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What Do Severe Pain In The Left Arm And Normal ECG Result Indicate?
Question: I am an 89 year old female. I have a pacemaker. For the past 2 days I have had a 8 pain in my left arm. Yesterday the ambulance came to my Independent Living facility. I refused to go after an EKG was normal.
Brief Answer:
the ECG is not conclusive
Detailed Answer:
Hello,
first of all the ECG is not conclusive about acute coronary events. A negative ECG can sometimes be found in patients with such conditions. Only the enzyme assay (troponin) is conclusive if done 6 hours after the onset of pain. So the normal ECG does not exclude heart related pain.
Regarding arm pain it can indeed be caused by an acute coronary event but we usually also expect chest pain. Musculoskeletal injuries or other disorders may cause arm pain. Nerve compression is another common cause. Patients with cervical spine disorders may experience such pain. There are other less common sources of pain like swollen and tender lymph nodes in the axilla, etc.
In any case investigation is required. Clinical examination and proper testing may reveal the diagnosis. If clinical examination does not indicate a musculoskeletal cause then troponin assay would sound reasonable.
I hope it helps!
Kind Regards!
the ECG is not conclusive
Detailed Answer:
Hello,
first of all the ECG is not conclusive about acute coronary events. A negative ECG can sometimes be found in patients with such conditions. Only the enzyme assay (troponin) is conclusive if done 6 hours after the onset of pain. So the normal ECG does not exclude heart related pain.
Regarding arm pain it can indeed be caused by an acute coronary event but we usually also expect chest pain. Musculoskeletal injuries or other disorders may cause arm pain. Nerve compression is another common cause. Patients with cervical spine disorders may experience such pain. There are other less common sources of pain like swollen and tender lymph nodes in the axilla, etc.
In any case investigation is required. Clinical examination and proper testing may reveal the diagnosis. If clinical examination does not indicate a musculoskeletal cause then troponin assay would sound reasonable.
I hope it helps!
Kind Regards!
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Are you recommending that I go to the hospital ASAP. I am not getting any relief from Tramdol.
Brief Answer:
that would be better...
Detailed Answer:
Yes, it would be better if you did. Another thing to keep in mind is that if the pacemaker has substituted your heart in initiating the electrical signal required to move the heart muscle, then the ECG would have become very difficult to interpret. So I do believe that the cause of pain has to be clarified as soon as possible.
Kind Regards!
that would be better...
Detailed Answer:
Yes, it would be better if you did. Another thing to keep in mind is that if the pacemaker has substituted your heart in initiating the electrical signal required to move the heart muscle, then the ECG would have become very difficult to interpret. So I do believe that the cause of pain has to be clarified as soon as possible.
Kind Regards!
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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