possible cardiac?

[foodwoman]

    28 year old male patient appears in excellent condition, no allergies, only on low dose zoloft (50 mg) for PTSD.Hour and a half after eating a normal supper, felt lightheaded, lay down, then the following s/s began and called 911 about one hour later.
    PMHX: One similar episode this summer, involving only the right forearm, no C/P, etc., and no diagnosis given.
Neither episode preceded with stress, strain, trauma, vaccines, illness or exposure (known). No other history, no stress, strain, recent vaccines or illness. Smokes, but no recreational drugs or acohol on board.
    What began as severe pain radiating from below the proximal wrists (ulnar side) on both arms, slowly spread within a half an hour to nearly the elbows. Ran upward in about a two inch line width. fingers had cap. refill <2 secs., but were 'numb and tingly'. Was not hyperventilating, no carpal spasms. He called 911 after he developed severe (10/10) chest pain, left anterior chest over heart area and traversing moderately across chest, nonradiating to back, no N/V. Upon palpation, pain no different on rib cartilage from muscle area, deep inspiration makes pain slightly worse; 'certain movements make it worse', no coughing, BBS CTA, pulse ox 92 - 96 room air, 97 - 98 on 4 lpm oxygen. Skin w/d but patient feels 'cold';- no shivering. BP within normal limits; 12 lead unremarkable,  Gave ASA & sublingual ntg sprag with CP going slightly lower (8/10 vs 10/10). No other changes.  Ideas on what this was? ( He was NOT faking s/s.) Thanks.


This discussion is related to arm and chest pain problems.

[foodwoman]

He had same symptoms whether sitting upright or lying supine, no pain in gastric area or behind right shoulder blade, no nausea or vomiting.  Also still cannot explain specific and very extreme pain that was steadily moving bilaterally up the arms...?  Was nonspecific on meal other than it was 'just a regular dinner like I usually eat'.  (Which could mean anything, but still presents nothing abnormal such as an extremely rich/fatty meal, I would think).

[Caryopteris]

I'm thinking gallbladder attack.  The info was good, except you didn't mention whether it was a fatty meal or what it was he ate.  

[Red_Star]

Chest pain that occurs within a few hours after eating is usually a gastrointestinal problem. GERD and H Pylori bacteria come to mind. Both mimic a heart attack.