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Suggest Treatment For Severe Chest Pain, Loss Of Appetite And Nausea
Question: I have been having chest pain in the upper center and left side for four days. It's like a deep achey burn. It's not acid refulx because I have had a scope done and it showed nothing. My arms are heavy and have pains in the left forearm, wrist, and near the shoulder. My ring and pinky fingers have a pins and needles feeling on both hands. I have upper back pain. I feel like I am having a heart attack. When I went to the ER three days ago, they did an EKG, chest X-ray, and blood work. My troponin was normal, but my D dimer was high at 247 when normal is <235. I know you can have heart attack symptoms for up to a couple months before you have the actual attack.
Is there any test they can do to see the cause of this pain? It is not anxiety because I have been sick for almost three months and it happened out of nowhere. I wore a heart monitor for three weeks and it showed sinus tachycardia and skipped beats every time I recorded such feeling. My blood pressure is also low with the systolic being always low. Currently, my pressure while sitting is 99/73 and my pulse is 90. I am 30 years old 5'4 and 116lbs. Throughout the time I have been sick, I have lost 15lbs from loss of appetite and nausea when eating. I was able to eat normally again a couple weeks ago, but for the last four days I am too sick to eat. My blood pressure has never been low like this before I got sick in early November.
Is there any test they can do to see the cause of this pain? It is not anxiety because I have been sick for almost three months and it happened out of nowhere. I wore a heart monitor for three weeks and it showed sinus tachycardia and skipped beats every time I recorded such feeling. My blood pressure is also low with the systolic being always low. Currently, my pressure while sitting is 99/73 and my pulse is 90. I am 30 years old 5'4 and 116lbs. Throughout the time I have been sick, I have lost 15lbs from loss of appetite and nausea when eating. I was able to eat normally again a couple weeks ago, but for the last four days I am too sick to eat. My blood pressure has never been low like this before I got sick in early November.
Brief Answer:
Stress thallium!
Detailed Answer:
Hi,
Thanks for choosing HCM.
Cardiac origin of chest pain is very unlikely in a young female unless there is a strong history of cardiac problem in family or patient is a cheonic smoker.
However as per your query,Yes you can go for Stress thallium test,It a nuclear based non invasive test in which activities of heart is observed pre and post exercise with the help of a radioactive XXXXXXX This test is highly sensitive (>98%) to rule out coronary artery disease,It would also help to know your cardiac output.cardiac output is the amount of blood pumped out of the heart to maintain blood pressure.
Intially few base line tests like 2d echo and stress test etc could also be done but even after combining them together their sensitivity is less then 80%.So i would recommend you to go for stress thallium test directly.
Please attach the reports of your hoter.
Tachycardia is due to low blood pressure.As cardiac output is low heart contracts more to maintain the supply of blood to periphary and other organs.
However heaviness in arms with a feeling of pin pricking(parasthesia) with history of back pain can be a indicator of problem with cervical spine,Hence a mri screening cervical spine should also be done.
D dimer is a old test and symptoms of pulmonary embolism are very different.Borderline elevationin D dimer does not make any significance.
Advice
follow up with reports
Stress thallium!
Detailed Answer:
Hi,
Thanks for choosing HCM.
Cardiac origin of chest pain is very unlikely in a young female unless there is a strong history of cardiac problem in family or patient is a cheonic smoker.
However as per your query,Yes you can go for Stress thallium test,It a nuclear based non invasive test in which activities of heart is observed pre and post exercise with the help of a radioactive XXXXXXX This test is highly sensitive (>98%) to rule out coronary artery disease,It would also help to know your cardiac output.cardiac output is the amount of blood pumped out of the heart to maintain blood pressure.
Intially few base line tests like 2d echo and stress test etc could also be done but even after combining them together their sensitivity is less then 80%.So i would recommend you to go for stress thallium test directly.
Please attach the reports of your hoter.
Tachycardia is due to low blood pressure.As cardiac output is low heart contracts more to maintain the supply of blood to periphary and other organs.
However heaviness in arms with a feeling of pin pricking(parasthesia) with history of back pain can be a indicator of problem with cervical spine,Hence a mri screening cervical spine should also be done.
D dimer is a old test and symptoms of pulmonary embolism are very different.Borderline elevationin D dimer does not make any significance.
Advice
follow up with reports
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Nagamani Ng
Answered by
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