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Experiencing chest tightness, shortness of breaths, pain in jaw and arm. X-ray, ekg normal. Heart attack?

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General & Family Physician
Practicing since : 2010
Answered : 661 Questions
I have been experiencing intermittent left jaw and left arm pain accompanied by chest tightness/fullness for about two weeks now. I went to the ER four days ago and they did an EKG, blood work (including cardiac enzymes), put me on a heart monitor and did chest x-rays. Everything was normal. I do have bad anxiety, which is what they told me it was as has every doctor I have been to in the past year regarding thinking something is wrong with my heart. However, the jaw and left arm pain is concerning me because it is somewhat new. I don't have to constantly, but seems like i do have it everyday and I get really scared when it comes on. In addition to my ER visit this past Sunday, I have had two other EKGs in the last month...all were normal....and a little over a year ago, I had an echocardiogram, a chest CT scan, and a holter monitor done....all of which were normal as well. My question is can I be assured with these tests and my lastest ER visit that my heart is fine and I am not having warning signs of a heart attack? I know my anxiety is really bad, but I just don't understand how anxiety could be causing all these physical symptoms like chest tightness, jaw pain, left arm pain, shortness of breath......Please help. Any advice you could give me would be greatly appreciated. I am having trouble functioning and living a normal life because I am so scared I am going to drop dead of a heart attack.
Posted Wed, 3 Apr 2013 in Heart Attack
Answered by Dr. Muhammad Ishfaq Habib 16 minutes later
Thanks for the query

All the diagnosis especially heart related problems are made on the basis of the investigations carried out. If they come back normal, we assume the patient is normal so if you tests are normal then it means you don't have any heart problem

The age for heart attacks is above 40 and you are still too young for it. Anxiety do cause such problems because it is a psychological problems and alter the neurotransmitter levels with the brain and thus producing symptoms throughout the nerve distribution so you have to assure yourself that you have a healthy heart and it is not at the age of developing problems :)

If you still have some query, feel free to ask

Above answer was peer-reviewed by
Follow-up: Experiencing chest tightness, shortness of breaths, pain in jaw and arm. X-ray, ekg normal. Heart attack? 14 minutes later
Thank you Dr. for your answer. Would the tests that I listed in my previous post (CT scan, echocardiogram, EKG, etc.) indicate if I had any type of blockage in my arteries? I guess I am most worried about a blockage or coronary artery disease because of the left arm pain and back pain and jaw pain that I have been experiencing. And lastly, would someone have heart attack symptoms for weeks without actually having a heart attack? I know that I am just 30 years old, but I have read on the internet about women in their 30's having heart attacks although I know it is very rare. I have no family history of heart trouble and I don't have high blood pressure or high cholesterol and I am 125 lbs. so I really don't have any risks factors that I can think of. Do you think there is any need to have any more testing done, and if so, what would it be? Again, thank you so much for your help.
Answered by Dr. Muhammad Ishfaq Habib 1 hour later
Thanks for the query

If there is was any blockade then EKG would have detected changes. Also you have done cardiac enzymes which is very much specific for conditions like Myocardial infarction and streptokinase is give on the basis of this test. So it would have certainly have raised if there was any minor blockage.

You also have done CT scan which gives very detailed image of the arteries and have only 10% less specificity than angiography which is invasive procedure and on one will ever advise to go for it without any reason.

So in my opinion, you do not need any further workup. just enjoy your healthy life as you are being over conscious. i would recommend you to have some sessions with psychologist for you anxiety.

If you still have query, feel free to ask, it will be my pleasure to help you out

Above answer was peer-reviewed by
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