Chest Pain and Numbness

[jbm]

I am 30 tears old, a smoker, overwight and have high cholesterol (277). My blood pressure is however normal. I began having chest painss about 5 months ago. They are atypical in that they do not come during exertion. They just come sometimes regardless as to what I am doing. I had a stress test about two months and it came back normal. They chest pains seem to have intensified as of late, and I am now noticing numbness in my left hand. The pain will sometimes spread to my left shoulder and even occasionly to my left arm.
Does this sound like a heart condition even though I have a normal stress test? Could this be anxiety?
Any help is appreciated.
Thank You.

[Minkira]

I don't know where to stick this and I guess I'll have to use this thread so sorry in advance.

I'm a 14 year old girl realatively average height and weight but if i had to guess maybe a tiny bit over normal weight but not much. Low blood pressure runs in the family and my grandmother has had various heart problems.

Every once in a long while (sometimes months in between) my hands will be numb and my fingers more often. The numbness is more like having a pain in my fingers or hand and being able to feel nothing else.

I have chest pain a lot so it never really occured to me as irregular. Mostly i'll have faint pains that feel like they're coming from my ribs and they don't last long. Not as often, but more often than numbness, I'll have very sharp pains that seem to last forever. I have to stop everything i'm doing to grab my chest, curl up, and wait it out.

I didn't want to make a big deal out of it to my parents if it was nothing but after reading and article about things not to ignore on MSN I was worried. I want to know if i should be worried enough to seek help. Thank you for anyone who's willing to help.

[briane]

Congratulations on the weight loss.  Thats Wonderful!!

[pikamom]

Thanks for that motivating testimony! It's so true everything you said about the desire to be healthy has to be stronger than the addiction. I never smoked so that's not a concern, but I do have food addiction and spent years on the couch in a deep depression. Had 2 back operations for the disc at L5 S1 and now walk with a cane. But last year I lost 60 pounds with weight watchers (now average weight) and started walking 30 minutes 3X a week and doing some yoga daily. My back pain has lessened considerably and my outlook on life is positive. The depression is a thing of the past. But I don't know how many times I wish I could overeat, but I don't because I know if I start gaining again I'll quicky go back to my old ways. Right now my motivation is still high and I have to work to keep it there.

[No Bypass / No Stents]

I think that the secret to changing habits is to develop a consistent desire for activities or qualities that becomes stronger than the addictions.

I was a heavy cigarette smoker but was able to quit cold turkey when I was in my 20's.  The secret for me was to never touch a cigarette under any circumstances and to develop a strong and constant desire for clean lungs.

I was a workaholic in my 40s, hardly ever walked, ate every meal in a restaurant, and was 245 lbs.  By the time I was 48, my lower back hurt just to walk a few hundred yards.  I knew that I was a high risk for heart attack, yet couldn't or wouldn't change my ways.

Now I have developed a consistent habit of walking for 35 minutes twice a day on a hilly course.  I walk before work in the morning and by the time I get to work, the endorfins have kicked in and I feel wonderful.  I walk again before lunch and the troubles of the workday just melt away.  This gets the poisonous stress hormones out, gives me cardiovascular tone, and keeps my legs fit.  And guess what - no more lower back pain.  I really don't miss a day anymore because I don't want to feel poisons of sugar, caffiene, and stress remaining in my body.

I would never eat an orange before and I won't normally eat them now.  But I no longer take sandwiches when I take a hike, just fruit and granola bars.  And an orange really tastes good after walking uphill for a few hours.  I also keep them in my car.  During the boredom of sitting in traffic, it gives me something to do, to peel and split an orange.

I am fortunate to live in the Pacific Northwest and have renewed my love of the outdoors.  The happiest times of my year were the extended backpack trips that I took in the North Cascades last summer.  I so look forward to doing that again this summer.  

Today I will go out back country skiing with a couple of my favorite and most comedic dogs.  The desire to get out in the forest is now so strong that I must do this every weekend.

I look forward to my annual climb of Washington State's second highest volcanoe next August.  It's tough for a guy with a totaly occluded RCA, a 90% ostial occlusion of the circumflex, and a "cratered" plaque in his left main, but I have so developed a habit of getting to the top of that mountain every year and crave looking out from the top.

I stopped at the mini-mart last night and contemplated buying some chocolate chip cookies.  I walked out without them, because My desire for low cholestorol and disease free arteries is now stronger than the addiction.

Same with alchohol.  My desire for a well functioning brain, lack of a hangover, and low blood pressure usually outweighs my addiction.

You see that I really don't think trying to stop something without developing a strong desire and need for something counter to it will work.  Even the desire to live isn't strong enough, because no-one believes they will die today - it's somewhere off in the future.  Even some people who had proof positive that smoking a cigarette would kill them today would still smoke it because the addiction is so strong.

I don't always choose to not endulge activites that are bad for me, but If I take the time to think about the things that I really want, I don't poison myself as much as I once did.  Also I depend on lipid lowering drugs to make up for my remaining weakness.  Hopefully, I will need them less as the years go on.

Best Wishes

[pikamom]

The doctor didn't answer as to whether he thinks you have a heart condition. I guess the best thing to do would be to visit your family doctor who can then refer you to a cardiologist if he thinks you need it. Or go to the ER when you're having symptoms and see if anything shows up on EKG. They don't usually think it could be your heart at a young age, but there are always exceptions. Better safe than sorry. And I agree with the things you can do to improve your longterm outlook. It's hard, my husband and I had checkups in December and my husband (37) was advised to quit smoking and lose weight. He was given a prescription for some medicine to help quit and he cut down for awhile but now is back at it. He went on a diet for about 2 weeks as well but now is back to his old eating habits. Very hard to do consistently day in and day out.

[No Bypass / No Stents]

You have stated 3 risk factors for coronary artery disease: Smoking, High Cholesterol, and Overweight.

Although you may make it to 45 or 50 without a heart attack you are certainly at high risk for a heart attack as you grow older.

I had a family history of heart disease, was overweight, had high total cholesterol and low HDL "Good" cholesterol.  I had a confirmed heart attack at 50, but had a similar episode in my early thirties and just laid in bed for a week rather than seeking medical attention.

If I could do it all over again I would have started working on the risk factors when I was 25.

I suggest that you do the following:

1.  Stop smoking today.
2.  Get as much meat and dairy out of your diet as possible.  Try to develop a taste for fruit and vegetables.
3.  Get on a statin drug such as Lipitor to lower you TC below 200 and preferably lower.
4.  If your HDL cholesterol is low (below 45) do what is required to get it up to at least 50.  That would include daily exercise and possibly Niaspan.
5.  Develop a habit of daily exercise.  I walk a hilly course for 35 minutes before work and at noon and do more on the weekends.
6.  Work at appreciating life and lowering stress.

If you don't do these things, you may live to 50, but if the bill comes due, like it did for me, it's a *****.

Believe me - it's real!

Good Luck

[CCF-M.D.-CRC]

Dear jbm,
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 and coronary artery spasm), 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.

[jbm]

Let me clarify, the numbness is more of a tingling then anything else.