Chest pain with sharp pain to my left shoulder

[stormyj]

I had an endoscopy last year that revealed I have a hiatal hernia.  They didn't say what type, but I should manage it with diet and shouldn't have any symptoms.  Yesterday, after a buffet lunch, I felt pressure in the middle of my chest, then a sharp,burning pain that went to my left shoulder and behind the shoulder blade.  It made it hard to breath the pain was so bad.  However, when I would lay down, the sharp pain would go away.  Is this my heart or my stomach?  I couldn't stand or sit up.  I've had this happen to me before in the past.  It's very similar to the sharp pain you feel after you've had surgery when you've had anesthesia.  I'm 38 years old, 105 pounds, and have a history of heart disease and high cholesterol in the family.

[chicora]

A related discussion, chest pain after aortic valve replacement was started.

[kaceyj]

i also experience the same type of pain except it does not dibilitate me from standing or sitting. its a sharp, burning type pain that somtiemes goes to my left shoulder and the middle of my left arm between shoulder and elbow. i have been diag. w reflux and h-pylori bacteria. they say it is not the heart but it sure doesn hurt and its scary.. i feel ur concern and hope u get the appropriate help. my only suggestion would be to take mylanta during an episode and see if it helps. if it does it is DEF ur stomache. they say stomache pain can be felt everywhere. i also get gas pains under my left breat and around my armpit. so strange...

[Avel]

The only way to know if the aorta might be involved is to have a test that can "see" the entire aorta. A CT scan with contrast or an MRI will show the entire aorta.

The Bicuspid Aortic Foundation has an awareness alert campaign regarding acute aortic syndrome. You may find more information on their web site at www.bicuspidfoundation.com

Best wishes,
Avel

[stormyj]

Thank you for your posts.  I called my doctor who directed me to the emergency room even though the sharp pain had stopped.  EKG, heartrate, and blood tests for cardiac enzymes,cholesterol,gall bladder, liver, and kidneys were all normal.  But my blood pressure was high.  I usually don't have high blood pressure.  I was in the emergency room so long that my family doctor was out for the day by the time they were done with test.  I should be speaking with her today.  Thanks again for the posts and suggestions.

[Avel]

Just wondering if you were evaluated for acute aortic syndrome - or pain coming from the aorta in the chest?

Do you have any family history that would be suspicious for aortic disease - someone whose sudden death was attributed to heart attack, but without confirmation by an autopsy?  Were you checked for a bicuspid aortic valve, which also may be associated with aortic aneurysm and dissection?

If it were myself, I would want to be checked for those.

Best wishes,
Avel

[Flycaster305]

My experience with heart attacks and angina do not include sharp, stabbing pain.  I always describe it as pressure, and the pressure radiates toward my left arm.  I'm not a doctor, but stabbing pain doesn't sound like a heart issue.  I'd certainly investigate any chest pain, however.

[CCF-M.D.-MJM]

Hello,

This doesn't sound like cardiac chest pain, but this isn't something that I feel comfortable managing over the internet.  I usually advise that chest pain sydromes be managed in a hospital or emergency room.  Once the symptoms have been proven to be non cardiac, it is ok to manage them in the office.  The work up should include serial EKGs, cardiac enzymes, and potentially a stress test if there is any question.

I hope this helps.  Thanks for posting.