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I am smoker. Started feeling pain in arm and sweating while sleeping. Is it related to heart disease or stroke?

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Practicing since : 1981
Answered : 922 Questions
Hello Doctor,
Last night in my half sleep I felt pain in my Left Arm and I was sweating as well. I had heavy dinner (non-veg) 30minutes before sleeping and it was little more oily than usual.
I am a smoker and smoke around 7-8 cigarettes per day (though trying to quit) and my BMI is 27.75. Also I feel physically exhausted too early like climbing stairs (3 Floors)
I am worried now because I've read somewhere that left arm pain could be a symptom of heart disease or stroke.
Now I am determined to start a healthy life style (quit smoking, balanced diet and Exercise).
Knowing all these facts, does it look like alarming situation?
Do I need some examination / diagnostic tests to be sure about my health?

Thanks in Advance!
Posted Sun, 19 Aug 2012 in Hypertension and Heart Disease
Answered by Dr. Anil Grover 2 hours later

Thanks for writing.
I am a qualified and certified cardiologist. I read your mail with diligence. I can assure you, while it is good that the episode made you aware that you need to change your life style, it was not a heart attack. Let me start with the risk factors for coronary artery disease or stroke. Then you decide for yourself which doctor you have to see.
You need a doctor to follow you up. Including filling in the unfilled information about risk factors for coronary artery disease. Thirty three is just the right age to start acting on prevention so that you do not have heart disease later in life. So let us start with risk factors.
At any age, following is the list of risk factors for future development of Coronary Artery Disease. Let me enumerate and you can place yourself the risk you are carrying ('*' means you have the risk factor, '+/-' means I do not know and about others you know better):-

Diabetes +/-
Stress* (who does not have stress in our modern day life?)
Obesity and Sedentary Life Style+/-
High Bad Cholesterol and Lipid Component +/-
Total Cholesterol above 190 mg%, LDL above 130 mg%, VLDL above 40 mg%,
Triglycerides above 150 mg%, Apolipoprotein B above reference value
Low Good Cholesterol and Lipid Component: +/-
Apolipoprotein a below reference range for the lab and
HDL below 40 mg% for man & and 50 mg% for woman
Family History 0f Coronary Heart Disease +/-
Increasing age*
Being a Man (as opposed to women) till the age 45*

From the list, above you have some risk factors. Smoking, Stress, being a man and increasing age has been identified. Therefore, I will strongly recommend consulting your doctor; he may complete the list as well do the EKG / TMT to find out target organ damage due to smoking. It is good that you have decided to give up smoking but that is easier said than done. Take help of the doctor, nicotine gum or patch or spray, but do give this habit up.
It is never too late to change. With your weight (which you have not written but I am presuming you are overweight) everything you do will have to be under supervision. It need not be cardiologist but your primary doctor can guide your way back to health - I am happy to read that your intention is to do that. You may need drugs and he/she (or ask the dietitian) to advise you about diet low in calories and cholesterol, advise you on quantum of exercise. You ought to keep your weight under control for you do not want other attack. If you like non vegetarian food, you cannot take red meat but there is no bar (in taking certainly quantity had to be less) on egg white, roasted chicken and roasted fish.
Exercise: Brisk walk at the speed of 5 KM/Hr for 40 minutes per day every day is enough aerobic exercise you need for keeping your heart healthy. If you have any query I will be too happy to answer. Good Luck.

With Best Wishes
Dr Anil Grover,
Medical Specialist & Cardiologist
M.B.;B.S, M.D. (Internal Medicine) D.M.(Cardiology)
http://www/ WWW.WWWW.WW
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