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Developed sharp pain in the chest with cold sensation. Had acid reflux. Could this be heart issue?

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Practicing since : 1998
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Hi,
Last night, while lying down, I developed a sharp and sore pain in the centre of the chest about 8cms above the navel in perhaps the 4th rib area, it's about 2-3cms tall in area and 1-2cms in width.
At the same time, I experienced what I think was an icy cold sensation in the area which perhaps extended to the arms.
Could this be caused by the heart, I've also had an issue of acid reflux and thought perhaps that could cause the pain. There is no feeling of pressure or heaviness and no shortness of breath.


Thanks.
Posted Wed, 3 Jul 2013 in Hypertension and Heart Disease
 
 
Answered by Dr. Sukhvinder Singh 58 minutes later
Dear Sir,
A pain of angina is a feeling of pressure or heaviness, in the center of chest, which may radiate to other areas, comes on walking/ running or carrying weights/ exercise or may be increased by these maneuvers and relives at rest. Usually it is not a sharp pain. Mostly it is not a localized pain.
Hence your description has a few atypical features but still, it can not be concluded 100%, that your pain does not belong to heart. I would request you to see your physician on priority, so that the issue or cause can be sorted out. To rule out a cardiac cause not only involves history but examination and investigations also.
(We can not conclude, just by history, that it is not anginal, although history may suggest that it is not anginal.)
Hope this helps. Feel free to discuss further.
Sincerely
Sukhvinder
Above answer was peer-reviewed by
 
Follow-up: Developed sharp pain in the chest with cold sensation. Had acid reflux. Could this be heart issue? 4 minutes later
Dear Dr. XXXXXXX

Thanks very much for the information. I have had an exercise stress echocardiogram done in Sept. 2011 and an ECG in Aug. 2012. They were normal but my performance on the stress treadmill test was slightly below expected for my age although I understand there wasn't anything on the walls of the heart seen to indicate any issue.

Would you suggest a repeat of these investigations? My father has had a few stents in his heart in his mid 50s and my grandfather had a heart bypass around the age of 80, or perhaps it was in the 70s. Could a CT calcium score provide any useful information because I understand that unless the score is very low or very high, it usually doesn't yield much information.

Also, what does the icy cold sensation extending to the arms but not the back suggest most likely?

Thankyou.
 
 
Answered by Dr. Sukhvinder Singh 15 minutes later
Dear Sir
No, I would not suggest this (Exercise ECHO) to you. Only if your treating physician could not find a non-cardiac, satisfactory cause for your symptoms, he will advise these tests. He may find a cardiac cause, even then these tests will not be required. Yes an ECG should be done.
A negative or normal stress test does not warranty that you will not have a heart attack in near future. That is the limitation of stress test.
No I do not want you to get a CT calcium scoring. It does not add much to usual risk assessment.
An icy cold sensation may belong to disorder of nerves (first possibility), heart or at times food pipe. Sensation, and its description, is so subjective that it can be seen in isolation. It has to be evaluated with other findings.
Feel free to discuss further.
Sincerely
Sukhvinder
Above answer was peer-reviewed by
 
Follow-up: Developed sharp pain in the chest with cold sensation. Had acid reflux. Could this be heart issue? 14 minutes later
Thanks Dr. Sukhvinder,

I will present these symptoms to my physician and hope that he will firstly look at non-cardiac causes, as they are not typical for heart pain.


Thanks,
Best regards.
 
 
Answered by Dr. Sukhvinder Singh 1 hour later
Most welcome Sir.
Sincerely
Sukhvinder
Above answer was peer-reviewed by
 
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