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Heart Disease (Expert Forum)
Chest Pain and Numbness
This forum is for questions and support regarding heart issues such as: Angina, Angioplasty, Arrhythmia, Bypass Surgery, Cardiomyopathy, Coronary Artery Disease, Defibrillator, Heart Attack, Heart Disease, High Blood Pressure, Mitral Valve, Pacemaker, PAD, Stenosis, Stress Tests
Chest Pain and Numbness
by jbm, Mar 14, 2002 12:00AM
I am 30 tears old, a smoker, overwight and have high cholesterol (277). My blood pressure is however normal. I began having chest painss about 5 months ago. They are atypical in that they do not come during exertion. They just come sometimes regardless as to what I am doing. I had a stress test about two months and it came back normal. They chest pains seem to have intensified as of late, and I am now noticing numbness in my left hand. The pain will sometimes spread to my left shoulder and even occasionly to my left arm.
Does this sound like a heart condition even though I have a normal stress test? Could this be anxiety?
Any help is appreciated.
Thank You.
Does this sound like a heart condition even though I have a normal stress test? Could this be anxiety?
Any help is appreciated.
Thank You.
Doctor's Answer
by CCF-M.D.-CRC, Mar 15, 2002 12:00AM
Dear jbm,
There are many causes of chest pain. The one that doctors worry about the most is cardiac because it has the potential to be life-threatening. Once this is ruled out the work-up can proceed at a more leisurely pace.
Amongst the cardiac causes of chest pain are: ischemia (due to blockages - including both stable and unstable angina and acute heart attack and coronary artery spasm), pericarditis (inflammation of the sack around the heart), myocarditis (inflammation of the heart), cardiomyopathy (heart failure) and rarer causes such as coronary artery dissection, acute rupture of the heart and valves and infections of the pericardium.
Gastrointestinal causes of chest pain include reflux (acid from the stomach washing back into the esophagus), gallstones, esophageal spasm, esophageal rupture, varicose veins of the esophagus, strictures of the esophagus, tumors of the esophagus and other less common GI problems.
Pulmonary (lung) causes include pneumonia, pulmonary embolus, pneumothorax, pleuritis and bleb rupture.
Other potential causes are aortic dissection, back and spine problems and musculoskeletal (muscle strain, rib fracture, etc.).
Psychological causes of chest pain are common and include panic attacks, anxiety, stress and mental duress.
As you can see the list of potential causes in long and may take a little bit of time to determine the precise cause. A good Internal Medicine doctor should be able to work through the potential causes of your symptoms.
There are many causes of chest pain. The one that doctors worry about the most is cardiac because it has the potential to be life-threatening. Once this is ruled out the work-up can proceed at a more leisurely pace.
Amongst the cardiac causes of chest pain are: ischemia (due to blockages - including both stable and unstable angina and acute heart attack and coronary artery spasm), pericarditis (inflammation of the sack around the heart), myocarditis (inflammation of the heart), cardiomyopathy (heart failure) and rarer causes such as coronary artery dissection, acute rupture of the heart and valves and infections of the pericardium.
Gastrointestinal causes of chest pain include reflux (acid from the stomach washing back into the esophagus), gallstones, esophageal spasm, esophageal rupture, varicose veins of the esophagus, strictures of the esophagus, tumors of the esophagus and other less common GI problems.
Pulmonary (lung) causes include pneumonia, pulmonary embolus, pneumothorax, pleuritis and bleb rupture.
Other potential causes are aortic dissection, back and spine problems and musculoskeletal (muscle strain, rib fracture, etc.).
Psychological causes of chest pain are common and include panic attacks, anxiety, stress and mental duress.
As you can see the list of potential causes in long and may take a little bit of time to determine the precise cause. A good Internal Medicine doctor should be able to work through the potential causes of your symptoms.
Although you may make it to 45 or 50 without a heart attack you are certainly at high risk for a heart attack as you grow older.
I had a family history of heart disease, was overweight, had high total cholesterol and low HDL "Good" cholesterol. I had a confirmed heart attack at 50, but had a similar episode in my early thirties and just laid in bed for a week rather than seeking medical attention.
If I could do it all over again I would have started working on the risk factors when I was 25.
I suggest that you do the following:
1. Stop smoking today.
2. Get as much meat and dairy out of your diet as possible. Try to develop a taste for fruit and vegetables.
3. Get on a statin drug such as Lipitor to lower you TC below 200 and preferably lower.
4. If your HDL cholesterol is low (below 45) do what is required to get it up to at least 50. That would include daily exercise and possibly Niaspan.
5. Develop a habit of daily exercise. I walk a hilly course for 35 minutes before work and at noon and do more on the weekends.
6. Work at appreciating life and lowering stress.
If you don't do these things, you may live to 50, but if the bill comes due, like it did for me, it's a *****.
Believe me - it's real!
Good Luck