What Causes Chest Tightness And Left Arm Ache With Left Sided Jaw Pain?

Posted on Sat, 21 Jun 2014

Question: I was admitted to hospital last night and had an abnormal ecg but blood tests showed no heart attack
They said they think my arteries aren't getting enough oxygen and referred me to a cardiologist and sent me home
I suffer with chest tightness/pain and left arm ache and left sided jaw pain constantly

Will I be ok until I see a cardiologist? I'm so frightened I'm going to die

Answered by Dr. Anantharamakrishnan (1 hour later)

Brief Answer:
Relax / You are Ok / You will be OK

Detailed Answer:
Dear friend,
Welcome to Health Care Magic

Heart attack is not common in women / that too at this age / especially so during the fertile period.
The very fact that you have been discharged – means the doctors are confident, you didn’t have an attack! And that you could afford to wait…. If there was an imminent danger, they would not have sent you home…

Generally 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…

Coronary Artery Disease has to be excluded, if suspected… A Treadmill Exercise Electrocardiogram (TMT) is generally done. If it is normal, nothing further to do…. If in doubt, further work up is done..

If your problem is worse, you can go to ER again, any time / they can repeat the ECG and enzymes on the spot.

Take care
God bless

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Anantharamakrishnan (29 hours later)

What I'm frightened about is the abnormal ecg. Could I have a heart attack because of that? Why else would I be getting central chest pain/tightness and jaw and arm pain?

I know I didn't have a heart attack then but could I be leading up to one? With the abnormal ecg and the dr saying he thinks my arteries aren't getting enough oxygen?

Answered by Dr. Anantharamakrishnan (9 hours later)

Brief Answer:
Have a second opinion & more investigations

Detailed Answer:
Hi

There could be hundreds of reasons for an abnormal ECG.
An abnormality could at times bee a normal variation in some… it does not always mean something is wrong.
Also, it is not wise to conclude from a single ECG.
In case of doubt, we have to repeat it after a time..
We have to do stress ECG (treadmill exercise ECG).
If TMT (Treadmill Exercise ECG) 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.
At this age – if anything – a block is not at all common / birth defects like abnormal origin or course of coronary arteries (blood vessel) is more likely than block

Generally there are other indications in history and examination too.
Chest pain could be from muscle spasm, nerve irritation, ribs, food pipe and so on

It will be a good idea to have a second opinion
Angio is the definitive diagnostic tool

Regards

Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar