chest pain leg pain low O2

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[Michael J. McWilliams, M.D.]

If there is a bad connection or bad contact with your finger, the pulse ox and heart rate readings can be off.  I have been called to see patients many times with low saturations that were just bad contact with the finger. The important short term question is are your oxygen sat's dropping -- they should not drop like that.  It sounds like that issue was resolved in your regular doctors office when they didn't drop with walking but this is a key issue to resolve.

If the neurologist doesn't think the numbness and tingling is neurologic but your internist strongly believes that it is, obtain a second opinion.  In the mean time, ask your doctor to look into why your rate is increasing so quickly with minimal exertion (if this is a new issue).

This is your health, be vigilant in obtaining answer to your questions.  I also notice that you are probably a little overweight.  Take these health concerns to heart and work with your doctors to get your weight down and take your life back!

Thanks for posting.

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Thanks for your fast response.  They have not addressed the fast hr and hypoxia yet.  When I went to my reg dr he was concerned because my check in hr was 52 (it has always been 85 - 88).  It was the nurse at check in who walked me with the O2 sensor because I said that my legs feel heavy when I climb stairs.  At that time my O2 dropped to 87 after I had only taken 5 or 6 steps.  The nurse said my pulse was too irregular for her to get a good reading (either wrist) after she had taken me on stairs.  Because I had also had 2 episodes where I felt suddenly faint, my dr ordered an event monitor test.  I do not know the results yet.  My dr sent me to the Neuro dr because of the off and on tingling.  It was at the Neuro dr's office that fast hr happened.  My check in rate was only 60, but became 125 after just a few steps.  The O2 remained constant at 94 (nornal for me) until I climbed some stairs.  Then My hr went to 140 and O2 dropped to 87.  He said "not Neuro."  The follow up visit at my reg dr office was with another dr (mine was out of town).  Then my check in rate was 98 and immediately climbed upon walking but O2 remained constant (they did not take me on stairs).  The heart cath was 4 yrs ago and the last thalium stress test was 2 yrs ago.

[Michael J. McWilliams, M.D.]

Mr. Toad,
It sounds like there are several issues going.
The fact that you have a negative thalium stress and a cardiac cath that shows non obstructive coronary disease, you know the chest pain is not from coronary disease.

Hypoxia (low oxygen content in blood) can cause numbness and tingling in the hands and feet, but usually not pain.  I would want to repeat the ambulatory pulse ox first to confirm that there was not a loose connection --- this cause a falsely elevated heart rate and a low oxygen saturation.  If  you truly have oxygen desaturation with ambulation, this needs to be addressed – there has to be a reason why.  Hypoxia has a lot of possible causes.

The fast heart rate is unlikely causing hypoxia but it is possible that hypoxia is causing the fast heart rate.  You need an evaluation by someone that can take the time to think about all the issues and put this together.  The issue is not coronary disease, I cannot think of neurologic cause to fast heart rate, hypoxia and numbness, but I would want to see the tests myself to make sure they were believable.  Have they explained the fast heart rate and hypoxia (low oxygen saturation in the 80’s) to you?

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My post did not post - here is the question.  I am a 45 year old male 6ft 285 lbs sedentary life style.  I have struggled with high blood presseure since I was 13.  It stays normal now without meds.  I have had chest pains for a little over 4 yrs. 4 yrs ago an abnormal ecg normal one chest pain episode landed me in the hospital.  I always get abnoemal ecgs under stress so thallium is added and images are normal.  Since my brother died suddenly at 61 from heart attack, they did cath anyway.  It showed only a 30% blockage and I was dismissed.  2 yrs ago chest became worse.  Thallium test was still normal.  Now I have pain in lower legs with more frequent chest pain.  Since leg pain is "stocking" and accompanied sometimes by tingling dr thought neuro.  Neuro dr says mris and physical exam normal.  My heart rates have always been in mid to upper 80s.  Last visit the hr was 52.  Nurse put 2 senser on my finger and walked me.  After 5 or 6 steps O2 dropped to 87 and did not come and pulse became too irregular for nurse to obtain.  At neuro office pulse was 60.  Dr did same test.  O2 stayed at 94 but hr went to 125 after 4 or 5 steps.  Did stairs.  Pulse went to 140, legs starting hurting bad and O2 dropped to 87.  Went back to reg dr.  Check in pulse was 98.  Did walk test agian without stairs.  Pulse went to 130 O2 stayed normal.  Reg dr still thinks neuro.  What do you think?