had two episodes of extremely painful shest pain through to back, ? heart or Gallstones have APS

Caroline,

Thanks for your question and sorry for the delay.

With known gallstones, this certainly could be causing your two episodes of chest discomfort.  However, other possibilities need to be considered also, such as heart disease, other gastrointestinal problems (hiatal hernia, reflux esophagitis), and a few others.  Diagnosing chest pain can be challenging, especially in women who manifest heart disease in many more ways than men. 

I suggest you make an appointment with your physician for his evaluation.  He will ask questions about your two episodes which might help steer him in making a determination.  The best time to make the diagnosis of gallbladder attack is during (or immediately) after the pain, when a special nuclear scan (pipida scan) can be performed that can demonstrate blockage of the drainage system of the gallbladder.  It's this blockage that causes the pain.    Of course, you will need an EKG and general blood work including liver function tests, and if everything is inconclusive, stress testing is another consideration. 

With your history, you can't take any symptom lightly.  You need to follow through and investigate any serious symptom.  Also remember that you are on warfarin, which can complicate any situation and its treatment.

I hope this has been helpful.  Feel better.

Martin Cane, M.D.