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Heart Disease (Expert Forum)
Chest, shoulder, left arm discomfort - three years
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 Prolapse, Pacemaker, PAD, Stenosis, Stress Tests.
Chest, shoulder, left arm discomfort - three years
by KPL, Jul 27, 2002 12:00AM
I have been having left chest discomfort at the third rib, shoulder and left arm bicep pain for almost three years now. The pain can be characterized as aching and or throbbing. Sometimes the chest discomfort can be sharp and quick. These sensations come and go for no reason throughout the day. However, they appear more often in the morning. Sometime I have discomfort at the bottom of the zyphoid process on both sides but this appears to be minimal.
Now I might add that all this started to occur in Sept. 99 after both of my parents died in April and July of that year. I have had many tests of various kinds over the past three years. Stress echo 9/99, Stress Cardiolite 6/02, 21 day event monitor 3/00. These were all negative. Bone scan, EMG's, chest MRI, many blood test to include thyroid and auto immune diseases. These and all my X rays have been negative. One cervical MRI showed a small herniated disk at the c5-c7 level and my neurologist thinks this could be the reason for the discomfort. I also am taking 10 mg of Paxil for anxiety and some panic attacks and Xanax as needed. I used to be at 20 mg but lowered it to 10 mg's in April 2002.
I always seem to be tense around my chest and arm area even when I am cycling and playing tennis 2 to 3 times a week. The Xanax seems to reduce these feelings but they return without cause or warning. My greatest fear is that something has been missed in all my cardiology or other tests. Can this really be anxiety related? This is very frustrating!
Do you have any thoughts on how I should proceed from here!
Thanks!
Now I might add that all this started to occur in Sept. 99 after both of my parents died in April and July of that year. I have had many tests of various kinds over the past three years. Stress echo 9/99, Stress Cardiolite 6/02, 21 day event monitor 3/00. These were all negative. Bone scan, EMG's, chest MRI, many blood test to include thyroid and auto immune diseases. These and all my X rays have been negative. One cervical MRI showed a small herniated disk at the c5-c7 level and my neurologist thinks this could be the reason for the discomfort. I also am taking 10 mg of Paxil for anxiety and some panic attacks and Xanax as needed. I used to be at 20 mg but lowered it to 10 mg's in April 2002.
I always seem to be tense around my chest and arm area even when I am cycling and playing tennis 2 to 3 times a week. The Xanax seems to reduce these feelings but they return without cause or warning. My greatest fear is that something has been missed in all my cardiology or other tests. Can this really be anxiety related? This is very frustrating!
Do you have any thoughts on how I should proceed from here!
Thanks!
Doctor's Answer
by CCF-M.D.-RCJ, Jul 27, 2002 12:00AM
kpl,
Sorry to read of your troubles. You didn't give your age, gender, or other cardiovascular risk factors. I'll assume that you are otherwise healthy.
Your pain is very atypical for cardiac pain; in fact we would characterize it as noncardiac. Typical angina has the three following characteristics: substernal location, relived by rest or nitroglycerin, and squeezing or pressure-like pain. If you are a young person without these characteristics, your probability of having cardiac disease is approximately 1 to 4%. The negative stress tests dramatically reduce these percentages.
You have a choice. You can decide that you absolutely need to know if you have coronary artery disease and undergo cardiac catheterization with its attendant risks. Or, you can decide to live with the very small chance that you might have coronary artery disease.
Anxiety absolutely can precipitate and potentiate chest pain and other maladies. I think that the strategy that makes the most sense for you is to seek therapy for your anxiety disorder. If you are able to control the anxiety and panic attacks and you are still having chest pain, re-pursue diagnostic evaluation at that time.
Good luck.
Sorry to read of your troubles. You didn't give your age, gender, or other cardiovascular risk factors. I'll assume that you are otherwise healthy.
Your pain is very atypical for cardiac pain; in fact we would characterize it as noncardiac. Typical angina has the three following characteristics: substernal location, relived by rest or nitroglycerin, and squeezing or pressure-like pain. If you are a young person without these characteristics, your probability of having cardiac disease is approximately 1 to 4%. The negative stress tests dramatically reduce these percentages.
You have a choice. You can decide that you absolutely need to know if you have coronary artery disease and undergo cardiac catheterization with its attendant risks. Or, you can decide to live with the very small chance that you might have coronary artery disease.
Anxiety absolutely can precipitate and potentiate chest pain and other maladies. I think that the strategy that makes the most sense for you is to seek therapy for your anxiety disorder. If you are able to control the anxiety and panic attacks and you are still having chest pain, re-pursue diagnostic evaluation at that time.
Good luck.
Member Comments (1)
by iceman0201, Dec 12, 2008 08:51PM
A related discussion, arm discomfort, chest pain was started.
