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Pain in arm and shoulder blades, gas, bloating, tiredness. Need for concern about low heart rate readings?

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Hello. Since around February this year I have been experiencing differing symptoms which I am concerned may be heart related. I have visited my doctor who believes they are not related to my heart but more to symptoms of anxiety (which I suffer from) and some type of GERD.
I am 34, 13.5 stone in weight and 5' 5" tall, therefore around 2 stone overweight, having lost around 5 stone in weight over the last 3 years. My BP is generally around 125/72 in the morning and a bit higher in the afternoon around 128-130/74. My pulse is normally around 68 but after resting for a few hours normally rests are 58-59, with occasions where it goes down to 54-55.
I often experience mild pain in my left arm generally on the upper side of my arm around the elbow join and around my bicep area. I also have mild pain in my left shoulder and in between my shoulder blades, my doctor believes this relates to the GERD symptoms of gas and bloating (which I have) and the acid irritating the nerves. The pain does not seem to have any correlation with exertion. I am reasonably active, horse riding on average for 3-4 hours a week which I have been doing for around 5 months and less active prior to this although I had bouts of swimming and cycling to help reduce weight.
I occasionally feel tired and lethargic.
I had an ECG last year which was OK and my cholesterol level is also OK.
Should I be concerned of some heart related issue causing these symptoms and should I be concerned about the low heart rate readings.
Posted Sun, 25 Aug 2013 in Hypertension and Heart Disease
Answered by Dr. Anantharamakrishnan 26 minutes later
Hi friend,
Welcome to Health Care Magic

     Your symptoms do not suggest Coronary Artery Disease (CAD) – pain from the heart is oppressing, in central chest (and left), worse on effort, relieved by rest, may radiate to shoulders and arms, associated with sweating and so on. You have excellent effort tolerance and that itself is a point against heart as a cause of pain... However, it is better to have a Treadmill Exercise Electrocardiogram (TMT-may be with thallium isotope) - it will be the best option to exclude ischemia (reduced blood flow / Coronary Artery Disease).

     Standard ECG records the electrical activity of the heart, for a few seconds. It can detect the heart rate occurring during that time only. If the rate is slow and the episode occurs randomly, one needs Holter or event monitor.

An endoscopy will confirm the role of Oesophagus and the stomach.

If there are no clues and if the problem is still bothering, CT of the chest, as also of cervical and thoracic spine may help to elucidate lung and bone problems...

Take care     
Wishing speedy recovery
God bless
Good luck
Above answer was peer-reviewed by
Follow-up: Pain in arm and shoulder blades, gas, bloating, tiredness. Need for concern about low heart rate readings? 33 minutes later
Are my pulse readings a concern or considered ok/normal?

Answered by Dr. Anantharamakrishnan 2 hours later

Normal pulse (heart) rate is between 60 and 100 / Rate below 60 is slow - called bradycardia
Rate of 55 is generally no cause for immediate concern, but will need work up. It can be normal in some, especially athletes. / It can be lower at some times, and unobserved... hence suggested the need for Holter monitor (24 to 48 hours; ambulatory), for favour of further assessment and assistance

Above answer was peer-reviewed by
Follow-up: Pain in arm and shoulder blades, gas, bloating, tiredness. Need for concern about low heart rate readings? 7 hours later
I was wondering whether my symptoms could relate to TOS (Thoratic Outlet Syndrome) as I also have tingling in my left hand on the side of the little finger and the finger next to it and also signs of Carpal Tunnel as well as nerve tingling in my head. The neurologist I saw believed this was created by my anxiety symptoms.
Answered by Dr. Anantharamakrishnan 1 hour later
In overweight people, compression neuropathy often occurs – carpal tunnel, thoracic outlet and so on... / However, distribution in unrelated areas and tingling in the head are highly suggestive of Anxiety... / CT, as suggested, will usually settle the issue of outlet syndrome...

Above answer was peer-reviewed by
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