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Dr- 1. What Are The Symptoms/characteristics Of Angina Pain? 2.

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Posted on Wed, 22 May 2019
Question: Dr-

1. What are the symptoms/characteristics of angina pain?

2. I experienced radiating pain in left arm & left pectoral region while resting/lying down for several nights along with back spasms.

3. The next night I experienced severe pain in left arm & left pectoral area that lasted about 10 minutes while sleeping, along with upper back spasms. The pain was severe enough to awaken me.

4. I had no other symptoms such as shortness of breath, dizziness, vomiting etc...

5. What are chances that what I experienced was angina pain?
doctor
Answered by Dr. Ilir Sharka (12 minutes later)
Brief Answer:
I would recommend as follows:

Detailed Answer:
Hello!

Welcome to Ask a Doctor service!

I passed carefully through your question and would explain that considering the description of the chest pain, we can not exclude angina.

Another possible cause to consider would be chronic backbone degenerations. Was the pain modulated by deep breathing or any certain body position? This would be indicative of a musculo-skeletal pain or chronic degenerations of the backbone.

Anyway, considering the fact that you had pain last night, I would first recommend performing a resting ECG and cardiac enzymes as soon as possible.

Some other tests to consider would be : a chest X ray study in order to investigate for a lung disorder, a lateral cervico-thoracic spine X ray study in order to investigate for chronic degenerations of the backbone and some blood lab tests (complete blood count, PCR, ESR) for inflamamtion.

If suspicions of coronary artery disease are raised, the next step to follow would be performing an exercise cardiac stress test .

You should discuss with your doctor on the above tests.

I remain at your disposal for any further questions whenever you need!

Kind regards,

Dr. Ilir Sharka, Cardiologist
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ilir Sharka (57 minutes later)
Dr-

1. The pain seemed to arise usually when I lie down to sleep & not otherwise.

2. I took EKG & it was fine. My cardiologist has recomended nuclear stress test & Cardiac CTA

3. I was debating taking the tests - because of the long term effects of radiation exposure from these tests

4. What do you think?
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Follow up: Dr. Ilir Sharka (4 hours later)
Dr- to clarify..

1. EKG/blood work for enzymes was performed after the first few incidents of radiating left arm/left pectoral pain & the results were fine. Then the next day I experienced severe pain in my left arm/left pectoral region while sleeping which lasted about 10 minutes

2. no studies were performed after the severe pain that I experienced while sleeping - instead i went to see my cardiologist

3. he has recommended the nuclear treadmill stress test & the cardiac CTA

4. my concern is whether these tests are truly necessary since i will be exposed to radiation & that will increase the risk of cancer later in life

Thanks,
doctor
Answered by Dr. Ilir Sharka (4 minutes later)
Brief Answer:
I would recommend as follows:

Detailed Answer:
Hello again!

Thank you for the additional information.

I agree with you on the fact that cardica CTA and nuclear stress test impose some risk of radiation.

Anyway, even though the ECG and cardiac enzymes resulted normal, we can not exclude coronary artery disease.

For this reason, I would recommend discussing with your doctor on the possibility of performing a dobutamine stress echo or a stress cardiac MRI in order to investigate for coronary artery disease. These tests do not impose any risk of radiation and are quite safe.

As the pain is triggered by lying position, I would recommend performing a chest X ray and a spine X ray too.

In the meantime, I would recommend taking an antiacid or PPI (omeprazole, pantoprazole, etc.), in order to prevent acid reflux, which may trigger this situation too.

Hope to have been helpful!

Wishing all the best,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ilir Sharka (2 minutes later)
Dr -

1. would it be wise to undergo just one of the two tests that my cardiologist has recommended & see if a problem is revealed before completing both tests?

2. if so which test would you recommend completing first?

3. or do you think under the circumstances i should complete both tests?

Thanks,

Answered by
Dr.
Dr. Ilir Sharka

Cardiologist

Practicing since :2001

Answered : 9533 Questions

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Dr- 1. What Are The Symptoms/characteristics Of Angina Pain? 2.

Brief Answer: I would recommend as follows: Detailed Answer: Hello! Welcome to Ask a Doctor service! I passed carefully through your question and would explain that considering the description of the chest pain, we can not exclude angina. Another possible cause to consider would be chronic backbone degenerations. Was the pain modulated by deep breathing or any certain body position? This would be indicative of a musculo-skeletal pain or chronic degenerations of the backbone. Anyway, considering the fact that you had pain last night, I would first recommend performing a resting ECG and cardiac enzymes as soon as possible. Some other tests to consider would be : a chest X ray study in order to investigate for a lung disorder, a lateral cervico-thoracic spine X ray study in order to investigate for chronic degenerations of the backbone and some blood lab tests (complete blood count, PCR, ESR) for inflamamtion. If suspicions of coronary artery disease are raised, the next step to follow would be performing an exercise cardiac stress test . You should discuss with your doctor on the above tests. I remain at your disposal for any further questions whenever you need! Kind regards, Dr. Ilir Sharka, Cardiologist