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Pain In The Chest And Upper Back, Arm. Nausea, Dizziness And Shortness Of Breath. Checked Blood For Cardiac Enzymes, Did EKG. Normal Results. Advice?

I am a 45 year old female. For 2 days I have been having pain in my chest (very slight), pain in my upper left back by the shoulder blade, pain in arm, tingly fingers, nausea , dizziness and shortness of breath. I went to the ER yesterday and they did an EKG and drew blood twice in 3 1/2 hours for cardiac enzymes. They said everything is normal. Today I am still having all the symptoms. I am a little worried, but am reluctant to go back.
Sat, 4 Aug 2012
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Cardiologist,  's  Response
Hi there. Thanks for writing in. I am a qualified and certified cardiologist and I read your mail with diligence. For diagnosing heart disease two out three should be present. 1. Typical Pain 2. EKG changes which appear later 3. Serum enzymes elevation. Obviously, these criteria were not satisfied yesterday. As I said, EKG and enzymatic changes are dynamic and can present within 24 hours, I would urge you to go their today. In worst case scenario also the diagnosis of presence or absence of heart disease will be confirmed. This has long term implication. Alternatively, you may be suffering from Gasto Esophageal Reflux Disease (GERD) which at times mimic heart disease but actually a highly treatable non-cardiac condition. Avoiding ER will not solve this problem of yours. Go ahead to ER. Good Luck.
With Best Wishes.
Dr Anil Grover,
MBBS, MD (Internal Medicine) DM (Cardiology)
Cardiologist
http://www.healthcaremagic.com/doctors/dr-anil-grover/63370
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Pain In The Chest And Upper Back, Arm. Nausea, Dizziness And Shortness Of Breath. Checked Blood For Cardiac Enzymes, Did EKG. Normal Results. Advice?

Hi there. Thanks for writing in. I am a qualified and certified cardiologist and I read your mail with diligence. For diagnosing heart disease two out three should be present. 1. Typical Pain 2. EKG changes which appear later 3. Serum enzymes elevation. Obviously, these criteria were not satisfied yesterday. As I said, EKG and enzymatic changes are dynamic and can present within 24 hours, I would urge you to go their today. In worst case scenario also the diagnosis of presence or absence of heart disease will be confirmed. This has long term implication. Alternatively, you may be suffering from Gasto Esophageal Reflux Disease (GERD) which at times mimic heart disease but actually a highly treatable non-cardiac condition. Avoiding ER will not solve this problem of yours. Go ahead to ER. Good Luck. With Best Wishes. Dr Anil Grover, MBBS, MD (Internal Medicine) DM (Cardiology) Cardiologist http://www.healthcaremagic.com/doctors/dr-anil-grover/63370