Hi Casey, give my best to your husband, he is very lucky to have you helping him the way you are, please keep up your support, it is crucial for people having serious problems which aren’t diagnosed, or misdiagnosed.
I have a suggestion which might be helpful, as I know that 1 in about every 100 people was born with a bicuspid aortic valve (instead of tricuspid) and many of them aren’t diagnosed until they reach the morgue. BAV is something that obviously doesn’t get as much attantion as it should, despite the high prevalence. Mine started with a few episodes of c/p many years ago, then I started having severe night sweats, nausea/vomiting, dizziness, and sob and increasingly more regular c/p with exertion or laying down. It sounds like many of the symptoms he/you describe fit the bill, but it could still be many things. I will also say that people who have this condition are prone to abdominal problems (as I have been my entire life) due to the body shunting blood away from the intestines first during episodes of increased heart failure, i.e. exerting himself, or the end of the day.
Do his ankles ever swell? When does the chest pain usually start? Does the chest pain change with inspiration/movement or palpation? Does the pain seem to radiating from one point to another point? Does he get SOB when lying down? Productive cough (color of phlegm?)? What does he find helps relieve the pain? Rest? Does he wake up with chest pains and SOB, or his dizziness? How does he describe the pain in his chest, besides intermittent?
I would like our country to start screening for this congenital heart defect, like the AMA and international community of valve specialists and many cardiologists believe should be done. This is a serious heart condition which can start affecting people who have it, at any age and usually kills by causing an aneurysm, which eventually dissects, if not recognized. People with this heart problem often have connective tissue problems and this might be an early sign in some. Has he had an ultrasound(echo), stress echo of his heart to check for valvular problems? If not, please have his doctors check it.