Why Am I Experiencing Sharp Pain In Temporomandibular Joint And Heaviness In Chest During Pregnancy?

Posted on Thu, 26 Dec 2013

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Thu, 26 Dec 2013 Answered on

Mon, 13 Jan 2014 Last reviewed on

Question : This is long winded sorry. I am a 26 year old white female with no cardiac risk factors who is 28 weeks pregnant,who happens to work as a cardiac nurse by profession. A couple days ago i had severe heartburn accompanied by nausea and vomitting- i know this is common in pregnancy however this is my second child and the firat time i experienced heartburn that didnt resolve after an antiacid. I also had some mild left arm weakness. Yesterday those symptoms did resolve with the exception of heartburn after eating but i did experience intermittent sharp specific pain in the tmj on the left side and lower jaw on my right side- very brief though and usually resolved after palpation. Today i woke up and the heartburn nausea and jaw pain are all subsided however i have a heaviness in my chest. My daughter and husband and been battling a head cold for sometime and i myself feel stuffy and more so like this heaviness is the same type of heaviness I have wxperienced numerous times before being an asthmatic with an UPper respiratory cold. It is at the base of my neck and feels as if something is in my throat with occasional sharp pains that seem to subside with deep inspiration. However because i am a cardiac nurse i am feeling slightly anxious about all these symptoms despite the fact that they are not occuring similtaneously, and wanted another opinion.

Answered by Dr. Jorge Brenes-Salazar (28 minutes later)

Brief Answer: Most likely non cardiac Detailed Answer: Dear XXXXXXX Thanks fof the query. Your estimated probability of having coronary artery disease is extremely low, and given the pregnancy and prior history of heartburn, on the second stage of pregnancy, there is a VERY high likelyhood that these are related to reflux, rather than coronary artery disease. Pain that lasts a few seconds or less than 3 minutes as you know is rarely cardiac in origin. As you work in a cardiac Unit, walking the "extra mile" would include having a 12-lead ECG at the time of symptoms; if no evidence to support ischemic changes, I would shy away from thinking about a cardiovascular cause. Hope this helps wish you the best, Dr Brenes-Salazar MD Mayo Clinic MN Cardiology

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Jorge Brenes-Salazar (17 hours later)

New question- the last two nights i have bren waking up tachy and SOB, no recollection of abad dream. Also concerning to me. I have a hx of svt and my recent echo is completely normal, thoughts?

Answered by Dr. Jorge Brenes-Salazar (26 minutes later)

Brief Answer: Holter vs event monitor Detailed Answer: Dear XXXXXXX Thanks for the follow up. Quite difficult to say if its sinus because of waking up scared or another type of SVT; if the symptoms happen every day, a 24-48 h Holter may be advisable; otherwise if they are infrequent or unpredictable an event monitor may have higher yield.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Jorge Brenes-Salazar (3 minutes later)

Ive already had an event recorder thays how i was diagnosed with the svt. My question was more if you thought that these episodes were something that needs attention. Again my anxiety seems to be increasing over the past couple days. Could it be anxiety related?

Answered by Dr. Jorge Brenes-Salazar (2 minutes later)

Brief Answer: Certainly Detailed Answer: For sure. Atrial arrhytmias are very susceptible to adrenergic stimulation, so anxiety for you may be acting like coffee or alcohol for other types of patients; if it was a benign SVT (eg. AVRT, AVNRT, atrial tachycardia) I would not worry much and it would not warrant medication for symptom control if they are so short lived.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar