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What Causes Excruciating Pain In Chest, Back, Arm, Jaw And Neck?

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Posted on Wed, 28 Jan 2015
Question: I have been having excruciating pain in center of my chest and back, pain in arm, jaw, & neck. Shortness of breath sometimes. Gets worse when I eat sometimes. I have gone to the ER many times & all my ekg's: normal, Troponin I: <0.02 (0.00-0.05 reference range), Holter Monitor: Normal, Stress Test: Normal. Cardiologist says it's not my heart. Keep waking up randomly at night with a quick sensation of heaviness in my chest & racing heart. I don't know what to think....
doctor
Answered by Dr. Muhammad Ahmad (1 hour later)
Brief Answer:
It seems like a mixed issue, Muscles plus stomach.

Detailed Answer:
Brief Answer:
It doesn't seem to be a cardiac issue

Detailed Answer:
Hello

Welcome to Health Care Magic.
My name is Dr Muhammad Ahmad & i will look into your problem.

I have gone through your query and would try to help you in the best possible way.

I understand your concern and being a RESIDENT OF CARDIOLOGY myself, i will hereby try to talk about differentials for your better understanding and alleviating the anxiety you must be in.

Cardiac pains:
1- They are NEVER sharp excruciating pains,they are dull pains like soar muscles or a compression.
2-They start with work out and go away as you are at rest.
3- When its paining they in most case get relieved by a nitroglycerin tab under tongue.
4- Regular "work out cardiac pains" (angina) usually show up in stress testing.
5- They are very rarely present in men below 40.
6- They never Get worsened by food intake, they stay the same.

My opinion:

1- Its is not a cardiac issue doesn't fit ANY criteria. so you shouldn't be worried.
2- Your stomach seems to be having problems , that's why when you eat pain gets bad,because stomach releases acid at food intake. Stomach pain is mostly central or left sided and it can also be reffered to bacl.

3- Jaw and neck pain usually happens in muscle spasm of cervical muscles and nerves involvement. This can be due to prolonged sitting or standing plus old age changes in spine.

4- Some times our psychological experiences like anxiety or a dream makes our heart racing and we get up with this sensation and find our heart racing which makes us more anxious and worsens the situation.


WHAT CAN BE DONE:
1- Warm compresses at the tender area really help in most patients.
2- Local pain killer cream/gel like burfen cream or diclofenac Cream.
3- Pain killer like Tylenol do help.
4- I will encourage you to visit your physician and if you can visit a rheumatologist or an orthopaedic doctor, it will be great.
5- If this doesn't respond to simple pain killer treatment, your doctor may switch you to anti inflammatory meds and opioids.
6- You may also get consult with a physiotherapist for more targeted exercises.
7- For stomach you can use antacids it will help with pain after meal and that excruciating chest pain.
8- avoid Tobacco ,alcohol,spice, fried food and coffee, caffeine, (anything that applies )
9- I would also suggest my patient to use cap omeprazole 40mg for better relief.

WHAT TO EXPECT:

It just needs one or two months if good treatment care and physiotherapy and things will be much better.




END NOTE:

I would ask you not to worry this problem DOES NOT seem to be a serious one..with some rest care and medication it will subside in about a month hopefully.

Hope I have answered your query. If you have any further questions I will be happy to help if not then don't forget to close the discussion and rate it.
Wishing you good health !!




Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Muhammad Ahmad (4 hours later)
Here is a more descriptive details of my symptoms and history:

I get excruciating pain in the center of my chest and back, random hot sweats, pounding/fluttery sensation in chest (racing heart beat), pain in left arm (sometimes in right arm), pain in jaw (mostly on left side), shortness of breath, on and off. I've had these similar but milder symptoms inconsistently for the past year, but it has gotten very severe only recently (past week and a half). Whats new now is that I also get mild and excruciating headaches before or after along with random mild left thigh pain. I had the excruciating headaches with trouble comprehending speech and speaking on and off before the severity of the above symptoms started happening. I was checked out for this by two doctors and they said neurologically there was nothing wrong that it could be stress. I have to tendency to want to cough at times as well. I would say a few days before. I feel like I cant catch my breath when I stand up and my chest feels heavy. Chest pain, jaw pain, and arm pain wake me up sometimes at night or morning. I also wake up randomly with shortness of breath and like I'm grasping for air sometimes.

I am a 27 year old female, obese (BMI: 40.21--5'6" 249 lbs), with normal blood pressure when checked by doctor, sedentary lifestyle. Non-smoker, non-drinker. Cholesterol- LDL 111, HDI 49, Trig 61, Total: 172 (checked Sept. 2013). I have gone to the ER numerous times throughout the year because of the severity and intensity of my symptoms. They keep diagnosing me with GERD, they used to help a lot, now they don't help at all. I have seen a PA-C two times already and she keeps reassuring me that its not my heart, that I am too young to have heart disease. She recommended a 48 hour holter monitor (2013) for my palpitations, came out normal. Only yesterday did she let me have a stress ekg (because of the severity and consistency of my symptoms and the fact that I went to the ER numerous times) it came out normal. Every time I go to the ER (within the past few weeks, I've been there a total of 5 times), all EKG's were normal, Troponin I: <0.02 (reference range: 0.00-0.05).

I passed out at the hospital when waiting for the doctor during my recent visit, and he said my heart rhythm determined that my blood pressure lowered, when the monitor said it went really high, my heart rate went up to 130bpm. I don't know what to think or what to do, I am scheduled to see my doctor 1/7/2015 @ 10am, but I am VERY concerned about my symptoms. Thank you!
doctor
Answered by Dr. Muhammad Ahmad (5 hours later)
Brief Answer:
This DOES NOT look like a cardiac issue.

Detailed Answer:
Hi,
Thanks for writing back,
I understand your concern and i understand this is making you really anxious and i will try to explain things further to you before jumping into you differentials.

I will remind you of the nature of cardiac pains yet again:

Cardiac pains:
1- They are NEVER sharp excruciating pains,they are dull pains like soar muscles or a compression.
2-They start with work out and go away as you are at rest.
3- When its paining they in most case get relieved by a nitroglycerin tab under tongue.
4- Regular "work out cardiac pains" (angina) usually show up in stress testing.
5- They are very rarely present in men below 40.
6- They never Get worsened by food intake, they stay the same.

There is no indicative point in your history and test results which indicate a cardiac issue, I will explain every single issue you have by take excerpts from you own statement.

1-I get excruciating pain in the centre of my chest and back, random hot sweats, pounding/fluttery sensation in chest (racing heart beat).

This seems to be stomach issue which makes you anxious you start sweating plus your heart races due to pan and anxiety.

2-pain in left arm (sometimes in right arm), pain in jaw (mostly on left side), shortness of breath, on and off. my leg pains too now

This, as i told you in previous answer seems to be related to your life style... it's a neuro muscular issue you don't work out and have a sedentary life style so muscles get weak because of inactivity.Leg pain has same reason , low activity and heavy body leads to leg pain.

3- I've had these similar but milder symptoms inconsistently for the past year, but it has gotten very severe only recently (past week and a half).

It's because you are getting so anxious and thinking all the time about the problem.. when ever we focus on something , our brain enhances it in intensity whether it's you health your body your business or relations.

4-What's new now is that I also get mild and excruciating headaches. I had the excruciating headaches with trouble comprehending speech and speaking on and off before the severity of the above symptoms started happening.

Head ache is because of stress you are going through lately.

5-I feel like I cant catch my breath when I stand up and my chest feels heavy. Chest pain, jaw pain, and arm pain wake me up sometimes at night or morning. I also wake up randomly with shortness of breath and like I'm grasping for air sometimes.

Jaw and chest pain i believe are present because of the reasons i mentioned above and gasping happens when we get very anxious, you will also know that 100% of the time gasping or breathlessness occurs, you are suffering anxiety.

6-

I am a 27 year old female, obese (BMI: 40.21--5'6" 249 lbs), with normal blood pressure when checked by doctor, sedentary lifestyle. Non-smoker, non-drinker. Cholesterol- LDL 111, HDI 49, Trig 61, Total: 172 (checked Sept. 2013)

I have to congratulate you that you don't drink or smoke. and your lipid profile is so good, you can improve your HDL by working out, HDL save your heart. Your BMI should be from 23-27 i think you should consider reducing your weight.

7-I passed out at the hospital when waiting for the doctor during my recent visit, my heart rate went up to 130bpm.

It;s because you are taking too much stress in your visits, getting anxious about the outcome of the visit and that anxiety race your heart beat as well.


>>>I don't know what to think or what to do:

I will guide you through and i hope you will find some better way to deal with the problem.

It really needs your determination no one else can help you fight through.

1-Meet a physio therapist and start getting physiotherapy for your body pain issue.
2- Get your stomach treated but if you know there is what we call "stress ulcer" these ulcers are caused when a person is in stress so you have to get out of your stress to cure your stomach.
3-Meet a psychologist and get yourself out of stress with his help.
4- Start diet control and join a gym under very good instructor and reduce your weigh, i can assure you if your weight get reduced you will NEVER have heart or BP issues because with 40 BMI you have such a good lipid profile if you reduce weight there is NO WAY that your heart will get any problems in future.
5- Doctors , tests and examinations are there to rule out conditions we fear , when every doctor and every single test has told you that you DON'T have heart issues i think you should believe it and start considering other possible answer. You can't keep telling your self that if i have a jaw pain and left side pain i must have heart disease there are hundred other reasons which may be there, you have to trust professionals in this. I know it's hard to help getting worried but you have to fight it out, only your will can make it happen.

Hope I have answered your query. You can contact me directly when ever you want at
http://doctor.healthcaremagic.com/doctors/dr-muhammad-ahmad/69304

If you have any further questions I will be happy to help if not then don't forget to close the discussion and rate it.

Wishing you good health !!






Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Muhammad Ahmad (43 hours later)
Thank you for your detailed answer doctor! I appreciate it! Is my ldl number and hdl number putting me at high risk for heart disease now and in the future?
doctor
Answered by Dr. Muhammad Ahmad (6 hours later)
Brief Answer:
Your HDL and LDL are very fine. You can make them even better

Detailed Answer:
Hi,
Thanks for writing back

NO, your LDL and HDL are not in dangerous range .... and you might not be in danger for next 40 odd years but i suggested you to start working out for further decreasing the risk and betterment of your health status ...and to reduce risk even further in future, you have a super liver who is taking care of cholesterol even with such high BMI. You can help your liver and heart with exercise it will further make your health better..


Hope I have answered your query. You can contact me directly when ever you want at
http://doctor.healthcaremagic.com/doctors/dr-muhammad-ahmad/69304

If you have any further questions I will be happy to help if not then don't forget to close the discussion and rate it.

Wishing you good health !!

Dr. Muhammad Ahmad

M.B.B.S

Resident M.D-Cardiology.
Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
default
Follow up: Dr. Muhammad Ahmad (2 days later)
Thank you doctor! The reason why I was asking was because I was given this chart by the PA-C I saw for the stress test I had. It got me a little worried because, my hdl would be high risk & my ldl would be at risk according to this chart.
doctor
Answered by Dr. Muhammad Ahmad (19 hours later)
Brief Answer:
Don't Panic

Detailed Answer:
Hello,

Thanks for writng back,

I have closely seen the picture you sent me.

Yes HDL , if low , is considered as a risk, but to determine that if it is a risk for a particular patient, one needs to be a doctor.

HDL alone DOES NOT determine any thing, if your age was 50 your cholesterol was 200+ you had a high BP ... you were a smoker and had diabetes, then HDL would have been important.

BUT in your case, in 26 years of age with no diabetes and no smoking habits, where LDL is in upper limits ,HDL is low and cholesterol is 30 units below maxiumum limit, this low is NOT a big risk factor.


You can increase your HDL and reduce your LDL by very simple life style changes.

1- Reduce weight.

2- Don't consume, oily, fried, junk food, fizzy drinks, foods with high glicemic index and sugar content.

3- Brisk walk 5 times a week start with less and gradually increase the time as your body gets comfortable and stamina gets better.

4- Take cord liver oil capsule once daily..

5-Get your lipid profile checked after 2 months of life style change and you will see a big change

I hope this ansers the question, If you have more you can ask me otherwise close the discussion and rate it. Wish you health :)


Dr.Muhammad Ahmad.
M.B.B.S.
Resident M.D Cardiology.
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

Above answer was peer-reviewed by : Dr. Raju A.T
doctor
Answered by
Dr.
Dr. Muhammad Ahmad

General & Family Physician

Practicing since :2012

Answered : 1308 Questions

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What Causes Excruciating Pain In Chest, Back, Arm, Jaw And Neck?

Brief Answer: It seems like a mixed issue, Muscles plus stomach. Detailed Answer: Brief Answer: It doesn't seem to be a cardiac issue Detailed Answer: Hello Welcome to Health Care Magic. My name is Dr Muhammad Ahmad & i will look into your problem. I have gone through your query and would try to help you in the best possible way. I understand your concern and being a RESIDENT OF CARDIOLOGY myself, i will hereby try to talk about differentials for your better understanding and alleviating the anxiety you must be in. Cardiac pains: 1- They are NEVER sharp excruciating pains,they are dull pains like soar muscles or a compression. 2-They start with work out and go away as you are at rest. 3- When its paining they in most case get relieved by a nitroglycerin tab under tongue. 4- Regular "work out cardiac pains" (angina) usually show up in stress testing. 5- They are very rarely present in men below 40. 6- They never Get worsened by food intake, they stay the same. My opinion: 1- Its is not a cardiac issue doesn't fit ANY criteria. so you shouldn't be worried. 2- Your stomach seems to be having problems , that's why when you eat pain gets bad,because stomach releases acid at food intake. Stomach pain is mostly central or left sided and it can also be reffered to bacl. 3- Jaw and neck pain usually happens in muscle spasm of cervical muscles and nerves involvement. This can be due to prolonged sitting or standing plus old age changes in spine. 4- Some times our psychological experiences like anxiety or a dream makes our heart racing and we get up with this sensation and find our heart racing which makes us more anxious and worsens the situation. WHAT CAN BE DONE: 1- Warm compresses at the tender area really help in most patients. 2- Local pain killer cream/gel like burfen cream or diclofenac Cream. 3- Pain killer like Tylenol do help. 4- I will encourage you to visit your physician and if you can visit a rheumatologist or an orthopaedic doctor, it will be great. 5- If this doesn't respond to simple pain killer treatment, your doctor may switch you to anti inflammatory meds and opioids. 6- You may also get consult with a physiotherapist for more targeted exercises. 7- For stomach you can use antacids it will help with pain after meal and that excruciating chest pain. 8- avoid Tobacco ,alcohol,spice, fried food and coffee, caffeine, (anything that applies ) 9- I would also suggest my patient to use cap omeprazole 40mg for better relief. WHAT TO EXPECT: It just needs one or two months if good treatment care and physiotherapy and things will be much better. END NOTE: I would ask you not to worry this problem DOES NOT seem to be a serious one..with some rest care and medication it will subside in about a month hopefully. Hope I have answered your query. If you have any further questions I will be happy to help if not then don't forget to close the discussion and rate it. Wishing you good health !!