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Spasmodic Chest Pain Turning To Burning Sensation, Spells Of Nausea, Lightheadedness, Shortness Of Breath, Tingling Fingers. Cardiac Or GI Issue?
Question: Hello. For the past three weeks, I've been experiencing spasmodic sharp, stabbing pains on the left side of my chest, approximately an inch from my armpit. Although the pain initially presented following heavy meals, it has continued following light meals while sitting up and while laying down. Today, the pain appears to be transforming into a faint burning sensation in the same area, although it comes and goes within seconds. These episodes have been accompanied by a slight sensation of nausea, lightheadedness, minor shortness of breath, and thirst. Additionally, my left pinky and ring finger sometimes feel a bit tingly or numb. Should I be worried that these symptoms are cardiac-related, or are they more indicative of a GI issue?
Dear XXXXXXX
Thanks for your health concerns.
Although you are young, we can see obstructive heart disease in your age group as well, particularly if risk factors such as early first degree relatives with heart attacks, personal history of elevated cholesterol, diabetes, smoking or elevated blood pressure. Although some of the symptoms could be suggestive of reflux disease or gastritis, a treadmill EKG stress test might be considered to see if there is reproduction of symptoms or if there are electrical changes that might suggest heart disease. If this is noted to be normal, then I believe you and your doctor could focus more on other explanations including Gastro-intestinal and musculoskeletal causes.
Hope this is useful, wish you the best health, blessings,
Dr Brenes-Salazar MD
Cardiology
Mayo Clinic MN
Thanks for your health concerns.
Although you are young, we can see obstructive heart disease in your age group as well, particularly if risk factors such as early first degree relatives with heart attacks, personal history of elevated cholesterol, diabetes, smoking or elevated blood pressure. Although some of the symptoms could be suggestive of reflux disease or gastritis, a treadmill EKG stress test might be considered to see if there is reproduction of symptoms or if there are electrical changes that might suggest heart disease. If this is noted to be normal, then I believe you and your doctor could focus more on other explanations including Gastro-intestinal and musculoskeletal causes.
Hope this is useful, wish you the best health, blessings,
Dr Brenes-Salazar MD
Cardiology
Mayo Clinic MN
Above answer was peer-reviewed by :
Dr. Raju A.T
Good evening Dr. Brenes-Salazar,
Thank you very much for your prompt and insightful response. I do have an appointment scheduled with a potential next week and was wondering if there would be a reasonable case to request such a stress test. Under different circumstances, I would make such a request without hesitation, but the purpose of my appointment is to see whether the physician will agree to be my primary provider, in which case my next appointment wouldn't be until late XXXXXXX To complicate things further, my private insurance plan will not become active until XXXXXXX 1st at the earliest and is very limited in its coverage as it is not offered through any of my three employers.
With that said, would you say that there is enough risk for obstructive heart disease for me to request the stress test? To my knowledge, my parents and grandparents have not had a history of heart disease and did not experience heart attacks before age 60. Furthermore, there is no history of hypertension or diabetes within my family. Personally, I do not smoke, but at 160 pounds on a 5' 7" frame, I do consider myself to be overweight. Although I am still transitioning into a more physically active lifestyle, my primary job typically has me walking at a brisk pace for four hours at a time. During these times, I do not experience chest pain or tingling in my limbs, but I may feel slightly lightheaded or disoriented. I'm more than happy to request this test to complement the routine physical and detailed bloodwork that I already had in mind but only if it would be a sensible precaution against an elevated risk for my age group. Please let me know what your thoughts are. Thank you!
Very Respectfully,
XXXXXXX
Thank you very much for your prompt and insightful response. I do have an appointment scheduled with a potential next week and was wondering if there would be a reasonable case to request such a stress test. Under different circumstances, I would make such a request without hesitation, but the purpose of my appointment is to see whether the physician will agree to be my primary provider, in which case my next appointment wouldn't be until late XXXXXXX To complicate things further, my private insurance plan will not become active until XXXXXXX 1st at the earliest and is very limited in its coverage as it is not offered through any of my three employers.
With that said, would you say that there is enough risk for obstructive heart disease for me to request the stress test? To my knowledge, my parents and grandparents have not had a history of heart disease and did not experience heart attacks before age 60. Furthermore, there is no history of hypertension or diabetes within my family. Personally, I do not smoke, but at 160 pounds on a 5' 7" frame, I do consider myself to be overweight. Although I am still transitioning into a more physically active lifestyle, my primary job typically has me walking at a brisk pace for four hours at a time. During these times, I do not experience chest pain or tingling in my limbs, but I may feel slightly lightheaded or disoriented. I'm more than happy to request this test to complement the routine physical and detailed bloodwork that I already had in mind but only if it would be a sensible precaution against an elevated risk for my age group. Please let me know what your thoughts are. Thank you!
Very Respectfully,
XXXXXXX
Dear XXXXXXX
Thanks for the follow up query. If you have a recent lipid profile (cholesterol panel) done as you have, with your blood pressure and other parameters your heart disease in the next ten years through a risk calculator such as the framingham risk score. If putting all these variables together you are in the low risk category (usually less than 5% chance in the next 10 years) it might be reasonable to hold off on the stress test. If on the contrary you are found to be at least at moderate risk for cardiovascular disease he might feel more compelled to order it.
Hope that helps to clarify further.
Best regards
Dr Brenes Salazar
Thanks for the follow up query. If you have a recent lipid profile (cholesterol panel) done as you have, with your blood pressure and other parameters your heart disease in the next ten years through a risk calculator such as the framingham risk score. If putting all these variables together you are in the low risk category (usually less than 5% chance in the next 10 years) it might be reasonable to hold off on the stress test. If on the contrary you are found to be at least at moderate risk for cardiovascular disease he might feel more compelled to order it.
Hope that helps to clarify further.
Best regards
Dr Brenes Salazar
Note: For further follow up on related General & Family Physician Click here.
Above answer was peer-reviewed by :
Dr. Shanthi.E
Answered by
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