I posted this in the muscle and nerve forums, but I think I maybe should have posted it here.

I have seen several doctors (including 2 different cardiologists), and no one can seem to tell me what my problem is.

I'm a 29 year old male. I'm 6'1", and obese at 250 lbs. I've kept a careful journal of my symptoms, and my progress with this problem. I'll try to make this as brief as possible.

The short:
for five months, i've been getting sharp pains in my neck along the carotid arteries. Sometimes just one side, and sometimes both. It's gotten much better as time has gone on, but it started out pretty bad, and my doctor thought at first that it might be my heart, but that has been ruled out. I've been told it's muscular.

The long:
i'm not sure what information is or isn't useful, so i've just tried to summarize my whole relationship with this problem.

During march and april, I was drinking a _lot_ of caffeine. I would guess around six or seven cups of coffee a day. I was taking my ritalin in the recommended doses (10 mg three times a day). I was under a tremendous amount of stress due to work and school deadlines. To get rid a lot of this stress, I started hitting the gym a lot. I did a lot of upper-body weight training, perhaps improperly.

Then one day, during sex, I started getting sharp pains along my neck and headaches. The headaches stayed mostly in the back of my head. I also had a sharp pain in my sternum when I took a deep breath, and thought I might have a lung issue.

I found that the symptoms usually occurred if I exerted my upper-body.

I told my doctor about my problems. She said it sounded like my heart. My blood pressure was 110/65. My resting ekg was normal. So she ordered a treadmill.

It was two weeks before I could take the treadmill. In that time, I was taking 81 mg dose of asprin a day, and I cut out the weight training and the caffeine. During those two weeks, the symptoms seemed to get better. It would take more and more exertion to get them to show.

During my treadmill, I did not get any symptoms. Near the end of the test, when the incline was so steep that I had to hold on with my arms, it started just a little bit, and only on the left side. I started to get a headache on the left side of my head as well. The doctor said there was an identifiable shift in my ekg, and my blood pressure got up to 260/90. She recommended I see a cardiologist, and she prescribed 25mg toprol xl for the meantime.

It was a few months before I could see a cardiologist, but when I did, he said it looked like I might have arterial blockage, but said it could be muscular, and ordered a second stress test and bloodwork.

The second stress test my blood pressure got up 250/90, but there was no shift in my ekg and no symptoms. The doctor told me that my heart was fine, as was my cholesteral. He said the exaggerated metabolic response (by this I believe he was referring to my high bp) could be due to the fact that I stopped the toprol cold the day before the stress test.

I write for a living, and spend long hours at my computer. I've wondered if it was my posture, or something. I'm not sure what. I get the symptoms at weird times. I went from the heat into an air conditioned restaurant and sat down at a booth and had pain in my neck, both sides. I don't get the headaches anymore. I'm naturally concerned about it. I've gone back to drinking caffeine and taking my ritalin, and i've gone off toprol. The symptoms, while a fraction of what they used to be, still occur.

I'm not sure what I should or shouldn't do. I'm concerned that it may actually still be a cardiovascular issue. If it is just a muscular issue, then what on earth is it, and what should I do about it? I don't get pain when I stretch my neck or rotate my head. Could this be a nerve issue?

It's not that the pain is so uncomfortable that it is a problem itself -- it usually doesn't last very long, and it's not that bad. My real concern is that it could be an indicator of a serious problem.