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What Causes Weakness In The Arm And Leg Along With Leg Pain?

Posted on Tue, 13 Sep 2016

Question: I was in the ER last Friday - chief complaint was leg pain & arm & leg weakness.
I had previously been in ER mid May diagnosed with nonstemi mi (possibly artery spasm induced because spasm wasn't relieved in time). I was admitted to hospital in May due to changes (t wave elevations) on ecg & rising troponin levels after serial testing (only went over .3 after about 4 hours then XXXXXXX to only .8 before it started dropping back within normal range). Cardiac XXXXXXX only showed a minimal 20% blockage, no stent intervention needed.
Since then spasms have become more frequent and are happening with exertion & at rest (they were previously only at rest, middle of night & in morning), I have been treating with long acting & sublingual nitro.
Then the pain in back, legs, knee started along with weakness ... So I went back to ER since I can not get in to Cardiologist until Nov.
I was told my ecg was normal & given muscle relaxers & ibuprophen to treat sciatica. Today I picked up my records from that visit and read the echo report (which was not viewed by a physician until 10pm Sunday). It states:
Normal sinus rhythm; left atrial enlargement; NSST&T Wave abnormality; abnormal ecg;
Significant changes have occurred when compared to ecg of 5/16/16.
I'm concerned that although the nitro relieves my spasms that the frequency (between 4-6 per day) is causing harm to my heart or that I may be at risk for a stroke - how can I get seen by a specialist before November, or am I just being paranoid? I should mention that my mother died of a cerebral aneurysm at 61. I am a 57 yo female.

Answered by Dr. Prof. Kunal Saha (6 hours later)

Brief Answer:
Regular medication should bring it under control. Regimen needs to be decid

Detailed Answer:
Thanks for asking on HealthcareMagic.

I have gone through your query and understand your concerns. You seems to have vasospastic or Prinzmetal angina. Indeed that increases your chances of getting a cardiovascular complication like heart attack. Nitroglycerine should provide relief. Prinzmetal's angina typically responds to nitrates and calcium channel blockers. Use of a beta blocker such as propranolol is contraindicated in Prinzmetal's angina. Prazosin has also been found to be of value in some patients. Unless your GP can advise you on these, the only option would be to consult a cardiologist. So, if possible try to hasten the appointment.

Getting a CT Coronary Angiogram will help in reflecting the present condition of blood vessels supplying the heart. That could help in determining further line of action.

Feel free to write back in case of further queries.

Regards

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Prof. Kunal Saha (6 hours later)

Am already trying all the things you have mentioned & have had heart XXXXXXX (results are in my initial question). Main concern is report on recent ecg (see initial question) wondering if the frequency of these spasms is affecting my heart or if I may be at risk for a stroke.

Answered by Dr. Prof. Kunal Saha (52 minutes later)

Brief Answer:
Increased risk of heart attack, not stroke.

Detailed Answer:
Thanks for writing back. The spasms could increase the propensity of a cardiovascular event (heart attack) but not a cerebrovascular accident (stroke).

Regards

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Prof. Kunal Saha (11 minutes later)

What about the recent ekg report - it seems to indicate that there may have been (or is) another event - especially with the note about "significant changes" to previous ekg?

Answered by Dr. Prof. Kunal Saha (59 minutes later)

Brief Answer:
I have kept it in my consideration

Detailed Answer:
Yes, my comment is based on that.

Regards

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

Above answer was peer-reviewed by : Dr. Vaishalee Punj