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Are Chest Pain, Back Pain, Neck Tightness And Dizziness Signs Of Heart Attack?

Posted on Wed, 25 May 2016

Question: Hi, I am writing again because I am having a CT angiogram next week (after seeing a cardiologist on Monday) but I am still concerned about the pain on my left side. For over a month, I have had pain from my left back (near my left shoulder blade) that is also causing tightness in my left neck and most recently down my left arm (sometimes down to my pinky side, other times down to my thumb). I have been to the ER numerous times each time with an ecg and blood test (the last one kept me there for 7 hours monitoring my troponin) and everything has been negative. I also had a spell of dizziness a few weeks ago which prompted the visit to the cardiologist. I have had a 24 hour bp monitor and that was normal. The cardiologist told me that he doesn't think anything is wrong with my heart and offered to send me for a CT angiogram to put my mind at ease. My question is, could troponin tests have missed ischemia? I am scared that I am going to have a sudden heart attack waiting for the angiogram. It is hard to ignore the left side tightness that seems to keep coming back.

Answered by Dr. Ilir Sharka (22 minutes later)

Brief Answer:
I would explain as follows:

Detailed Answer:

Hello dear Norma!

Welcome back on HCM!

Regarding your concern about Troponin test, I would explain that Troponin is an excellent marker of myocardial damage. In cases when it results negative a myocardial injury is excluded with certainty.

So, I would say that Troponin test has an excellent reliability in excluding heart attach and ongoing myocardial ischemia (an excellent negative predictive value for myocardial injury).

The fact, you have done several tests (resting ECG, lab tests, including cardiac enzymes, excluded any possibility of having experienced any myocardial damage.

I think that your doctor has decided the right way by recommending you coronary angio CT exam.

In such way every raised suspicion about any heart implication on your recent complaints will be clarified.

You shouldn't worry until waiting for CT angiogram, because you have no medical evidence of experiencing any dangerous myocardial ischemia or injury.

Hoping my answer will be of some help to you!

Feel free to ask me again in case of any further uncertainties.

Kind regards,

Dr. Iliri

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Ilir Sharka (3 minutes later)

Im sorry for being crazy. It is just hard to stop worrying when the entire month of February (heart month) had news stories about heart attacks and their "other" symptoms besides chest pain .

Answered by Dr. Ilir Sharka (2 hours later)

Brief Answer:
I would explain:

Detailed Answer:
Hi again, Norma!

You are right to be concerned about your health after experiencing those complaints.

But, I would like to assure you that your actual clinical symptomatology and performed tests do not show any serious cardiac disorder.

I would like to review your coronary angio CT report after it's done.

Please upload a copy when available.

Meantime try to relax yourself!

Regards,

Dr. Iliri

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Ilir Sharka (18 minutes later)

Thank you. I will. :)

Answered by Dr. Ilir Sharka (8 minutes later)

Brief Answer:
You are welcome!

Detailed Answer:
Waiting for your medical results.

Meanwhile feel free to ask me again in case of any further uncertainties!

Have a nice time!

Dr. Iliri

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Ilir Sharka (34 minutes later)

Since you told me i could ask another question...

If my tests have been negative, is there the possibilty that it is only because there has been no actual heart damage, but my heart is still not receiving enough oxygen.

I am also worried vecause i am training for a half marathon but am worried about putting too much on my heart at thr moment .

Answered by Dr. Ilir Sharka (4 hours later)

Brief Answer:
Your angio CT scan will give more information on this issue.

Detailed Answer:
Hello again!

I understand your concern and would explain that your angio CT scan results will give a more precise information on the safety of continuing your training.

I would give a more professional information based on these test reports.

Hope you will find this answer helpful!

Regards,

Dr. Iliri

Note: For further follow-up it is advisable to consult an emergency medicine specialist. Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar