wah!!! I was actually feeling so much better since my first response to my arm pain. Now, you have me stressed a bit! I also see a cardiologist because of my family history and because of the arm and chest episode I had this last year. I think I am alot like you, in the fact that I can certainly be a freak about alot of health stuff, but on the other hand, I am a strong advocate for myself and others when it comes to health matters. I don't recall having a calcium count, but will double check my records and ask my doc. She is awesome and on top of women and heart issues. I also have chosen a female as my cardiologist. I never had arm pain until last year when I lost my sister, and it happened on Go Red For Women Day, when alot of heart issues were being discussed on tv. So, here I am in another high stress situation, but, alas, no chest pains like in my past, just arm pain. Thanks for your input, and I will definately not disregard any strange pains.
I thought I would share my experience, which is similar to yours. I'm a 54 Y/O male. I suffer from anxiety and it has manifested as left arm pain for many years. I also have CAD. My father died of an MI at 62 and my older brother has had triple CABG, so there's family history.
Frankly, I don't believe the answer is as cut and dried as suggested by the first response. Some points to ponder:
1. One can be anxious AND have coronary artery disease. I do. My father did. My brother does.
2. Prior to the first in a series of heart attacks, my father complained of left arm pain at rest, but dismissed it, thinking he was developing arthritis (this was in the 1950's). My brother also felt left arm pain at rest. This was >15 years ago and was his first symptom of CAD.
3. I have good aerobic capacity and high exercise tolerance. Treadmill tests are always normal and a nuclear stress test showed good cardiac perfusion. And yet, my calcium score was over 700 as of a few years ago, and is probably over 1000 by now. Despite the well-known limitations of such testing, no one would deny that a CAC (coronary artery calcium) score of >1000 means that, buddy, you have a non-trivial level of coronary artery disease. I'll also tell you this: The only reason I am FINALLY under a cardiologist's care (my HMO having refused such a referral in the past) is that I self-referred myself for the CAC test and waved the results at my GP, who then, bless him, referred me. I now, miracle of miracles, have the full attention of a cardiologist.
4. I hear you completely about anxiety. My arm will hurt if I watch an exciting football game or feel hurried; if I even think about work it will hurt. But I've shared this info just once with my cardiologist and now confine my comments to descriptions of exertional symptoms only, b/c he just isn't interested in non-exertional arm/chest pain as a symptom.
5. The simple explanation I got from the cardiologist about non-exertional arm pain is this: Stress can cause vasoconstriction. In extreme cases it can kill you (the proverbial healthy person who receives dreadful shocking news then keels over dead. The person didn't have CAD, just a sudden fatal stress-related constriction of the coronary arteries). In the same way, you don't *necessarily* have CAD with your arm pain. But then again, maybe you do. If you Google "angina", you'll find plenty of references from reputable sources that describe arm pain brought on by stress/anxiety as legitimate symptoms.
6. If I'm not mistaken, women tend more to exhibit atypical symptoms of CAD. Confirm this w/ your MD.
MOST IMPORTANT: If I were you and read this post, I would probably (as a fellow anxiety sufferer) freak out. PLEASE hear all sides of what I'm saying, i.e., a) that anxiety alone can certainly cause the symptoms you describe b) that CAD can, too and c) that you've taken the right steps in having diagnostic procedures done and d) you should continue to advocate fiercely for yourself.
With gentle self-deprecation I refer to myself as a head case AND a heart case.
And finally, inasmuch as, well, I AM a head case (as well as a lay person) I suggest you take all this as nothing more than a sharing of experience, obviously not as medical advice.
Based on the previous testing and your symptoms this isn't cardiac pain. I think you are correct that this is most likely stress related. You will have to figure out a way to get more relaxed. Different things work for different people. And of course, you'll have to work on eliminating stress in the first place. When you see you doctor make sure he/she examines you well to ensure that this isn't some type of neuromuscular or skeletal pain .
I do apologize if I provoked needless worry. You sound like you are in excellent hands! Good luck to you!