Re: Diagnosed with Arrhythmia, what about the pain?

Posted By Amy on May 12, 1999 at 14:59:24
I am a 32 y/o female, I weigh 150lbs. I have been having chest pain in what feels like my heart, since June 1997.
My chest pain was tender to the touch to the right of my heart by the solar plexus,it would also hurt just below my armpit and it spread to my arm (a cold line that would run down the inside of my arm) in Nov/Dec of '97, the pain then climaxed with a severe pain in my left upper arm in Jan. 98, I could not lift it above shoulder level, then it disappeared. Gradually that spring the chest pain started to come back and spread into my arm again. Through the summer & fall of '98 I noticed a definite increase in pain
when I would get excited (bookstores are the worst, I'm an avid book-a-holic.)
I have a very strong family history of heart attacks (no male survivors over 55 -most die at 45, and no female survivors over 65)and my cholesterol level has always been over 350 - 400. I had chest x-rays (7/97), ekg's (7/97), heart sonograms (8/97), thallium stress tests (7-97), some special test to look for blood clots in the lungs (2/98), A gallbaldder test (3/98) and I wore a Holter moniter for 24 hours (1/98). The only test to show
anything was the Holter monitor (arrythmia,tachycardia).
At the beginning of April 99, I began to have very strong pains in my chest and down my arm,  My family doctor suggested Thoracic Outlet as a possibility, he ordered a Nerve Conduction test (4/99) which came back normal & a MRI on the right side of my brain, normal. I still have these strong pains, I am very weak on my left side, no headaches. Can arrhythmia cause all this? My cardiologist thinks I have stress just because I am a mother. What can I do?

[Cleveland Clinic, MD]

Posted By CCF CARDIO MD - CRC on May 12, 1999 at 15:56:15
Dear  Amy,
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.
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.











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