Hi,

Thanks for the query.

1.     A heart rate of 60 to 100 beats per minute is normal. However, the heart rate are subjected to normal physiological variation at times of stress, anxiety, fever, infections, anemia and others. Apart from these, there are few other endocrine factors as well as cardiac conditions which may lead to high heart rate.
At the present moment, I would like to exclude an arrhythmia related to coronary artery disease (given that you have failed your treadmill test). This can be done an electrocardiogram which needs to be done when the heart rate is raised. An otherwise resting ECG also needs to be done.
I would suggest that you consult your physician and get a detailed examination and appropriate investigations done.

2.     A failed treadmill is suggestive of coronary artery disease. This is a condition where the blood supply to the heart (which is done by the coronary arteries) reduces in times of stress like exercise. This definitely warrants further evaluation and appropriate treatment with aspirin and other medications. I would also request you to answer the following questions:
A. Has a cholesterol level been done for you? If yes, can you please upload the reports?
B. When was the last time your blood pressure was checked? Was it high on any occasion?
C. Do you consume tobacco?
d. Do you have diabetes or any other medical disorder?
e. Has an echocardiogram or an angiogram been done for you? If yes, can you please share the reports?

3. It would have been better if you had mentioned what wakes up from sleep
- If it's chest pain, then it may be related to coronary vascular disease or heart burns. You may try over the counter proton pump inhibitors like ‘prilosec OTC’ once a day along with lifestyle modifications for the heartburn. However, given your history, I would strongly advise you to get yourself evaluated in detail by a physician or a cardiologist.
- If it’s due to any other symptom, please specify them to help me suggest better.

4. Numbness in the arm with difficulty to move it can occur due to
- Ischemic neuropathy (that results as a result of vascular compression of the limb). This is a reversible condition and symptoms improve in a few minutes.
- Transient Ischemic attacks which is a minor stroke condition.

A detailed neurological examination as well as screening for diabetes, cholesterols and others is warranted

I hope I have addressed your concern. Should you have any doubts with regards to my opinion, feel free to post them here. I will be glad to clarify them. Please accept this answer if you do not have any other query.

Best wishes.

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Hi,

Thanks for providing some more details about your problem. Let me work on them to help you understand your condition better.

Cold weather can trigger some changes in the heart functions - it needs to function faster and harder to maintain body temperature and hence the demand on coronary blood vessels is higher. Cold weather is also known to constrict blood vessels thereby reducing the oxygen supply to the heart. Both these phenomena are known to induce angina pectoris (chest pain) in many individual. You probably are experiencing the same during cold weather.

Further smoking half pack a day considerably increases the risks of coronary arterial disease apart from other medical illnesses.

With the presence of significant risk factors and episodes of frequent chest pains especially during cold weather, the need for further cardiovascular evaluation in high-lightened.

I advise you to consult your cardiologist at the earliest. Echocardiogram, angiogram and other cardiac investigations are warranted.

Hope I have answered all your queries. Should you have any other concerns; I will be available to address them too. And do not forget to accept this answer if you are satisfied with my answer.

Wish you all the best and good health!!

Best regards

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