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Chest tightness, pain in shoulder blade. EKG abnormal. Stress test scheduled. Can it wait?

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Practicing since : 1981
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two weeks ago I went to my physician because I had an episode where my chest was tight on the left side and I had mild pain in the left shoulder blade (just below it) and in the upper arm. They did an "EKG and indicated it was abnormal but didn't seem immediately concerned.

That seems to have continued for 5-7 days now and I'm nervous. I have a stress test scheduled for next week but don't know if I should wait or go to an ER.

Could it be something that can wait?


It doesn't seem to be affected by execs (I have been walking for three weeks at around 4 miles an hour for 45 min and have no problem). I definately feel it at rest but also while I'm walking. It has not gone away (but is constantly there)
Posted Mon, 10 Sep 2012 in Hypertension and Heart Disease
Answered by Dr. Anil Grover 5 hours later

Hi there,
Thanks for writing in.
I am a cardiologist and read your question with diligence.
Well, to diagnose a heart attack we follow World Health Organization Criteria (two out of three have to be positive)
1. Pain or angina equivalent symptoms rapid breathing rapid heart rate
2. Abnormal EKG especially EKG changes are dynamic that is change with time
3. Blood tests for heart enzymes that is Creatine Phospho Kinase Myocardial isoform(CPK MB) or Serum Myoglobin or Tropinin T or Troponin I.

Computer might have read EKG the way you describe but the attending doctor would have sufficient reasons to ignore that(in fact threshold to suspect and diagnose is kept very low so as not miss anyone may be at times even over diagnose) As on during your visit, you did not XXXXXXX the above criteria, it is highly unlikely that you had heart attack, then. But if you have apprehension, please visit ER for another EKG and TMT can wait or may not be necessary. You have hypertension that makes you for slightly higher risk for having heart attack. But the point against is nothing happens to chest pain on exercise. Personally, my suggestion is while waiting for TMT consult your regular doctor not necessarily a cardiologist so that your risk profile can be completed and your blood pressure is kept under control. As and when TMT is done - one is in better position to evaluate that. If you any further question I will be happy to answer. Good Luck.

With best wishes.
Dr Anil Grover,
M.B.;B.S, M.D. (Internal Medicine) D.M.(Cardiology)
http://www/ WWW.WWWW.WW
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