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Has stroke with minimal left side damage. Having frequent chest pain and poor circulation in feet. What should I do?

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General & Family Physician
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I am a 51 year old female. I have had a small stroke that left only minimal left side damage and some memory deficit. I have frequent chest pain, have peripheral neuropathy, probable Raynaud's syndrome (secondary) or very poor circulation in feet. I had a chest x-ray that my pulmonologist was pretty confident showed an enlarged pulmonary artery. I was sent for an EKG and echo that didn't show any significant abnormalities. Because I had the EKG and echo can I be confident that my heart is ok. I haven't actually seen a cardiologist. I get tired of seeing doctors. I do have some other medical stuff going on too. I guess my chest pain bothers me, but I feel since I've had the tests I should be ok.
Posted Wed, 31 Jul 2013 in General Health
Answered by Dr. Michelle Gibson James 33 minutes later
Hi, thanks for using healthcare magic

Chest pain can be worrying to anyone.
Chest pain can be caused by any structure in the chest from the skin inwards.

Skin: persons with a history of herpes zoster or any neuropathy affecting the nerves in the chest can have chest pain. This is usually sticking or tingling in nature, there may be no known precipitating factors.
This is treated with agents such as tegretol, lyrica, gapapentin, amitryptiline.

Muscles- any strain or minor trauma of the muscles can result in pain but this would usually be worse with specific movements and there may be a history of trauma.
This would be treated by rest and the use of anti inflammatory pain killers.

Bones: pain can occur due to trauma or inflammation of the ribs. It can also occur due to costochondritis. This is inflammation where the ribs XXXXXXX the sternum. It can cause mild to severe pain which is worse on moving the torso. Pain can be felt when compressing the sternum. It would generally be constant discomfort.
It is relieved by the use of anti inflammatory pain killers.

Lungs-Pain can occur due to the lining of the lung (the pleura) or related to the lung tissue itself.
Pleuritis or pleurisy is inflammation of the lining of the lung.This pain is usually worse on taking a deep breath
Infections of the lung, blockage of any of the blood vessels of the lung (pulmonary embolism) can also cause pain but this would normally be associated with other symptoms such as shortness of breath or fever (if there is an infection)
The enlargement of the pulmonary artery may be due to a previous blood clot in the lungs , it can be a sign of increase pressure in the blood vessels in the lungs.
This is called pulmonary hypertension and it can cause chest pain as one of its symptoms.
The echo however would have normally measured the pressures in the pulmonary blood vessels to see if there were high.

The heart- you have been evaluated and the results did not demonstrate any abnormalities so as you rightly said, it is unlikely to be related to the heart.

Esophagus- spasm of the esophagus and GERD can cause pain. Esophageal spasm would normally present with pain that may seem to spread outwards, it would be associated with difficulty swallowing.

Chest pain can also occur due to anxiety. If physical examination and investigations are conducted to assess for the above and there are no significant abnormalities then anxiety is considered.

I hope this helps, feel free to ask any other questions
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