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Is Experiencing Weird Shoulder Discomfort, Chest Discomfort And Jaw Pain Due To Cardiac Issues?

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Posted on Wed, 12 Jan 2022
Question: Possible cardiac issues? I have been experiencing weird shoulder discomfort on the left side that comes and goes. Recently I've also started to experience same type of discomfort in my jaw. Rarely does these feelings come with direct chest pain, however I have felt chest discomfort too. I had echo which was otherwise normal but showed mitral valve prolapse but doc said shouldn't cause any issues. I also had an exercise stress test. It did not show any ST segment depression nor did I have chest pain during it. However, I had three PVCs during the recovery period and felt very dizzy, ALSO, I found this study;
https://www.aafp.org/afp/1998/1001/p1126.html

"The three-minute systolic blood pressure ratio, another important indicator of significant coronary artery disease, is a useful and readily obtainable measure that can be applied in all patients who are undergoing stress testing for the evaluation of known or suspected ischemic heart disease. The ratio is calculated by dividing the systolic blood pressure three minutes into the recovery phase of a treadmill exercise test by the systolic blood pressure at peak exercise. A three-minute systolic blood pressure ratio greater than 0.90 is considered abnormal and has a diagnostic accuracy of approximately 75 percent for the detection of coronary artery disease (i.e., an accuracy comparable to that of ST-segment depression). Higher values for the ratio are associated with more extensive coronary artery disease, as well as an adverse prognosis after myocardial infarction."

My peak exercise systolic value was 182 and 3 minute into recovery it was 168. This makes the ratio for me; 0.92. Should I be concerned and ask for further testing? Could poor physichal health cause slower BP recovery without heart disease?
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Answered by Dr. Dr Sameer Maheshwari (40 minutes later)
Brief Answer:
You need further evaluation

Detailed Answer:

Hi,

Jaw pain and arm pain along with chest discomfort could be a sign of Coronary artery disease.
And yes 3min systolic bp is a indicator of possible chances of having a coronary disease in future despite having a normal stress test and I can see yours is on the high side.

So I'll advise you to get a better test done which is CT Coronary Angiogram which is a non invasive and a test with better sensitivity and specificity.
If that is normal than their is nothing to worry and you just have to maintain a healthy lifestyle and exercise regularly.

Thanks and take care
Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Nagamani Ng
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Answered by
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Dr. Dr Sameer Maheshwari

Cardiologist

Practicing since :2010

Answered : 818 Questions

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Is Experiencing Weird Shoulder Discomfort, Chest Discomfort And Jaw Pain Due To Cardiac Issues?

Brief Answer: You need further evaluation Detailed Answer: Hi, Jaw pain and arm pain along with chest discomfort could be a sign of Coronary artery disease. And yes 3min systolic bp is a indicator of possible chances of having a coronary disease in future despite having a normal stress test and I can see yours is on the high side. So I'll advise you to get a better test done which is CT Coronary Angiogram which is a non invasive and a test with better sensitivity and specificity. If that is normal than their is nothing to worry and you just have to maintain a healthy lifestyle and exercise regularly. Thanks and take care