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What causes pain in shoulder and left arm?

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Posted on Mon, 16 May 2016
Question: In the past few weeks i gave been to the ER numerous times because of pain in my shoulder and left arm and was diagnosed with anxiety.
Oops. Didnt mean to send. I have had blood work and ecgs. All were negative. Today i have a slight tightness in my chest. Could this be heart related if I have already gone to the ER numerous times for similar symptoms?
doctor
Answered by Dr. Ilir Sharka (1 hour later)
Brief Answer:
I would explain as follows:

Detailed Answer:
Hello!

Welcome and thank you for asking on HCM!

I understand your concern and would explain that if your resting ECG and cardiac enzymes have resulted normal during these episodes, a cardiac cause (myocardial ischemia) could be excluded.

Is this pain modulated by body movement or respiration? This would indicate a musculo-skeletal pain.

What about your heart rate? What are your heart rate values during these episodes?

Anxiety could explain all this clinical scenario.

Nevertheless, other causes like inflammation or a cervico-thoracic bulging disc should be excluded, before concluding that it is just anxiety.

I would recommend performing a chest X ray study, a cervico-thoracic spine Xray study and inflammation tests (PCR, sedimentation rate).

A nerve conduction study to examine the nerves of the shoulder and the arm could help exclude possible nerve compression, beginning from the cervical column down through the arm (the brachial plexus inflammation).

Anyway, these tests are not emergent and can wait until you consult with your attending physician.

Hope you will find this answer helpful!

Kind regards,

Dr. Iliri



Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Ilir Sharka (4 minutes later)
What would CRP and sendimentation rule out?
doctor
Answered by Dr. Ilir Sharka (1 minute later)
Brief Answer:
My answer as follows:

Detailed Answer:
Hello again!

PCR and sedimentation rate are indication of inflammation. They would rule out inflammation of the soft tissues, including the nerves, muscles and ligaments.

Hope to have clarified this uncertainty.

Best wishes,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Ilir Sharka (2 minutes later)
Than you. k
doctor
Answered by Dr. Ilir Sharka (46 minutes later)
Brief Answer:
You are welcome!

Detailed Answer:
You are welcome!

I am glad to have been helpful!

Greetings!

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ilir Sharka (1 hour later)
Are there certain heart ailments that could be causing dizziness and arm pain that would not show up on these tests? I know they show heart attacks, but ro they rule out other things?
doctor
Answered by Dr. Ilir Sharka (34 minutes later)
Brief Answer:
My answer as follows:

Detailed Answer:
Hello again !

Usually in the ER when suspected for heart attack, are performed a resting ECG and cardiac markers (which are myocardial enzymes, whose levels raise during myocardial ischemia, because they are released by the dead cardiac cells).

If these tests result normal, myocardial ischemia is excluded.

Hope to have clarified your concerns!

Regards,

Dr. Iliri


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

Cardiologist

Practicing since :2001

Answered : 8596 Questions

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What causes pain in shoulder and left arm?

Brief Answer: I would explain as follows: Detailed Answer: Hello! Welcome and thank you for asking on HCM! I understand your concern and would explain that if your resting ECG and cardiac enzymes have resulted normal during these episodes, a cardiac cause (myocardial ischemia) could be excluded. Is this pain modulated by body movement or respiration? This would indicate a musculo-skeletal pain. What about your heart rate? What are your heart rate values during these episodes? Anxiety could explain all this clinical scenario. Nevertheless, other causes like inflammation or a cervico-thoracic bulging disc should be excluded, before concluding that it is just anxiety. I would recommend performing a chest X ray study, a cervico-thoracic spine Xray study and inflammation tests (PCR, sedimentation rate). A nerve conduction study to examine the nerves of the shoulder and the arm could help exclude possible nerve compression, beginning from the cervical column down through the arm (the brachial plexus inflammation). Anyway, these tests are not emergent and can wait until you consult with your attending physician. Hope you will find this answer helpful! Kind regards, Dr. Iliri