non-cardiac chest pain. Lipid Health Dis. 2019 Dec 1;18(1):27.

Scragg R, Stewart AW, Waayer D, Lawes CM, Toop L, Sluyter J, et al. Effect of monthly high-dose vitamin D supplementation on cardiovascular disease in the vitamin D assessment study: a randomized clinical trial. JAMA Cardiol. 2017 Jun 1;2(6):608-16.

Visser M, Deeg DJ, Lips P. Longitudinal Aging Study Amsterdam. Low vitamin D and high parathyroid hormone levels as determinants of loss of muscle strength and muscle mass (sarcopenia): the Longitudinal Aging Study Amsterdam. J Clin Endocrinol Metab. 2003;88(12):5766.

Fabbriciani G, Pirro M, Leli C, Cecchetti A, Callarelli L, Rinonapoli G, et al. Diffuse muscoskeletal pain and proximal myopathy: do not forget hypovitaminosis D. JCR: Journal of Clinical Rheumatology. 2010 Jan 1;16(1):34-7.

Downloads

Published

2020-05-26

How to Cite

Nagabhushana, B. V., Mahesh, G., Subramanyam, P. S. S., & Rekha, A. (2020). Hypovitamanosis D and non cardiac chest pain. International Journal of Research in Medical Sciences, 8(6), 2210–2212. https://doi.org/10.18203/2320-6012.ijrms20202268

Issue

Section

Original Research Articles