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Neurology (Expert Forum)
Left arm ache
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Left arm ache
by Jaybo, Mar 11, 2004 12:00AM
I am a 44 year old male with a history of CAD. MI in May of 2002. Left anterior artery 85% blocked so a stent was applied. Also had many other smaller blockages -- right coronary artery 50-60% blocked. Here's the question. About a month ago, I started having faint middle chest pain but more noticable, an ache in my left arm and middle of my back, accompanied by light nautia and fatigue. Also, I noticed that my heart seemed to be skipping a beat often but that has since dimminished. Since my MI two years ago, I have been walking 2 miles every day and lift weights regularly. Also, I have dropped 40 lbs. At the same time this pain started, a routine blood test to check my liver enzymes came up whacky. CPK was 6000. My arms became so sore that I could barely move them. The CPK has since dropped to normal so my PCP assumed it was a viral thing and went away. However, I still have the left arm ache and it does not seem to be connected to physical activity, although my job recently has become a
VERY stressful place to be and I wonder how much that can be to blame. My cardiologist suspects a problem with that right coronary artery and ordered a stress test. That was four days ago and I am waiting for him to call me -- anxiously! The doctor who administered the stress test did not seem to be concerned about anything so now I don't know what to think. Well, Iv'e used up about all of my characters for this post and suddenly realize that I havn't really asked a question. I just am having trouble functioning this way and just wonder what could be going on.
VERY stressful place to be and I wonder how much that can be to blame. My cardiologist suspects a problem with that right coronary artery and ordered a stress test. That was four days ago and I am waiting for him to call me -- anxiously! The doctor who administered the stress test did not seem to be concerned about anything so now I don't know what to think. Well, Iv'e used up about all of my characters for this post and suddenly realize that I havn't really asked a question. I just am having trouble functioning this way and just wonder what could be going on.
Doctor's Answer
by CCF-Neuro-M.D.-CS, Mar 14, 2004 12:00AM
My first concern would be to exclude that this was not cardiac in nature. Once your cardiologist has done this then perhaps a neurologic cause should be considered. The most logical starting place is to evaluate the cervical spine. A bulging disc can cause arm pain, and mid- scapular pain. A MRI of the spine would be the most useful test, and then perhaps an EMG (muscle/nerve test). Regarding the elevated enzymes, it may have been viral, but could be related to medications. If you are taking a "statin" (choesterol lowering drug), this group of medication has been well known to cause muscle disease. I would have the CPK level followed up to ensure that it remains normal. Good luck.
