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Suggest Treatment For Pain In The Left Hand

Posted on Fri, 7 Apr 2017

Question: Hello there,
on march-11-2017 I have grat pain in my left hand around midnight.
I rushed to the hospital there the did my ECG which was normal. and gave me some pain killer. And did Troponin I (High Sensitive)[1](EMER) which came negative. Afer one hour doctor again did my ECG and found some spices between V2-V5 section of ECG Doctor suggested that we can admit you to ICU and can monitor you for 24 hours according to protocol. As all the tests are negative I asked them for discharge. The doctor also mentioned that it could be due to gas and acidity. But I am not sure what was the exact reason. Also, i don't know psychologically why my mind going again and again towards left of my chest.

Answered by Dr. Rishu Saxena (1 hour later)

Brief Answer:
Very unlikely to be cardiac event as Troponin was normal.

Detailed Answer:
Hi,
Thank you for posting query on this forum.
I am Dr Rishu Saxena and I'm going to answer your query. I've reviewed the investigations.

Left sided chest pain including hands can be caused by a number of conditions including Gastritis, Heartburn, acid peptic disorder, high levels of anxiety or esophageal spasm.

As ECG and Trop I (highly sensitive for Infarction) were normal, chances of it being a cardiac origin pain are very unlikely.

Diversion of your mind again and again to your left side is because of post traumatic stress causing obsession.

I would suggest you to go for test called 2D echocardiography. If 2D echo is also normal you are clear from cardiac side. E.C.G is the baseline test of cardiology and many times misses a cardiac event, hence a 2D echo should be done to rule out the possibility.

If 2D echo is normal an anxiolytic like Etizolam can be taken for a few days to reduce levels of anxiety along with antacids and Proton pump inhibitor like Nexium.

A gastroentrology expert advice should also be considered.

Feel free to ask further.
Thanks

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Rishu Saxena (20 hours later)

Hello Rishu,

Thanks for your quick response. I had my 2D ECO today and uploaded the reports.
Please take a look. Also, I need your thoughts regarding my body structure I am 5.7" and my weight is 85KG.
Feeling little pain on left side of chest with some gap.
Also, I haven't taken those medicines as didn't notice.

Thanks,
XXXX

Answered by Dr. Rishu Saxena (11 hours later)

Brief Answer:
Follow up answer

Detailed Answer:
Hi Dear,
Sorry for a bit late reply.
Have gone through all your reports
Your 2D echo is perfectly normal.Most likely its not cardiac pain.However sensitivity of echo alone to rule out cardiac origin of pain is about 60%,So would recommend you to go for a test called stress test.Combined together stress test and 2d echo are more then 85% sensitive to rule out cardiac disease.

Please answer following questions in details-
Do you lift weights?
How are your anxiety levels?
Sleep cycle?
Smoker or alcoholic?
Relieving factor of pain?
How long does it lasts?
Do it persists when you are busy(you are not thinking about pain)?
History of Gastritis,Acid peptric disorder,Gases,Indigestion?
Lipid profile.
Blood pressure on normal days?
History of early cardiac event in family?

Above answer was peer-reviewed by : Dr. Remy Koshy

Follow up: Dr. Rishu Saxena (53 minutes later)

Hello Doctor,

Please find the answers to your questions:--
Do you lift weights? ---------- I use to but not going gym any more
How are your anxiety levels? -------High
Sleep cycle? ---- 4-5 hour
Smoker or alcoholic? ------- I smoke hukka sometimes
Relieving factor of pain? ------ Not sure
How long does it lasts? ----- Not sure
Do it persists when you are busy(you are not thinking about pain)? ----NO
History of Gastritis,Acid peptric disorder,Gases,Indigestion? ----- Yes
Lipid profile. ------ NA
Blood pressure on normal days? -------- Normal
History of early cardiac event in family? ------- NO

Answered by Dr. Rishu Saxena (52 minutes later)

Brief Answer:
Its not cardiac.

Detailed Answer:
Hi again,
Most likely the pain is related to you gastrointestinal system and anxiety.
Have nothing to do with your heart.
You are clear from cardiac side,However to be on safe side a stress test can be done.

Suggestion
Consult a Gastroenterologist in specific on this forum,And not just a MD.
Start taking Pantoprazole one tablet daily empty stomach.
Anxiolytic can also be considered after consulting a gastro.

Thanks and good luck XXXXXXX

Above answer was peer-reviewed by : Dr. Kampana