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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
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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