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Dr. Andrew Rynne

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Exp 50 years

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Feeling nausea, esophageal pain, arm pain and back pain. Medical test normal. Any thoughts?

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Dr. Grzegorz Stanko

General Surgeon

Practicing since :2008

Answered : 5770 Questions

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Posted on Tue, 8 Jan 2013 in Hypertension and Heart Disease
Question: I have been experiencing very painful episodes of upper arm and upper back pain. These are often accompanied with some nausea and esophgial pain. I have had 2 ekg, an mri and a ct scan...all negative. These episodes started to occur in early November and only sporadically, when I was doing areobic exercise, such as tennis or running. They have escalated, however, and occur at any time almost every day, sometime twice a day. These episodes stop me in my tracks. I do slow breathing and they usually pass and I return to an absolute normal state of health. This is getting scary and it is really interfering with moy normally active life. I am schedule to see a vascular specialist but not for a few weeks. Your thoughts?? XXXXXXX
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Answered by Dr. Grzegorz Stanko 2 hours later
Hello!

Thank you for the query.

Your symptoms strongly indicate ischemic heart disease. EKG does not rule it out. You need to know that radiations not only destroys cancer cells, but also all other cells. If this radiation was localized to the chest, you can be sure that your heart vessels and aorta are involved into arteriosclerosis. This causes vessels narrowing and in some cases (like during the exercises) blood supply to the heart can be not sufficient. Moreover, radiation also can destroy heart valves.
This changes do not appear in a regular EKG. What you should have performed is a stress test and heart ultrasound. Also coronarography might be necessary.

Hope this will help. Feel free to ask further questions.
Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Grzegorz Stanko 18 hours later
Two questions... Would the Vascular specialist be the one to prescribe these tests?? AND...what kind of treatment would be involved???Thanks.
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Answered by Dr. Grzegorz Stanko 5 minutes later
Hello!

Vascular specialist seems not accurate choice as such specialist can diagnose only vessels diseases excluding heart vessels. Vascular surgeons do treat aortic aneurysms for example.
You should visit a cardiologist. He is the one who will perform heart ultrasound and stress test. Moreover he can also perform coronarography. If any changes in this tests, he may ask you to visit cardiac surgeon for heart surgery.
The treatment which can be done in your case strongly depends from the results of mentioned tests. If only heart vessels are changed, bypass surgery can be done. If the valves will be also changed, valve replacement can be done. Usually it can be done due to one surgery, but it is far too early to talk about it.

Hope this will help. Feel free to ask further questions.
Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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