I'm a 37 year old male about 20lbs over weight. My doctor has me on tricor and lipitor for cholesterol which stands around 179 corrected. My blood pressure is good, non smoker. I am also taking nexium and toporol xl. Back in 2003 I saw my primary car doctor for chest pains and palpitations, she did and ekg which looked normal. I was referred to a cardiologist who also gave me an ekg and a brief stress test (ran for several minutes then stopped with no cool down monitoring). He said everything looked good and that I just shouldn't worry about the palpitations as a lot of people have them and I have no family history. A few months after that I had a heart scan done on my own doing, I scored a 0. A few months ago I saw my regular doctor because my palpitations were occuring in intervals of about 5-6 per minute. She put me on toporol xl and they pretty much went away unless my stomach was on blink then the palpitations come back with a vengence. Last month my doctor gave me nexium which helped temporarily with the toporol xl. But I still have the pains daily. I had an ultrasound of my abdomen and blood work including lipase, hepatic panel, and h-plori. Everything was normal. The doctor said I had a full cardiac work up (which I disagree) and didn't have any other suggestions uless I wanted to go back to the cardiologist (it's been 2 years). The palpitations occur day/night, lying/sitting/standing, empty/full stomach. There is no pattern. The chest pains occur every day for several minutes many, many times per day. They are located between the centerline of my chest and my left nipple. Sometimes the pains are a numbing/flutter feeling and sometimes they are sharp, they feel deeper than the chest wall. The pain often times is present in my back, right of my lower shoulder blade. I also sometimes feel the pain in my shoulder and neck, and somtimes the pains occur under my left arm breast high. Often times the pains and palpitations are relieved with a bowel movement though i'm not sure which is causing which. I never get a racing heart, but I do get dizzy and sweaty sometimes. I feel that the cardiologist should have done an echo, and a holter test. Nobody has "seen" or felt one my my palpitations which are a pause followed by a large thump. Should I be letting this go and live with it or should I insist on more tests, if so what tests should I ask for (x-ray, upper gi, holter, echo)?? I'm self employeed and pay $966 per month for $0 deductible insurance, I have excellent coverage. Any other suggestions as to what might me causing these chest pains and palpitations would be greatly appreciated. Thanks in advance for reading my post, george