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Angina, arm & shoulder numb, friction while swallowing, benign (?) mediastinal mass

by Lee7009, Sep 02, 2009 02:31PM
I am a 39 year-old male, 175 pounds, father of 2 (ages 3 and 1) with another on the way next month. I smoked from 1989-1998 (never since).
My symptoms began with an episode of angina (chest & left arm) in 11/08; heart attack was ruled out in the ER, and pleurisy was a possible diagnosis.
Current symptoms are: Upper left chest pain/discomfort (non-pleuritic); my left arm (and shoulder blade) has felt heavy and numb intermittently throughout the day every day for several weeks; the chest discomfort runs up into my throat on the left side, at times into the jaw. Chest discomfort frequently comes on with simultaneous numbness immediately to the right of the left shoulder blade (straight through). Every night I wake up with left arm numbness, regardless of sleeping position (normally flat on back). It's uncomfortable to swallow and feels like cartilage is rubbing together causing friction (like a click) with each swallow; at times it feels like there is a lump on the left side of my throat immediately behind the right extreme of the left clavicle, and at times I feel nothing. I can clearly feel every heartbeat - especially while lying down - throb up through my neck and into my head. On 4 occasions over the last 2 weeks - twice while rubbing the left side of my neck and twice without – I’ve become lightheaded and the vision in my left eye has begun to get "snowy" (like a TV with no signal), sensations which I have literally been able to "shake off". Exercise does not worsen symptoms. In fact, they seem to subside while playing soccer. All symptoms are left side only.
Diagnostics so far:
Chest x-ray - negative (11/08)
Chest CT with contrast: heterogeneous soft tissue in anterior mediastinum 1.5 cm thick; no growth from 11/08 through 07/09. Thought to be benign residual thymic tissue.
Cardiology: 4 ekgs, stress test, echocardiography, halter monitor all normal.
MRI of brain, cervical spine, face orbit & neck: all normal.
EEG: normal.
Carotids (noninvasive): normal.
Transcranial Doppler: normal.
Video nystagmography: normal.
EMG/nerve conduction (left arm): normal.
Digestive workup/endoscopy: normal.
HIDA scan: normal.
Abdominal sonogram: normal.
Blood work to date (inc. lyme): normal.
There is a paternal family history of heart and blood vessel disease; my grandfather died of a heart attack at 40. My father has several stents in his left descending aorta and also renal artery. I lived in Ecuador and traveled to the Amazon regularly during 14 years (1988-2002).
With each negative test I am feeling more stressed about the continuing symptoms - like a time bomb waiting to go off. The next doctor I'll be seeing is a vascular specialist.
Any insight into what might be causing these symptoms would be GREATLY appreciated!
Thank you.
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