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Suggest Treatment For Chest Pain And Numbness

Posted on Wed, 15 Apr 2015

Question: Hi, I am feeling non specific chest pain, usually left side of chest..sometimes numbness / dull ache in left arm....I had visited a cardiologist....had ecg, it showed probable lvh... doctor had 2 d doppler echo thereafter... normal report.. My lipid profile report had remarked a total Chol 202, LDL Chol 140 and triglycerides..110.I have been prescribed concor am 5 since then... one year passed from last echo.. still feels numbness / pain...i have gastric problems also.. I have a BP monitor..reading mostly comes below 120/60... pulse sometimes go below 55 beats per minute..I am anxious whether, there is any artery blockage to my heart...Plse guide me for further management...Regards

Answered by Dr. Sandip Kabra (2 hours later)

Brief Answer:
You should not bother about artery blockage.

Detailed Answer:
Hi,
Welcome to health care magic,

Left sided chest pain doesn't necessarily arise from the heart.

Your ECG finding was indicative of LVH but your 2D-ECHO of heart came normal as stated by you.

Your cardiologist would have mentioned the thickness of left ventricle wall (in mm) in your 2D-ECHO report.If it is lees than 110 mm then you should not bother about LVH.

ECG indicates electrical activity of heart and condition of its chambers and it is a basic screening procedure of the heart although it is important.

2D-ECHO is more accurate and reliable marker than ECG as far as heart walls thickness and pumping is concern.

Your lipid profile is almost normal except LDL value is slightly above normal but not high.

You should continue with Tab.Concor-AM 5mg as your blood pressure is also under control with this tablet.

It could be possible that your gastric problem is causing your numbness or chest pain over left side.You can go for routine blood count,serum vitamin B12 level(mainly for numbness) with ultrasound abdomen.

You can consult any gastrophysician for it.

Antacid or proton pump inhibitors drugs can help to relief but the important thing is to diagnose this gastric problem first.

Lastly,you should not bother about artery blockage in the heart because your ECG report had not given any sign of ischemia rather just LVH as stated by you.

Coronary angiography can detect the exact site and size of the blockage at coronary arteries but in your case it is not required as per your symptoms and Echo,ECG report.

Do ask me if there is any doubt.

Thanks
Dr.Sandip Kabra

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Sandip Kabra (33 hours later)

whether ecg is indicative of artery blockage? I had lvh in ecg, 2d echo normal...ecg showed sinus rythm-normal P axis, V rate 50-99, probable lvh-multiple lvh criteria....Rate 76, PR 158, QRSD 97, QT -364, QTc- 410, Axis P 43 QRs 42, T 7....12 lead standard placement...Kindly interpret the result....is it required to go for cardiac catherisation for artery blockage...Plse guide me...Regards

Answered by Dr. Sandip Kabra (4 hours later)

Brief Answer:
No need of cardiac catheterization.

Detailed Answer:
Hi,
Thanks for your follow-up query.
ECG shows electrical activity and contratality of heart with structure of the heart chambers.
As your ECG finding is suggestive of LVH and if it has come normal in 2D echo finding then there is no need to worry.
Your ECG figures are almost within normal limits and importantly they are not indicating of any ishmemic changes.So,you do not need to worry about any heart issue or further evaluation like angiography.
Still,if have any doubt you can consult your family physician for clinical correlation with symptoms.
Thanks.

Above answer was peer-reviewed by : Dr. Pradeep Vitta

Follow up: Dr. Sandip Kabra (4 hours later)

I still feel frequent numbness, discomfort in left arm, sometimes pain...in back of shoulder...I m worried....mostly during evening after working hours in office..I am disturbed what is this due to.... could you suggest some probable causes...I m taking concor am 5 daily and sometimes my pulse falls below 50, diastolic pressure below..60..whether this can be due to the medicine.. Plse guide... Regards

Answered by Dr. Sandip Kabra (4 hours later)

Brief Answer:
Could be due to muscle strain or vitamin B deficiency.

Detailed Answer:
Hi,
One thing is clear that your numbness or discomfort of left arm to shoulder is not due to any heart problem.
Your pulse and diastolic blood pressure might be due to Tab.Concor asthis bisoprolol drug has this side effect in some cases.You can consult your treating physician for dose titration.
Your numbness or discomfort in left arm and sometimes pain in back of the shoulder in the evening time after working hours in office is seems to be a muscle strain. It can also be due to vitamin B12 deficiency specially in strict vegetarians unless there is history any nerve or bone involvement.
you can go for serum Vitamin B12 testing and take symptomatic treatment like non-steroidal analgesics and gabapentin with mehyl-cobalamine from your physician.
Better you consult your treating physician and take further advise for your gastric and above problem.
Thanks

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

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj