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Dr. Andrew Rynne

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What causes chest discomfort and pain in the palm of the hand?

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Dr. Sagar Makode

Cardiologist

Practicing since :2013

Answered : 1717 Questions

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Posted on Thu, 30 Mar 2017 in Hypertension and Heart Disease
Question: This is XXXXXXX iam 40 year old.

I had an Angiogram in October 2016 and it was normal(Clear Arteries), i smoke 3 - 5 cigarette a day, i take Novostat CV 10 and every alternate day since 1 year and do brisk walk every day for 30 Mins.My Lipid profile is normal and i dont have BP but iam diabetic but which is under control through medication, from past 2 months i get chest discomfort and light pain which dosn't radiate and pain in my palm(Near my thumb) after i smoke, i won't get tired and shortness of breath while brisk walk or on climbing of stairs. Yesterday had a ECG and BP test done both were normal. My Cardiologist says its a pain related to chest muscle . Wanted to know if this is related to any Cardio problem and why is the pain occurring after i smoke
doctor
Answered by Dr. Sagar Makode 56 minutes later
Brief Answer:
See the description

Detailed Answer:
hello,
This is unlikely to be cardiac pain. Firstly, cardiac pain would occur on exertion and relieves with rest. Also, your angiography was normal. Although, there can be disease of very small vessel, where angiography can be normal called as microvascular angina, but your symptoms are not compatible.
What kind of pain is this, does it increase on deep breathing. There are two possibilities I am keeping, first is of smoking induced lung irritation. This occurs due to irritation of lung linings due to smoke which would result in a pain. Secondly, it can be a reflux disease, especially if it is associated with bloating burping nausea vomiting, sour water feeling in throat etc symptoms. Smoking may aggravate both these conditions.
I would advise for one treadmill test if not already done, just to rule out microvascular angina.
You should try to cut down the smoking, because it's a very strong risk factor for heart diseases, and also you are diabetic. You should also have some antacid with prokinetic like tab Pan DSR beforebreakfast once a day for 2 weeks.
You should have a healthy lifestyle like avoiding fatty, oily and high calorie diet. Have low salt diet and monitor blood pressure regularly. Regular exercises like brisk walking, jogging according your capacity atleast 30 min a day and 5 days a week. Lots of green leafy vegetables, fruits, fish once or twice a week, avoid meat. Avoid smoking and alcohol if any. There shouldn't be abdominal fat deposition or obesity. Hope this helps you and get back if you have any doubts.
Above answer was peer-reviewed by : Dr. Remy Koshy
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Follow up: Dr. Sagar Makode 1 hour later

Thank you so much for your valuable consultation , just one question for my curiosity, after angiogram(Normal result) how much time will it take to built a plaque in artery for a smoker again in future ?

Aim planning to quit smoking at the earliest.

I do brisk walk of 30 Min. every day, take 2 floor stares to my office , i take Novostat CV 10 every day, i dont eat junk or fatty food , but iam little obese. I have mild alcohol (Beer) once in a week.



doctor
Answered by Dr. Sagar Makode 1 hour later
Brief Answer:
See the description

Detailed Answer:
It's ok to have occasional drinks.
It usually takes years, depending upon the genetic and other factors. In your case, if it has to be formed, then it will take Atleast 5-10 years. However, these are approximate estimates and cant be exactly judged. Sometimes, even a very mild plaque, may rupture and form a clot, leading to 100% obstruction. However, don't worry about it, just keep on exercising daily basis, if you have any symptoms during heavy activities then should be evaluated. Its like stress test and capture disease in early stage. All the best.
Above answer was peer-reviewed by : Dr. Nagamani Ng
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