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You are here: Experts > Health/Fitness > Medical Specialists > Heart & Cardiology > left side chest pain that radiates
Heart & Cardiology - left side chest pain that radiates
Expert: David Richardson - 10/30/2009
Question
QUESTION: hello, im a 24 yr old male. cholesterol 245, ive been having this left side chest pain for about a yr now. ive had echo,ekgs,stress echo,holter monitor, event monitor, and blood work. i also have been experiencing pac's and pvc's. all my test were normal besides the event monitor which showed the pac's and pvc's. today me and my fiance was about to eat at a restaurant and i started having the severe left side chest pain, radiating down my left arm and into my left hand, was sitting at the table and couldnt eat, felt to bad, and then is just went full blown, severe pain, cold sweats, feeling lightheaded,about to pass out, went to the ER, bp was 150/100. O2 levels was 100%. they did chest xray, urine sample, blood work, and ekg, said everything was completely normal. by the time i got in to do my ekg i was already feeling better. im still having the pain in the same spot right now on and off, with about 2 min breaks in between the pain, its localized on the left side of my chest, like right over my heart. 1.could this be Prinzmetal's angina? 2.could it be coronary artery spasms? are they dangerous? 3.could i have blockages still with all the test that i had? 4.that most recent spell tonight at restaurant felt so much like heart related and had all the signs and symptoms, what else could it have been, could it have been heart related but they didnt catch it at the ER? 5. is it possible that this could be angina, but just not show up on any tests? the pain is in the same spot and it is about one inch to the right of my left nipple, and it radiates down my left arm into my left hand, like inbetween my thumb and pointer finger, also hurts in the left side of my neck, when it happens i dont feel good at all and get really hot. sometimes it last for like 2 hours. does that sound like heart pain, and the pain is like right over my heart. thanks
ANSWER: Dear Michael,
I sent you an answer to this question last Sunday at 11:32 pm. Here is that answer
The most common cause of pain in a young person is cramping of the muscles in the chest wall. If you can modify the pain, make it better or worse, by pressing on the area that hurts, then you have proven that the pain is coming from your chest wall. Chest wall pain is a nuisance but no threat to life or health. At age below 45, chest pain is very unlikely to come from clogging of the coronary arteries that supply blood to the heart.
1. Prinzmetal angina is spasm of a coronary artery, and would have changed your EKG since the pain was still present.
2. Very unlikely, see above. Spasm can last long enough to cause a heart attack.
3. Also very unlikely. A stress test monitored by radioisotopes or echo gives 95% likelihood of no heart attack or cardiac death for at least 7 years, longer in a man as young as you are. Stress tests monitored by EKG alone are not sensitive enough.
4. Could be spasm of muscles in chest wall and arm. Very unlikely for heart pain to have not been recognized at once in the ER.
Please write back if this note doesn't answer all your questions.
David Richardson
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QUESTION: thank you, very much, could you please answer this added question for me.
5. is it possible that this could be angina, but just not show up on any tests? the pain is in the same spot and it is about one inch to the right of my left nipple, and it radiates down my left arm into my left hand, like inbetween my thumb and pointer finger, also hurts in the left side of my neck, when it happens i dont feel good at all and get really hot. sometimes it last for like 2 hours. does that sound like heart pain, and the pain is like right over my heart. ive been having the pain all day today and it seems like its getting a lil worse right now, its actually more in my left shoulder and arm right now. what could this be since its lasting so long, can heart pain present itself like that. also i cannot modify the pain by pressing on the area. thanks
ANSWER: No, it's not angina and doesn't sound like heart pain. I still think it's chest wall pain. Have you tried ibuprofen? Take 600 or 800 mg and see if that helps. If you have no ibuprofen, try Tylenol of Aspirin in pretty big dose. Best wishes.
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QUESTION: that can cause the pain that i describe and also how it radiates to my left arm, shoulder, and hand? also is it possible for angina, or heat pain to last this long (1yr) and not have any tests pick up anything? also could chest wall pain cause the symptoms that ive desribed? it just feels like such typical heart symptoms i just dont understand how it could be something else, i hope to God that it isnt my heart. just at a point in my life where i dont know what to do because i know how i feel and the pain is there and it resembles heart pain so much like 100%. its like a pinching/squeezing sensation in that area i described, right over my heart thanks
Answer
Yes, chest wall pain can cause all the pains you describe. The tests would have picked up any heart trouble. Typical heart pain is middle of front of chest pressure brought on by exercise and relieved by rest in 5 minutes, so your pains don't resemble heart pain at all. Please get on with your life.
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