Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
Suggest Treatment For Heart Palpitations, Jaw And Ear Pain
Question: Ten years ago I had an ablation for spontaneous intermittent afib, with a twenty year history. The ablation was very successful with only a few episodes in the interim. I am not unfamiliar with rapid heart beat (220 bpm) with jaw and ear pain, but I have always converted to nsr. At 74yo I am concerned about telling the difference between that pain and a heart attack. No meds
Brief Answer:
You need further tests
Detailed Answer:
Hi friend
Welcome to Health Care Magic
You are right – it is difficult to distinguish / even by experienced patients and physicians; even in the ER… Generally, the pain from the heart is oppressing, in central chest (and left), worse on effort, relieved by rest, may radiate to shoulders and arms, associated with sweating and so on.
As a rescue measure, if the pain is prolonged – say 15 minutes or beyond the usual limits, seek medical attention / especially if there are symptoms like blurred vision, dizziness, loss of consciousness, shortness of breath, you need urgent work up
As a preventive measure, it is better to have a Treadmill Exercise Electrocardiogram (TMT).
If it is normal, nothing to do – except to repeat annually.
If in doubt, further work up is done..
If TMT suggests ischemia, it is an indication for further work up – because at times, there may be false positive or false negatives. The next step is TMT with thallium isotope. It is the ideal non-invasive way to evaluate ischemia / to assess the PHYSIOLOGY (function) – to see whether the blood arriving at the heart muscle.
If there is a suggestion, the next step is to see the ANATOMY (structure) – undergo catheterisation and coronary angiography with a view for possible intervention. It is the only way to directly ‘see’ the block, if any – and its location, extent, severity and so on. Coronary arteriography is invasive but it is the gold standard for this.
Good luck
God bless you
You need further tests
Detailed Answer:
Hi friend
Welcome to Health Care Magic
You are right – it is difficult to distinguish / even by experienced patients and physicians; even in the ER… Generally, the pain from the heart is oppressing, in central chest (and left), worse on effort, relieved by rest, may radiate to shoulders and arms, associated with sweating and so on.
As a rescue measure, if the pain is prolonged – say 15 minutes or beyond the usual limits, seek medical attention / especially if there are symptoms like blurred vision, dizziness, loss of consciousness, shortness of breath, you need urgent work up
As a preventive measure, it is better to have a Treadmill Exercise Electrocardiogram (TMT).
If it is normal, nothing to do – except to repeat annually.
If in doubt, further work up is done..
If TMT suggests ischemia, it is an indication for further work up – because at times, there may be false positive or false negatives. The next step is TMT with thallium isotope. It is the ideal non-invasive way to evaluate ischemia / to assess the PHYSIOLOGY (function) – to see whether the blood arriving at the heart muscle.
If there is a suggestion, the next step is to see the ANATOMY (structure) – undergo catheterisation and coronary angiography with a view for possible intervention. It is the only way to directly ‘see’ the block, if any – and its location, extent, severity and so on. Coronary arteriography is invasive but it is the gold standard for this.
Good luck
God bless you
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
