Re: Chest Pains

Posted By CCF CARDIO MD - CRC on October 29, 1998 at 23:43:54:

In Reply to: Chest Pains posted by Kenneth Shauvin on October 28, 1998 at 17:52:46:






My wife suffers from chest pains on her left side and in her left arm.
She also has pains on her left side just below the left of center rib cage.  She has seen several doctors who have been unable to determine the cause.
Her speech also becomes a little slurred.
They always tell her that it is nothing to worry about but everything I have read about heart attacks leds me to believe that she is having one.
Sometimes to pain is very sharp and seems to be located in the center of her chest.  Can you recommend what step we should take next to determine what the cause may be?



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Dear  Kenneth,
There are many causes of chest  pain.  The one that doctors worry about the most is cardiac because it has the potential to be life-threatening.  Once this is ruled out the work-up can proceed at a more leisurely pace.   I too am concerned that your wife could be having a cardiac cause of her pain and would suggest following up with her doctor.  In addition if she has another episode I would recommend calling 911 and having her evaluated in an Emergency Department.
Amongst the cardiac causes of chest pain are: ischemia (due to blockages - including both stable and unstable angina and acute heart attack), pericarditis (inflammation of the sack around the heart), myocarditis (inflammation of the heart), cardiomyopathy (heart failure) and rarer causes such as coronary artery dissection, acute rupture of the heart and valves and infections of the pericardium.
Gastrointestinal causes of chest pain include reflux (acid from the stomach washing back into the esophagus), gallstones, esophageal spasm, esophageal rupture, varicose veins of the esophagus, strictures of the esophagus, tumors of the esophagus and other less common GI problems.
Pulmonary (lung) causes include pneumonia, pulmonary embolus, pneumothorax, pleuritis and bleb rupture.
Other potential causes are aortic dissection, back and spine problems and musculoskeletal (muscle strain, rib fracture, etc.).
Psychological causes of chest pain are common and include panic attacks, anxiety, stress and mental duress.
As you can see the list of potential causes in long and may take a little bit of time to determine the precise cause.  A good Internal Medicine doctor should be able to work through the potential causes of your symptoms.
I hope you find this information useful.  Information provided in the heart forum is for general purposes only.  Only your physician can provide specific diagnoses and therapies.  Please feel free to write back with additional questions.
If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire online by using the Heart Center website at www.ccf.org/heartcenter.  The Heart Center website contains a directory of the cardiology staff that can be used to select the physician best suited to address your cardiac problem.