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Having sharp pain in heart. Feel fatigued. What to do?

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Cardiologist
Practicing since : 1998
Answered : 1306 Questions
Question
Having a sharp pain at the same spot in heart since 5 days and when I lay down it goes away also I feel fatigued. I'm 49 yrs and weigh 200 lbs with 6 feet height.
Posted Wed, 25 Sep 2013 in Heart Attack
 
 
Answered by Dr. Sukhvinder Singh 20 minutes later
Brief Answer:
Atypical features but still need evaluation.....

Detailed Answer:
Dear Sir
The pain of heart attack or angina is usually not sharp, it is not localized to a spot, and it usually does not go away on lying down. These are atypical features which makes the likelihood of this kind of pain to be a anginal a bit low. However, since this is a new onset pain and is persistent, it should be evaluated further. Moreover, Angina or heart attack as a cause of chest pain can not be entirely ruled out historically only. It should be corroborated by other evidences like a normal ECG/ normal enzymes, depending upon the clinical scenario.
Other possibility can be a musculoskeletal pain considering its localized nature and relation to posture.
Generalized fatigue is a feature which is an indicator towards important underlying cause.
In nutshell, Despite the fact that this pain is not typical of heart attack, it needs to be worked-up. I would recommend you to see your physician on priority for evaluation of this pain.
Feel free to discuss further.
Sincerely
Sukhvinder Singh
Above answer was peer-reviewed by
 
Follow-up: Having sharp pain in heart. Feel fatigued. What to do? 15 minutes later
I have also stoped smoking weed and im on the third day. I cut down on smoking too recently. I also got slight pain on my left kidney as it has been diagnosed with a stone. I have a misbeat too since 15 yrs now. Can any of this could be the cause of the sharp pain im having in my heart?
 
 
Answered by Dr. Sukhvinder Singh 7 minutes later
Brief Answer:
None of these is likely cause.

Detailed Answer:
Dear Sir
1. Cannabis withdrawal is not known to be associated with chest pain. It may be associated with mood swings, loss of appetite, anxiety, headache, sleep disturbance etc.
2. Missed beats per say will not cause chest pain. Neither they predispose to heart attack.
3. Kidney stone pain radiates to scrotal region and inner thighs and not to chest.
Hence these possibilities as suggested by you are not likely to be cause for your heart pain.
Hope this helps. Feel free to discuss further.
Sincerely
Sukhvinder Singh
Above answer was peer-reviewed by
 
Follow-up: Having sharp pain in heart. Feel fatigued. What to do? 16 minutes later
What kind of doctor do you recomend me for further investigate about my problem and what tests do you recomend?
 
 
Answered by Dr. Sukhvinder Singh 1 hour later
Brief Answer: XXXXXXX medicine specialist

Detailed Answer:
Respected Sir
1. You should see an internist ( XXXXXXX medicine specialist). If he/she is not available, then you can consult the emergency room physician.
2. The exact tests will depend upon clinical findings on examination. However an ECG should be done to look for ischemic changes. If no alternate cause is established, Cardiac enzymes should also be measured to rule out a cardiac event.
Hope this helps.
Sincerely
Sukhvinder
Above answer was peer-reviewed by
 
Follow-up: Having sharp pain in heart. Feel fatigued. What to do? 26 minutes later
Thank you Sir.
 
 
Answered by Dr. Sukhvinder Singh 1 minute later
Brief Answer:
You are welcome Sir.

Detailed Answer:
You are welcome Sir.
Sincerely
Sukhvinder
Above answer was peer-reviewed by
 
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