35 yr old male, 20lbs overweight. Cholesterol now under control (god love statins!). Only family history is my grandfather who had a MI in his 50's but was a big time smoker and drinker.
I don't smoke, I exercise regularly, take statins and fish oil.
Over the past year I've had quite a bit of pains in my right arm between my elbow and armpit. It's like a shooting charlie horse, narrow in nature. Tricep area.
It's worst when riding bicyles (at a pretty high output). It also comes on if I'm real acutely stressed (it come on fast and shoots/pulses). Occasionally when I lay down at night before bed it feels like it cramps up.
What concerned me is when riding bicycles, or when stressed. Sometimes even when walking.
Now the strange thing is this. It comes on after 30 - 35 minutes or more of exercise. That is, in the first 20 minutes I can exercise as hard as I would like and nothing thus far, I mean 90% of max heart rate and nothing) Once I get past the 30 minute mark it can come on, and come on quickly. Movement out of a position doesn't seem to help much, but when I stop the activity it most times goes away quickly.
Then the other day I was walking around the city, not pushing it etc. After about 30 minutes, it came on again, not as strong as usual, but it came on.
Sorry I can't be more descriptive, it feels like a shooting charlie horse. I get NO chest pain with this, and no additional shortness of breath, or additional sweating.
What concerned me is that it does go away after stopping, but it's in my right arm not left, and doesn't seem tied to intensity, but rather duration. The stress/exercise component confused me.
13 months ago I passed a stress test. I went in then due to chest pain, high cholestorol, high blood pressure. I went 17 minutes at 17 mets. But again... that wasn't over 30 minutes.
Even more important than whether or not this is due to myocardial ischemia, is at what work level does it occur. You have very good exercise capacity, and statistically this portends very little to no risk of you having serious complications from heart disease. I would limit my exercise level so that you wouldn't reach the point of experiencing that chest pain, work on loosing the 20 pounds, work on blood pressure and cholesterol lowering (either via dietary or pharmacological means).
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