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Dr. Andrew Rynne

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Collar Bone Pain, Sharp Pain In Fingers, Numbness, Anxiety, Heart Palpitations. Heart Attack Symptoms?

i am a 22 year old female, mild smoker, with high anxiety , lately i have been having a dull pain where my shoulder meets my chest , sometimes the pain is sharp and goes down to my fingers other times it is dull and makes my fingers go numb, could this be a sign of heart attack or heart problems? it is happening now should i go to the hospital. i also have shortness of breath at times and some palpitations
Mon, 3 Sep 2012
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Internal Medicine Specialist,  's  Response
Dear friend, welcome to HCM !

Is the shoulder and arm involved the left?
There are three immediate differentials :
1- anxiety manifestations
2- cardiac ischaemia -pre -attack states
3- neuropathy

Your description fits all three possibilities, but none is perfect. heart attack pain is always on the left side.

So, still important to rule out cardiac affection by an EKG, Xray chest and affected shoulder.
An xray of the cervical spine may also be done to look for neuropathic pain, but it won't cause chest pain, breathlessness.

You should seek counselling for anxiety also and be treated for it if tests are negative.
Try to relax.
Take care and please keep me informed of your progress.
Good Luck !
I hope to have answered your query satisfactorily.
May I request for your rating and review of this answer before you accept the answer and close the query (if there are no more follow up questions)?
Thank you !
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General & Family Physician,  Dr. Neelam Ashish Vanjari's  Response
Hi,

Thanks for query.
The symptoms you are telling are more likely indicative of heart attack. Though anxiety can cause similar palpitations it is always safe to rule out heart attack.
I would suggest you to visit hospital and get electrocardiogram done along with enzyme study like CK-MB, TROPONIN T. The rise in enzyme levels along with ECG changes confirm the heart attack.

I hope I have answered your query. Feel free to revert back in case you have doubt.
Best regards,
Dr. Neelam.
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Collar Bone Pain, Sharp Pain In Fingers, Numbness, Anxiety, Heart Palpitations. Heart Attack Symptoms?

Dear friend, welcome to HCM ! Is the shoulder and arm involved the left? There are three immediate differentials : 1- anxiety manifestations 2- cardiac ischaemia -pre -attack states 3- neuropathy Your description fits all three possibilities, but none is perfect. heart attack pain is always on the left side. So, still important to rule out cardiac affection by an EKG, Xray chest and affected shoulder. An xray of the cervical spine may also be done to look for neuropathic pain, but it won t cause chest pain, breathlessness. You should seek counselling for anxiety also and be treated for it if tests are negative. Try to relax. Take care and please keep me informed of your progress. Good Luck ! I hope to have answered your query satisfactorily. May I request for your rating and review of this answer before you accept the answer and close the query (if there are no more follow up questions)? Thank you !