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What Causes Sharp Pain In The Left Side Of The Chest?
Question: Hi, I am 35 years, 65 Kg, height 5’6”, male from XXXXXXX I am having sharp pain in chest slightly leftwards for last 10 years. Sometimes this pain is also felt simultaneously in left shoulder or left arm or left head. Duration of this pain is 1- 5 seconds, mostly occurs while resting but its frequency and intensity is not certain. Sometimes it occurs while warming up or cooling down. Also noticed, that it is related to cold weather. Sometimes left part of head is numb and has pulsating pain. I do exercise, vegetarian except eggs, almost no dairy product, and no processed food. No tea coffee, no alcohol. Been smoker till 2008, quit. Had stomach acidity issue till 2012 but no more at all. There is no problem at all exercising in fact I feel great and energized doing it. None of my maternal or paternal relative have BP or cardiac issue except my younger brother who underwent Bentall’s procedure due to Aortic Dissection in march 2013, but he have a genetic condition called Marfan’s Syndrome, no other family member have this. I always thought it is muscular or gastro related, so it never bothered me until November 2015.
Last November on two successive nights I woke up feeling my chest pounding hard. Checked my BP and Heart rate everything normal on both occasions, but was not able to sleep well those nights every time fall asleep it woke me up I can feel my heartbeat and whole body is shaking in rhythm with it but my heart rate was absolutely normal. On third day all this panicked me I checked my BP it was raised so went to physician, BP 150/90 he told me its anxiety or due to some food, gave medicines for BP, anxiety and antacids. It helped me sleep, symptoms are as it is but milder now. Next day went to see cardiologist, I was too worried, he checked my BP 170/100, and did ECG, Tropnin T and ECHO all normal. Gave medicines for BP, anxiety and five days later did TMT, also normal. My BP came normal next day of visiting cardiologist and never XXXXXXX again. I also assumed it to be anxiety and stopped all medications, in 30-40 days everything was normal except that sharp occasional pinching which I was having for years but now more frequent. Summers of 2016 was ok not much issue.
In july 2016 suddenly foul smell (like from dead bodies) started coming from my lower centre chest. This smell is totally different from my body odor and it continued after that till date.
This November I felt some itching in centre chest on at least five different occasions while doing sudden exertion from rest like climbing a floor or getting up from chair or bed and rushing to open door.
On night of 28-nov-2016, I felt sudden tightening in my left upper chest for 1 or 2 seconds, during sexual exertion, it felt like something had grabbed it tried to find the muscular nature by examining different chest and shoulder muscles but didn’t find anything wrong. Checked BP it was normal. On 1-dec consulted cardiologist, was nervous , BP 170/90, I denied testing this time but he said in the wake of new event we have to do all tests again. LIPID, HBAC, ECG, ECHO, Tropnin T, Na & K, TMT all normal.
But this time ECG machine interpretation was “acute MI (inferior)” and Tropnin T level was 13.65 against normal value of 14.
Does this is anything to worry about?
What is that bad smell?
As symptoms are intensifying year after year, what may be the cause?
What further investigation can be recommended, if any?
Cold weather increases it, why?
Last November on two successive nights I woke up feeling my chest pounding hard. Checked my BP and Heart rate everything normal on both occasions, but was not able to sleep well those nights every time fall asleep it woke me up I can feel my heartbeat and whole body is shaking in rhythm with it but my heart rate was absolutely normal. On third day all this panicked me I checked my BP it was raised so went to physician, BP 150/90 he told me its anxiety or due to some food, gave medicines for BP, anxiety and antacids. It helped me sleep, symptoms are as it is but milder now. Next day went to see cardiologist, I was too worried, he checked my BP 170/100, and did ECG, Tropnin T and ECHO all normal. Gave medicines for BP, anxiety and five days later did TMT, also normal. My BP came normal next day of visiting cardiologist and never XXXXXXX again. I also assumed it to be anxiety and stopped all medications, in 30-40 days everything was normal except that sharp occasional pinching which I was having for years but now more frequent. Summers of 2016 was ok not much issue.
In july 2016 suddenly foul smell (like from dead bodies) started coming from my lower centre chest. This smell is totally different from my body odor and it continued after that till date.
This November I felt some itching in centre chest on at least five different occasions while doing sudden exertion from rest like climbing a floor or getting up from chair or bed and rushing to open door.
On night of 28-nov-2016, I felt sudden tightening in my left upper chest for 1 or 2 seconds, during sexual exertion, it felt like something had grabbed it tried to find the muscular nature by examining different chest and shoulder muscles but didn’t find anything wrong. Checked BP it was normal. On 1-dec consulted cardiologist, was nervous , BP 170/90, I denied testing this time but he said in the wake of new event we have to do all tests again. LIPID, HBAC, ECG, ECHO, Tropnin T, Na & K, TMT all normal.
But this time ECG machine interpretation was “acute MI (inferior)” and Tropnin T level was 13.65 against normal value of 14.
Does this is anything to worry about?
What is that bad smell?
As symptoms are intensifying year after year, what may be the cause?
What further investigation can be recommended, if any?
Cold weather increases it, why?
Brief Answer:
Non cardiogenic pain....
Detailed Answer:
Hi,
I went through your details with diligence. The described symptoms are not classical of cardiogenic pain. Further more you have been evaluated extensively and all your reports have been negative for cardiac pain. Even the latest reports done early this december were negative. Troponin T at 13.65 is still negative. And TMT is negative indicating there is no inducible angina or exercise intolerance.
Acute inferior MI noted on ECG script is a machine read comment which may not be always true. You can upload this ECG here and let me look at it.
Accordingly based on the details provided, my answers to your question are:
1. I am not worried about your situation. Perhaps it's related to anxiety alone.
2. At this point, I don't find any specific organic cause to explain this bad odor. I will suggest speaking to your doctor. He/she can examine the skin as well as digestive system to check for source of this odour.
3. As mentioned earlier, your symptoms and investigation report indicates a non cardiac pain more likely related to anxiety. I will suggest restarting antianxiety treatment through your doctor / specialist.
4. In my opinion, it would be good idea to treat anxiety phase. Further evaluation can be decided based on response to treatment.
5. Some nerve fibres get sensitized during cold weather and this may cause pain. You may have a similar issue. However I will look forwards to anxiety treatment response before considering any other possibilities here.
In short, based on the facts submitted, all your complaints may be secondary to anxiety. Getting treated for anxiety should benefit you.
Hope this answers your question. I will be available for clarifications.
Regards
Non cardiogenic pain....
Detailed Answer:
Hi,
I went through your details with diligence. The described symptoms are not classical of cardiogenic pain. Further more you have been evaluated extensively and all your reports have been negative for cardiac pain. Even the latest reports done early this december were negative. Troponin T at 13.65 is still negative. And TMT is negative indicating there is no inducible angina or exercise intolerance.
Acute inferior MI noted on ECG script is a machine read comment which may not be always true. You can upload this ECG here and let me look at it.
Accordingly based on the details provided, my answers to your question are:
1. I am not worried about your situation. Perhaps it's related to anxiety alone.
2. At this point, I don't find any specific organic cause to explain this bad odor. I will suggest speaking to your doctor. He/she can examine the skin as well as digestive system to check for source of this odour.
3. As mentioned earlier, your symptoms and investigation report indicates a non cardiac pain more likely related to anxiety. I will suggest restarting antianxiety treatment through your doctor / specialist.
4. In my opinion, it would be good idea to treat anxiety phase. Further evaluation can be decided based on response to treatment.
5. Some nerve fibres get sensitized during cold weather and this may cause pain. You may have a similar issue. However I will look forwards to anxiety treatment response before considering any other possibilities here.
In short, based on the facts submitted, all your complaints may be secondary to anxiety. Getting treated for anxiety should benefit you.
Hope this answers your question. I will be available for clarifications.
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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