A ? Regarding HA symptoms in women

[PerdidoKeyFlorida]

Hi,

I'm a 40 yr old female, 5'9", 195 lbs., smoker, right handed, high cholestorol/triglycerites/low HDL (recent dx).  I had an echocardiogram yesterday and I'm wearing a holter monitor today.  My doctor ordered the echo and HM because of symptoms I reported to him.  I'm under care for cervical spinal stenosis, DDD, protruding lumbar discs, ulnar nerve entrapment.

Here is what I reported:  In the spring of 2001 I began having what I sometimes call attacks, sometimes spasms (I have a hard time describing them - they don't feel like a charley horse).  They are crushing in nature, centered in my upper back, between the shoulder blades.  Pain radiates down both arms, leaving them feeling weak/heavy/limp.  I can move them, but even moving them a fraction causes horrible pain.  I can feel them coming and have to lie down - my shoulders get tight and my arms feel funny.  The attacks reach top intensity within a few seconds and last a few minutes.  In the spring of 2001 the attacks were sporadic and lasted only a couple minutes, but by Dec 2002 they were almost daily and lasted much longer - up to 6 minutes.  They fade in intensity and go away.

They are not seizures or panic attacks.  I'm not sure if these things are related to my spinal problems or a signal of something else, which is why the doc ordered the tests.  

My question:  are the attacks I'm describing like anything one with a heart condition might have?  I've heard women sometimes have different symptoms than men when it comes to their heart.

[CCF-M.D.-RCJ]

Perdido,

Thanks for the post.

Did you see a cardiologist yesterday or an internist?  Your symptoms would be best managed by a good internist, as they could be coming from many things.  There is a comoon saying in medicine -- "when all you have is a hammer, then everything looks like a nail", which basically implies that if you see a cardiologist, he is going to order heart-related tests, but might not order the abdominal ultrasound that picks up the gallstones (for example).

The heart would be a very unlikely cause for these symptoms, although "never say never".  The fact that particularly points away from the heart is that the pain worsens with arm movement.  Certainly many other parts of the story are also less consistent with the heart.

Seek attention from a good internist, and good luck.

[nurse12hr]

Has your gallbladder been evaluated?

[PerdidoKeyFlorida]

Thanks Doc and Christie.  A neurologist sent me for the tests.  

results:
Normal left ventricular size; normal systolic function with a questionable apical wall motion abnormality.  Mild mitral reguritation.  Trivial tricuspid regurgitation.

So that's a bill of clean heart health, right?  I still have to get the Holter Monitor results, but I'm sure now they'll be normal as well.  

No one has checked the gallbladder.  I see my primary care physician on 9/2 and will discuss what's next.  Now that I know it isn't my heart, it isn't seziures or MS, etc., we can pursue other avenues.

Thanks again for posting a response.

[PerdidoKeyFlorida]

Echo report:

Quantitative data:  left atrium 38, aortic root 26, left ventricle (ED) 49, left ventricle (ES) 35, left ventricular posterior wall thickness 9, interventricular septum 9.

Overall, left ventricular size and function was normal, but in some views it appeared that the apex was somewhat hypokinetic.  The left atrium and aorti root were unremarkable.  The aortic valve was without stenosis or insufficeincy.  There was only mild mitral regurgitation; trivial triscupid regurgitation.  There are no masses, vegetations or thrombi seen.  There is no effusion.

[janne]

You mentioned you had spine problems. What about a pinched nerve in your neck?  My husband had the exact symptoms (but legs affected , not arms) and it was a major disc herniation in his lumbar area. CAT scan and x-rays did not show the problem. Only an MRI picked up the problem (a major central disc herniation).
Just a thought.
Jann