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What Causes Severe Pain In Chest And Left Arm While Walking?
Posted on
Tue, 21 Jul 2015
Medically reviewed by
Ask A Doctor - 24x7 Medical Review Team
Tue, 21 Jul 2015
Answered on
Thu, 6 Aug 2015
Last reviewed on
Question : Hello, i have severe back pain(between snoulders) chest pain and left arm pain. It happens when im walking and im worried its heart related.ive been to my local gp and he diagnosed athritis of the spine. Ive had 3 stress tests and around 12 ecgs, all normal .Ive also been in and out of hospital and they say my heart is fine.my tests cons show signs of imfection, given anti biotics to clear it and it keeps happening. I was assesed for chest pain on exerciton 5 months ago and had a normal exercise stress test. Im around 3 stone overweight and have high bloodpressure.the pain comes and goes when im not active my stomach has a history of bleeding and was checked on monday 20th july 2015. The specialist said my stomach had healed and that is wasent my stomach causing these symtoms. Ive asked my doctor for an angiogram in the past amd he said no. Reason being ive had 3 negative stress tests, he said that should be more than enough to rule out a cardiac problem. Please advise doctor, as i am worried the problem is heart related.
Brief Answer:
It doesn't seem cardiac related, but a differential diagnosis is necessary.
Detailed Answer:
Hello!
Thank you for asking on HCM! I understand your concern, and would like to explain that you shouldn't be worried about any possible heart implications in your recent clinical scenario (your recurrent chest pain), as it is not the case.
You chest pain characteristics (occurring on resting and disappearing on physical exertion [as it has happened during you repeated cardiac stress tests]), exclude a possible cardiac related scenario. Your 3 last stress tests and other additional tests confirm this conclusion.
From the other hand, it is necessary to perform a comprehensive differential diagnosis, to rule in the right extra-cardiac factor responsible for your pain symptomatology.
I would suggest some key points to follow:
(1) It is important to investigate further your possible spine degenerative processes, which may have leaded to a radicular syndrome (compression of a spinal nerve root, and consequently yielding the underlying pain).
A careful neurological status examination, coupled with a cervical-thoracic MRI is necessary to eventually clarify this issue. You have to discuss with your neurologist about that.
(2) Sometimes, a previous gastrointestinal disorder (a penetrating gastric ulcer, etc.) may be expressed as back pain, even when the GI endoscopy exam results normal. There may be microscopic changes not visible on a routine endoscopy. Probably a trial of PPIs therapy (Omeprazole, Pantoprazole, etc.) would help to rule in/out this possible option (to see an eventual pain relief).
(3) Even a gallbladder or pancreatic disorder (inflammation or anything else, etc) may be a reason for such a clinical presentation. An abdominal ultrasound would be helpful to identify any possible lesions, and raise sufficient suspicions for further diagnostic work up.
Hope to have been helpful!
Feel free to ask me whenever you need! Greetings! Dr. Iliri
It doesn't seem cardiac related, but a differential diagnosis is necessary.
Detailed Answer:
Hello!
Thank you for asking on HCM! I understand your concern, and would like to explain that you shouldn't be worried about any possible heart implications in your recent clinical scenario (your recurrent chest pain), as it is not the case.
You chest pain characteristics (occurring on resting and disappearing on physical exertion [as it has happened during you repeated cardiac stress tests]), exclude a possible cardiac related scenario. Your 3 last stress tests and other additional tests confirm this conclusion.
From the other hand, it is necessary to perform a comprehensive differential diagnosis, to rule in the right extra-cardiac factor responsible for your pain symptomatology.
I would suggest some key points to follow:
(1) It is important to investigate further your possible spine degenerative processes, which may have leaded to a radicular syndrome (compression of a spinal nerve root, and consequently yielding the underlying pain).
A careful neurological status examination, coupled with a cervical-thoracic MRI is necessary to eventually clarify this issue. You have to discuss with your neurologist about that.
(2) Sometimes, a previous gastrointestinal disorder (a penetrating gastric ulcer, etc.) may be expressed as back pain, even when the GI endoscopy exam results normal. There may be microscopic changes not visible on a routine endoscopy. Probably a trial of PPIs therapy (Omeprazole, Pantoprazole, etc.) would help to rule in/out this possible option (to see an eventual pain relief).
(3) Even a gallbladder or pancreatic disorder (inflammation or anything else, etc) may be a reason for such a clinical presentation. An abdominal ultrasound would be helpful to identify any possible lesions, and raise sufficient suspicions for further diagnostic work up.
Hope to have been helpful!
Feel free to ask me whenever you need! Greetings! Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Doctor, my symtoms are worse when exercising. I had chest pain and pain in my left arm during my last stress test.. I was told to continue for as long as i could. The specialist said that there was no changes on the ecg that would suggest a cardiac problem. The back pain is also worse when i eat. I would like to mention that i was given a nitro spray as a precution in the weeks before my last stress test. This also didnt help my symtoms. The chest pain is not new, but the back pain is. I will ask my doctor regarding the other problems have similar symtoms
Brief Answer:
It doesn't seem to be cardiac related.
Detailed Answer:
Hi XXXXX!
Though pain may have been present in one of your stress tests, its characteristics are not compatible with an ischemic heart disease. I would like to review that cardiac stress test report. Please, could you upload it??
I strongly recommend you to discuss with your attending physician and follow the above recommended diagnostic points.
Regards,
Dr. Iliri
It doesn't seem to be cardiac related.
Detailed Answer:
Hi XXXXX!
Though pain may have been present in one of your stress tests, its characteristics are not compatible with an ischemic heart disease. I would like to review that cardiac stress test report. Please, could you upload it??
I strongly recommend you to discuss with your attending physician and follow the above recommended diagnostic points.
Regards,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Doctor, i didnt get the report. I stay in scotland and the healthcare system is the NHS.i never seen the report, the doctor never showed me the response that was sent from the hospital. All he said was that i tested negative for significant heart disease. Thanks
Brief Answer:
A comprehensive differential diagnosis is necessary!
Detailed Answer:
OK XXXXX!
Spine degenerative disorders may be exacerbated during strenuous physical effort.
So, if not associated with other symptomatology, specific ECG changes and hemodynamic abnormalities, a clinically important cardiac ischemia is excluded with a high probability.
Just discuss with your attending doctor about the above mentioned option, and if he could guide you through the diagnostic process.
Best regards,
Dr. Iliri
A comprehensive differential diagnosis is necessary!
Detailed Answer:
OK XXXXX!
Spine degenerative disorders may be exacerbated during strenuous physical effort.
So, if not associated with other symptomatology, specific ECG changes and hemodynamic abnormalities, a clinically important cardiac ischemia is excluded with a high probability.
Just discuss with your attending doctor about the above mentioned option, and if he could guide you through the diagnostic process.
Best regards,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks doctor, i appreciate the in depth answers you have given me. I realise now that i dont fully understand heart disease. I know that you do, and i accept your answer. Ill speak to my doctor(again) regarding these ongoing symtoms. thanks again
Brief Answer:
You are welcome!
Detailed Answer:
I wish you a good XXXXXXX XXXXX!
I am at your disposal, whenever you have any uncertainties to clarify.
Wish you good health! Dr. Iliri
You are welcome!
Detailed Answer:
I wish you a good XXXXXXX XXXXX!
I am at your disposal, whenever you have any uncertainties to clarify.
Wish you good health! Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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