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What Causes Sudden Onset Of Chest Pain Along With Pain In Shoulder And Arm?

Posted on Wed, 21 Oct 2015

Question: I have sudden chest pain, headache, shoulder pain, arm pain its been an year I have that. I feel its a heart condition. Got my ecg, echo and tmt done all are perfectly normal. I had many spells of diziness and palpitations. Consulted three cardiologists and 6-7 gp all says my heart is normal but I am not convinced I want to go for CT angiography but my family does not permit my as they think I am alright and dont need that test. Please help Iam 29 male.

Answered by Dr. Anantharamakrishnan (1 hour later)

Brief Answer:
YES - you don't need CT angio

Detailed Answer:
Hi friend
Welcome to Health Care Magic

Your symptoms do not suggest Coronary Artery Disease (CAD).

     Treadmill Exercise Electrocardiogram (TMT) is the ideal non-invasive way to evaluate ischemia / to assess the PHYSIOLOGY (function) – to see whether the blood arriving at the heart muscle.
If it is normal, nothing further to do –
     ECHOcardiogram sees the heart valves (Mitral Valve Prolapse) / heart muscle (Cardiomyopathy) and heart function (Ejection fraction, wall motion abnormality) / clots... When it is normal in your case, NOTHING TO DO any further
     CT angio is non-invasive study for the ANATOMY (structure). It is not done, unless there is strong suspicion of CAD in TMT. IT IS THEREFOR UNNECESSARY in your case and also it is unnecessary exposure to radiation.

yes, there is no need for CT angio, for you

Good luck
God bless you

Above answer was peer-reviewed by : Dr. Neel Kudchadkar

Follow up: Dr. Anantharamakrishnan (7 hours later)

Sir attached are all the reports of my echo and tmt my xray is exactly normal. I am not sure weather these teat tells us anything about heart blockage. Because I have sudden jaw pain or hand pain while jogging. I have been hospitalised for chest pain for 5-6 times but nothing detected in ecg. I have indigestion problem and burping all day. Why am I not normal? Please help. Every time i find out new thing that these tests are not correct always.

Answered by Dr. Anantharamakrishnan (3 hours later)

Brief Answer:
likely psychosomatic

Detailed Answer:
Hi

Well, every test has its limitations. But, tests are not interpreted in isolation, but always in relation to other tests and the total clinical picture. A new test will also be similar! The treating doctor alone could conclude better based on total clinical picture…

Symptoms do not always have an underlying physical cause.
Physical symptoms can result from psychological cause – that is called psycho-somatic. Psychiatric consultation – Psychological assessment and assistance – will clarify the issue and help. Consulting a psychiatrist does not mean the patient is having psychiatric problem – just like consulting a cardiologist does not mean cardiac problem. It is done to rule in as often as to rule out…. Drugs like anti-depressants not only treat depression, but also raise the threshold of pain perception.
The same reason may be responsible or indigestion and burping. You may consult a Gastroenterologist / if necessary, have an upper GI Endoscopy (Gastroscopy) to exclude problems of the food pipe (Oesophagus) and stomach

Regards

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Anantharamakrishnan (27 minutes later)

Thank you for the reply sir. I am certain that these problems are from my mind but than also I am not able to help myself. I feel i have a heart attack every day and it raises the problem. But I took antidepressent it reduced my bp it was 80/120 but after it was 70/100. Also i feel different pains while jogging. Are blockage also tracked in the tests i have done. My personal life is ruined by this .

Answered by Dr. Anantharamakrishnan (11 minutes later)

Brief Answer:
you are healthy / you will have a long life

Detailed Answer:
Hi

The BP is still in normal range…
You can discuss with your doctor and change the antidepressant

The combination of Normal TMT and ECHO - EXCLUDES any heart disease.
You are young and you will have a long life. Don’t worry. Fear of disease is worse than disease! Ignore the issue and enjoy life. Have rapport with family and friends / go out to park and beach / practise yoga and learn relaxation techniques. Keep following up with your doctor, for any new problems.

Regards

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Anantharamakrishnan (38 minutes later)

Thanks for the help sir. One last question: few days back i had strangled like chest pain in centre of my chest accompnied by palpitation. This pain was too strong and remained for less than a minute I am just curious what it was. Rest I will try to forget this problem and continue working on yoga and outdoor vaccations. Thanks Again for this comforting relief.

Answered by Dr. Anantharamakrishnan (25 minutes later)

Brief Answer:
Similar issue / no cause for worry

Detailed Answer:
Sounds like pain from chest wall muscles… spasm from posture at work, sleep etc… often occurs…
Palpitation could be from fear. A single self-terminating episode of palpitation need not be of concern.
Many cases of palpitation are benign, especially when associated with normal ECHO and do not require any treatment or investigation. If one also have symptoms like blurred vision, dizziness, loss of consciousness, shortness of breath, along with this, / as also recurrences , then - we proceed to work up further… like Holter monitor recording to document and analyse. You don't require...

Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Prasad