question-icon

What causes heart palpitations, tightness in left shoulder, neck and left arm?

default
Posted on Fri, 6 May 2016
Question: Hi,

I have been dealing with various health issues and am very worried. Back in December i was having heart palpitations. I mainly noticed them at rest, but there were a few times I felt them during exercise. Recently i have been having tightness in my left shoulder and neck down my left arm. I was extremely worried about this and visited the ER on the 21st which ran bloodwork, ecg, and chest xrays. Everything was normal but then this week (on the 24th) I felt a bit lightheaded at work. I went for a run at around noon and felt quite lightheaded after my run. I ended up going back to the Er and again the tests were normal. I finally got an appointment with my PCP on the 26th and he will be sending me to a cardiologist. Based on the negative tests in the ER, could i still be experiencing symptoms of an impending heart attack?
doctor
Answered by Dr. Ilir Sharka (2 hours later)
Brief Answer:
I would explain as follows:

Detailed Answer:

Hello,

Welcome back on HCM!

I carefully reviewed your recent clinical history and would like to explain that it is quite unlikely that your complaints be related to a cardiac ischemia disorder.

You young age, your repeated normal ECGs, laboratory cardiac markers and nonspecific clinical symptomatology suggest this conclusion.

So, you should relax!

Meanwhile, I would recommend exploring in different directions instead.

If your neck and left shoulder tightness (irradiating down your left arm) is associated with difficulty in exerting full arm movements, especially raising your arm from a horizontal position to vertical one, then an inflammation of brachial plexus should be ruled in/out.

In this regard, a nerve conduction study (ENG) is necessary for concluding a possible diagnosis.

Another responsible cause to be investigated is a cervical spondylarthrosis.

A cervical X ray study could clarify this issue.

In case of sufficient suspicions on the above issues cervical and brachial plexus MRI would be advisable for definitely refining the diagnosis.


But, if after a careful physical exam, lab tests and after exploring all the above mentioned options nothing results, then anxiety or just panic attacks could be a possible cause of your complaints.

You need to discuss with your attending doctor on the above mentioned issues.

Hope to have been helpful to you.

In case of any further uncertainties, feel free to ask me again!

Kind regards,

Dr. Iliri


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Ilir Sharka (5 hours later)
Should I not worry about the heart palpitations even when they occurred with exercise a few times?
doctor
Answered by Dr. Ilir Sharka (6 hours later)
Brief Answer:
Opinion as follows:

Detailed Answer:
Hi again,

I don’t see any reasons why you should worry about heart palpitations while exercising.

As far as your heart tests and other medical exams have concluded normal results you shouldn’t be concerned at that point.

You should know that palpitations are variably found in many normal individuals (especially more sensible ones).

Furthermore, in physical exertion and psychological stress heart palpitations are quite a common finding expressing also a more increased cardiovascular workload.

The only advice is to be careful with training: it is necessary that physical activity be gradually scheduled; preferably under an expert (physical trainer) supervision if possible.

Wishing you are having a pleasant weekend!

Kind regards,

Dr. iliri

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Ilir Sharka (10 hours later)
Last question. I keep reading stories of heart attacks being missed in young women because they are discharged too fast. Is it possible that i was seen too early the first time i visited the Er (within two hours of arm pain) then too late 10 days later and and 4 days after that?
doctor
Answered by Dr. Ilir Sharka (1 hour later)
Brief Answer:
A heart attack would have been revealed for sure.

Detailed Answer:
Hi,

As I explained you before your clinical symptomatology is quite impossible to be an expression of any cardiac disorders.

A heart attack, even if it could be missed at first medical contact in a hypothetically supposed situation, leaves distinct signs on ECG, cardiac ultrasound and underlying lab tests (including cardiac markers).

So, in my opinion, 10 days and four days after a cardiac injury would be hardly missed.

It is true that the world is full of surprises and exceptional situations, but this is not your case.

Instead, I advise you to consider discussing with your attending physician on the above mentioned alternative options and recommended tests.

Feel free to discuss with me any further uncertainties whenever you need.

Best wishes,

Dr. Iliri

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Ilir Sharka (6 hours later)
What about an impending heart attack? Is it possible to catch it before it happens?
doctor
Answered by Dr. Ilir Sharka (8 hours later)
Brief Answer:
My answer as follows:

Detailed Answer:
Hello again!

I would explain that impeding heart attack is quite impossible when all cardiac tests have resulted normal. So, relax and do not worry about it!

Nevertheless, a resting ECG and cardiac markers (myocardial enzymes) would help detect on time a possible myocardial infarct.

Hope to have clarified some of your uncertainties.

If you have any other questions, feel free to ask me directly at any time by clicking on the link below:

http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=69765

Best wishes,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Ilir Sharka

Cardiologist

Practicing since :2001

Answered : 8282 Questions

premium_optimized

The User accepted the expert's answer

Share on
What causes heart palpitations, tightness in left shoulder, neck and left arm?

Brief Answer: I would explain as follows: Detailed Answer: Hello, Welcome back on HCM! I carefully reviewed your recent clinical history and would like to explain that it is quite unlikely that your complaints be related to a cardiac ischemia disorder. You young age, your repeated normal ECGs, laboratory cardiac markers and nonspecific clinical symptomatology suggest this conclusion. So, you should relax! Meanwhile, I would recommend exploring in different directions instead. If your neck and left shoulder tightness (irradiating down your left arm) is associated with difficulty in exerting full arm movements, especially raising your arm from a horizontal position to vertical one, then an inflammation of brachial plexus should be ruled in/out. In this regard, a nerve conduction study (ENG) is necessary for concluding a possible diagnosis. Another responsible cause to be investigated is a cervical spondylarthrosis. A cervical X ray study could clarify this issue. In case of sufficient suspicions on the above issues cervical and brachial plexus MRI would be advisable for definitely refining the diagnosis. But, if after a careful physical exam, lab tests and after exploring all the above mentioned options nothing results, then anxiety or just panic attacks could be a possible cause of your complaints. You need to discuss with your attending doctor on the above mentioned issues. Hope to have been helpful to you. In case of any further uncertainties, feel free to ask me again! Kind regards, Dr. Iliri