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Are Sudden Discomfort And Abnormal Sensation In Left Arm Signs Of Depression?
Question: Hi
My wife who is 50 years has been having sudden discomfort (fast heartbeat) along with kind of sensation in her left arm till tip of her middle finger, which last few seconds. It may appear many times a day and for somedays it never appears. She has seen a cardiologist and has prescribed the following medicine.
Metoprolol -25mg (1/2 tab twice a day) - this was prescribed after seeing her ECG. Dr said its fine but there is a slight pain. He also said the symptom could be due to depression.
Serotina- 10mg (1/2 tab at night)
Just want to your view on this.
My wife who is 50 years has been having sudden discomfort (fast heartbeat) along with kind of sensation in her left arm till tip of her middle finger, which last few seconds. It may appear many times a day and for somedays it never appears. She has seen a cardiologist and has prescribed the following medicine.
Metoprolol -25mg (1/2 tab twice a day) - this was prescribed after seeing her ECG. Dr said its fine but there is a slight pain. He also said the symptom could be due to depression.
Serotina- 10mg (1/2 tab at night)
Just want to your view on this.
Brief Answer:
I would explain as follows:
Detailed Answer:
Hello!
Welcome and thank you for asking on HCM!
I carefully passed through your question and would explain that it is important performing a comprehensive differential diagnosis of different causes that may lead to this symptomatology:
1- Coronary artery disease. I would like to review her ECG if you can upload it for another second professional opinion. Did she perform cardiac enzymes during this episode?
2- Anxiety could also lead to similar symptoms.
3- A backbone disorder, affecting the cervical spine (slipped cervical disk), leading to radicular pain in this region (especially when considering the radiating pain in the finger) could lead to this symptomatology.
4- Other metabolic disorders to consider could be: thyroid dysfunction, electrolyte imbalance or chronic anemia.
Metoprolol is a betablocker used to treat tachycardia. While serotina seems to be an antidepressant (which is commonly used to treat anxiety disorders).
Coming to this point I would recommend performing further tests to investigate for the possible cause of her troubles:
- an ambulatory 24-48 hours ECG monitoring to examine her heart rhythm trends during a prolonged time.
- a cervical spine X ray study to investigate for backbone disorders. A cervical spine CT scan or MRI may be needed for this purpose too.
- thyroid hormone levels for thyroid dysfunction
- blood electrolytes for electrolytes imbalances
- complete blood count for anemia
A cardiac stress test may be needed if suspicions of cardiac ischemia are raised.
If all the above tests result normal, you should consider anxiety as the main cause of her symptoms. In such case, she should continue taking serotina 10mg or consult with a specialist of this field to find the proper treatment options.
Hope you will find this answer helpful!
Feel free to ask any other questions whenever you need!
Kind regards,
Dr. Iliri
I would explain as follows:
Detailed Answer:
Hello!
Welcome and thank you for asking on HCM!
I carefully passed through your question and would explain that it is important performing a comprehensive differential diagnosis of different causes that may lead to this symptomatology:
1- Coronary artery disease. I would like to review her ECG if you can upload it for another second professional opinion. Did she perform cardiac enzymes during this episode?
2- Anxiety could also lead to similar symptoms.
3- A backbone disorder, affecting the cervical spine (slipped cervical disk), leading to radicular pain in this region (especially when considering the radiating pain in the finger) could lead to this symptomatology.
4- Other metabolic disorders to consider could be: thyroid dysfunction, electrolyte imbalance or chronic anemia.
Metoprolol is a betablocker used to treat tachycardia. While serotina seems to be an antidepressant (which is commonly used to treat anxiety disorders).
Coming to this point I would recommend performing further tests to investigate for the possible cause of her troubles:
- an ambulatory 24-48 hours ECG monitoring to examine her heart rhythm trends during a prolonged time.
- a cervical spine X ray study to investigate for backbone disorders. A cervical spine CT scan or MRI may be needed for this purpose too.
- thyroid hormone levels for thyroid dysfunction
- blood electrolytes for electrolytes imbalances
- complete blood count for anemia
A cardiac stress test may be needed if suspicions of cardiac ischemia are raised.
If all the above tests result normal, you should consider anxiety as the main cause of her symptoms. In such case, she should continue taking serotina 10mg or consult with a specialist of this field to find the proper treatment options.
Hope you will find this answer helpful!
Feel free to ask any other questions whenever you need!
Kind regards,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you very much Doctor.
I have uploaded the ECG that was taken yesterday prior to the medication.
Since she is in a remote island , she would need to come to the capital city for CT and MRI.
She has had a accident when a bread fruit hit on her back when she was about 14 years.
I have uploaded the ECG that was taken yesterday prior to the medication.
Since she is in a remote island , she would need to come to the capital city for CT and MRI.
She has had a accident when a bread fruit hit on her back when she was about 14 years.
Brief Answer:
Opinion as follows:
Detailed Answer:
Hello again,
I carefully reviewed the uploaded ECG recordings and would confirm that your wife’s ECG is quite normal (no rhythm disturbances, no cardiac conductance or repolarisation abnormalities).
No suspicions about cardiac ischemia could be raised by her resting ECG.
A cardiac stress test would be helpful to further investigate on this direction.
Her past accident may have probably left any adverse consequences on her backbone structure.
Nevertheless, it is advisable to follow the above recommended tests for a differential diagnosis of her complaints.
I recommend discussing with her attending physician to seen the opportunity on the above mentioned issues and find the best way of localizing the responsible factors of her recent clinical scenario.
Wishing you a pleasant weekend!
Regards,
Dr. Iliri
Opinion as follows:
Detailed Answer:
Hello again,
I carefully reviewed the uploaded ECG recordings and would confirm that your wife’s ECG is quite normal (no rhythm disturbances, no cardiac conductance or repolarisation abnormalities).
No suspicions about cardiac ischemia could be raised by her resting ECG.
A cardiac stress test would be helpful to further investigate on this direction.
Her past accident may have probably left any adverse consequences on her backbone structure.
Nevertheless, it is advisable to follow the above recommended tests for a differential diagnosis of her complaints.
I recommend discussing with her attending physician to seen the opportunity on the above mentioned issues and find the best way of localizing the responsible factors of her recent clinical scenario.
Wishing you a pleasant weekend!
Regards,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you so much, Doctor .
Meanwhile, is it ok for her to continue with the medication prescribed?
Regards,
Nasru
Meanwhile, is it ok for her to continue with the medication prescribed?
Regards,
Nasru
Brief Answer:
Current medications seem to be safe.
Detailed Answer:
Hi Nasru!
Yes! The actual therapy seems to be safe. She may continue the prescribed medications at least until a definite clinical conclusion of the performed tests has been done.
In case you need a second professional opinion after having the conclusions of the recommended medical tests, you can ask me directly through the following link:
http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=69765
Best wishes,
Dr. Iliri
Current medications seem to be safe.
Detailed Answer:
Hi Nasru!
Yes! The actual therapy seems to be safe. She may continue the prescribed medications at least until a definite clinical conclusion of the performed tests has been done.
In case you need a second professional opinion after having the conclusions of the recommended medical tests, you can ask me directly through the following link:
http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=69765
Best wishes,
Dr. Iliri
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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