If it's not the heart, what is it?

[MathewStreet]

Hello. I'm putting this here but I just don't know what the problem is.

For two years now, I have regularly been waking up with pins and needles in my lower left arm, which go after I've moved it about a bit. Obviously, my first thought was that it might be a heart problem, but I had FOUR ECGs over the course of the next 2 years plus a blood test, all of which showed no heart abnormality. I also had a CT Scan which showed no neurological explanation.

Two weeks ago, I started to have burning twinges in my chest, only lasting less than a second but still worrying. Last Sunday, it started to get worse. Every time I started to doze off to sleep, I would be awoken suddenly by a pain that could occur anywhere between my shoulders and nipple line, and I would wake up with my left side throbbing fast in time with my heartbeat. I went to my gp, she took my blood pressure - normal - and listened to my heart on the stethoscope and said my symptoms were nothing more than a virus that would clear in ten days.

I had two nights of reasonable sleep with Nurofen painkillers, but this Saturday night I had NO sleep at all as this happened constantly every time I tried to go to sleep. On one occasion, the pain seemed to roll from my breastbone to my left shoulder, other times it was under my left arm or at the bottom of my ribcage.
I've constantly been feeling tightness around my breastbone during this, and moderate shortness of breath but during the day, pain is manageable and I get on with my day. It is at night when this takes over.

This Sunday I went to hospital emergency, as I was really afraid I was about to have a heart attack. I had two further ECGs, also blood pressure, pulse and temperature. ALL of these tests were normal results. The doctor said he thought the problem was in my chest wall, not my heart, maybe 'muscular skeletal' but couldn't diagnose me, as Emergency doctors are only there to prevent any immediate threat. He advised me to go back to my GP. I have a new appointment this week, but tonight I cannot sleep again. It feels like extreme indigestion in my upper chest, also pain under my left armpit, and waking up with my upper body throbbing.

Any ideas what this might be? Repeat ALL ECGs and blood pressure are normal, the ER Dr thinks it isn't the heart, I don't smoke, occasionally drink and do have a fatty diet but am starting to cut back on both.
Thanks.

[Rosemary349]

I've nothing to add except I do hope you manage to find out what this pain is as it is very distressing and you are left with a lot of uncertainty.

Good luck in finding the answers  :-)

[erijon]

I can understand your frustration, just make sure you find a doctor that you can work with and will take the time to check you out. These are guideline and everyone is different so don't ignore your pains, just find someone that will give you the attention you need to be sure and  get some care if your symptoms change or worsen just to be safe, we need you on the forum!

Jon

[MathewStreet]

Thanks Jon.
Looking at those two lists, it isn't the cardiac pain.

On the second list virtually everything fits. All last week, I walked to and from work, and a lot of walking around at work, and there was no increase in pain, it's ALWAYS when I am 'resting'.

I've lost faith in the GP, though, as I don't think it's a 'virus', I have normal temperature.

[erijon]

Sounds like you've been through a lot. Here are some guidelines from the National Insitute of Health for cardiac and non-cardiac pain;

Typical angina (cardiac) pain

Is precipitated on exertion.
Becomes worse as the exertion continues.
Is felt across a wide area in the middle of the chest (not in the cardiac apex), is tight and constrictive in nature and makes the patient to slow down or stop the physical activity.
May be transmitted to the neck, jaw, arms, epigastric region, or back.
May become worse in cold weather, after a heavy meal, or during static work .
Is relieved in a few minutes by rest or glyceryl trinitrate.

Atypical Chest Pain Not Suggestive of Coronary Heart Disease (CHD)

Appears also at rest.
Exercise tolerance is good despite pain.
Continues for hours or days.
Is associated with breathing or chest wall movements.
Is sharp in character.
Is displaced laterally towards the apex.
May be felt on palpation.
Is experienced as palpitations or occasional ectopic beats.
Is felt in the upper abdominal region or below the left costal arch.
Is not relieved with glyceryl trinitrate within a few minutes.

Even so, your symptoms sound like they are not typical of cardiac pain but you really need to follow up with your doctor to be safe. It's just not worth taking any chances. If your symptoms worsen consider going back to the ER.

Hope this helps,

Jon