Brief Answer:
Same exact symptoms for 5 years?

Detailed Answer:
Good evening. My name is Dr. Saghafi and I'm from XXXXXXX Ohio. I understand that your brother is having symptoms as you've described of a chest pain below the level of the sternum which runs to the back and then, a warm tingling sensation radiates down the left arm AND left leg. That is a very interesting distribution.

You state that these symptoms have been recurrent for >5 years. Does this mean that he has been previously checked, perhaps even multiple times? What have the results been? Is there a coronary issue? Is there an aortic aneurysm? Has he received a full workup with ultrasounds, EKG's, Holter monitors, echocardiogram, enzyme studies, etc. etc.? If so, what have the final results been according to the cardiologists? Also, with the ingestion of 6 beers per day has there been any other set of complications such as GI ulcers, bleeding, intestinal disorders, or liver disease?

I guess I'm not understanding how so many other things seem to have been done for him such as X-rays of the back, MRI's of the brain, but there is virtually down that I see that is cardiac related.

The tingling is unlikely to be NERVE PAIN as much as it is REFERRED PAIN from some process in the heart or aortic region having to do lack of oxygenation to the heart muscle itself. But interestingly enough the distribution is to the arm AND the leg...that's a little unusual

What treatments have been recommended to treat your brother? If these are the same symptoms over and over again, and if nothing positive is ever found with respect to cardiac disease, or other problems, what is the impetus to continually return to the ER?

Does he follow with a cardiologist? My guess is probably not...or at least not very compliantly if he has one. Does he have medications that he takes on a regular basis? Are there reactions with the alcohol he drinks as well? Have these symptoms remained stable over time or are they getting worse?

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This query required 26 minutes of physician specific time to review, research, and compile the final draft for envoy.

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