
Having Pain In Arm And Back, Feeling Shortness Of Breath. Medical Test Normal. Any Heart Related Problem?

XXXXXXX
Thanks for writing to us.
You seem to a very intelligent person indeed! – you have rightly suspected Coronary Artery Disease (CAD) and sought timely medical attention. And the best has been done.
> A negative blood work (cardiac markers / enzymes) has ruled out recent injury to the heart
> A negative stress EKG has ruled out chronic or underlying CAD, as the cause of your symptoms.
> An ECHOcardiography has also ruled out effects of coronary insufficiency – like abnormal wall thickness, movement and so on
> Yes – these tests are ENOUGH TO RULE out the PROBLEM
> Relief by nitroglycerine does NOT confirm Angina (heart pain) - the drug dilates and relieves spasm – esophageal spasm is also relieved. There are instances where it has been used to reduce severe spam in anal fissure! (Sorry for the example – but true).
In an emergency, it is generally given even without waiting for a diagnosis – for pain relief. No harm is done, if it is not heart pain / it helps if it is heart pain. For - in ER - treatment goes hand in hand and/or precedes diagnosis – Benefits must accrue early / No harm should be done.
YOU DO HAVE A CLEAN XXXXXXX OF HEALTH
There is nothing whatever to suggest a heart problem in the whole picture – except your initial description of the pain. And in a situation like this, we tend to think of the worst scenario and project it subconsciously.
It is very very uncommon to have CAD at this age, in the absence of positive risk factors (Family history / Smoking / Cholesterol / Diabetes etc...)
They might have done your lipid profile / or will be planning in a month
Everything has been done properly / everything is normal so far.
I don’t think you need anything else for the present – by way of medicine or investigation.
All the best
Good luck


XXXXXXX
Thanks for writing back.
We know what it is not / We don't know what it is!
> Muscle spasm is the most likely cause - muscles of the chest wall...compounded or caused by tension of the situation.
> Cervical spondylosis - aging or degenerative changes of the neck vertebrae can press on the nerves and could cause pain at front or back of upper chest.
> Food pipe and wind pipe are there too. These structures can be involved by a variety of processes.
As you rightly said, it is a guess - watch for any pointers - following the lead may throw some light. If there is nothing, try to forget it and enjoy life...
God bless you
Good luck

Answered by

Get personalised answers from verified doctor in minutes across 80+ specialties
