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Forum Name: Cardiology Symptoms

Question: intermittent left side chest pain, left arm ache


 titlegirl - Fri Jan 20, 2006 4:50 pm

Hi -
I am a 26 year old female - 5'2, 105 lbs. No previous health issues. Family history: uncle died @ 52 from heart attack, half-brother had minor heart attack @ 43 (although he smokes & drinks as much as possible..), grandmother died of heart attack @ 75.

For about a month, I have been having chest pain that comes and goes - and varies in type of pain. Sometimes it feels like a dull ache in upper left chest, sometimes it is a sharp spasm type of pain (that lasts only a few second to perhaps a minute or so), sometimes it is a sharp pain lower, near top of ribs. In the past few days, my left arm has been aching. The pain does not seem to change with, and is not brought on by activity (walking or going up strairs). I don't have any shortness of breath.
I went to a cardiologist a few months ago (pre-chest pain) because I was having heart palps. Blood work & echo normal. EKG prints as "abnormal", but cardiologist thinks normal enough for me - perhaps some variation due to hormones - plus, every time they do an EKG I am on the verge of a panic attack with heart racing (had similar EKG year and half ago). Sometimes my heart races for no reason (seems like seperate issue from chest pain?) and cardiologist thinks "innapropriate sinus tachycardia" which she says is not dangerous, just uncomfortable. Suggested "pill in pocket" method of treatment -beta blocker- if I have an episode that becomes unmanageable- I have not taken any of the meds to date.
I am scheduled for a stress-echo in 3 weeks - cardiologist wants to do for my peace of mind (I used to exercise 3X per week - 2-3 miles and since palps began am too nervous to jog).
anyway, I am frankly scared to death that I am going to have a heart attack from these strange chest pains and now the arm aching.

As additional background: about two years ago I had mild chest pain and left arm pain - went to urgent care facility - they did EKG and sent me to ER (because EKG showed same "abnormal" read) - I spent 6 hours in ER (they did CT scan to rule out blood clot) and then they just monitored me for a while (I was having extreme anxiety about the whole thing)- finally sent me home. I went to a cardiologist the next day for follow up Echo and EKG which were supposed to have been normal. Then I had no symptoms for about two years until present.

Today, I called the cardiologist's office to see if they could fit me in with Dr. - talked to nurse instead. I explained the pain and she thought it sounded like muscle or pinched nerve pain and suggested taking aspirin or advil and see what happens. I'm still scheduled for stress-echo in 3 weeks.

As I said, I am very frightened that I am going to have a heart attack. I realize that my fear my be a little irrational given my age, but still... any advice or suggestions would be appreciated.
Thanks very much.
 Dr. Yasser Mokhtar - Sat Jan 21, 2006 6:47 am

User avatar Dear titlegirl,

In your case, given the lack of major risk factors for coronary disease (i am not sure whether we should consider your half brother as a positive family history given the fact that he is half a brother and given the fact that he is a smoker), and your chest pain characteristics, the probability that this pain is due to coronary disease is quite low.

The pain that you are having might be due to a problem in the spine of your neck or a muscle problem. There are other potential causes in your case as well such as mitral valve prolapse (benign condition that should have appeared on the echocardiogram but since it did not appear on the echocardiogram then you most probably don't have it). The sensation of palpitations sometimes can present with chest pain or discomofort. Anxiety attacks can somtimes present also with chest pain.

To have the peace of mind, it is not a bad idea to have the stress echocardiogram, but the probability that it will turn out positive in your case is very miniscule, meaning that there is nothing to worry about.

In the meantime, if your thyroid functions have not been already checked, i suggest you have them checked.

Thank you very much for using our website http://doctorslounge.com and I hope that this information helped.

Yasser Mokhtar, M.D.
 achare83 - Mon Jan 26, 2009 11:29 pm

Your story sounds very familiar to mine. I am 25 female, thin, good health. Family history: father has hypertension. A few months after I started using birth control, I started having near blackout spells while sitting on the couch and my heart rate would increase and I would have palpitations. It scared me to death and the first time I had a CT done on my heart to rule out blood clots(which came back normal). A month later it was still happening and one time I went to the emergency room and they did blood work which was normal. They also gave me a 24 hr heart monitor to wear. Result were sent to a cardiologist to read. It was normal because I didn't have any symptoms during the 24 hour period. The cardiologist thought it could be SVT and ordered a stress test and a long term heart monitor. The stress test was normal. I had also had several EKG's done around this time. The only abnormality the doctor found was like you "inappropriate sinus tachycardia". He also said I had an "abnormal" heart rhythm but that it was probably normal for my heart, just statistically abnormal. I stopped taking birth control and I haven't had any other "episodes" but I still have palps occasionally. But since then I have starting having left arm pain. It has been present everyday for the last 2 months or so. Some days more painful than others. It feels kinda like it could be muscular but I'm not sure if it is related. I saw your post and it seems very similar so I was wondering what currently is going on with your health now. It has been 3 years, so did your pain go away? Did you experience anything else?
 scared1234 - Tue Apr 21, 2009 4:34 am

titlegirl and achare83, i'm having almost exact same issues. how are you doing? stress ecg and all other tests have returned normal for me as well. only abnormality is that sinus arrhythmia. did you or your doctors find anything else wrong?

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