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What Could Cause Chest Pain Or Shoulder Pain While Asleep?
Question: Dr-
1. Last week I had some pain in the middle of my chest while asleep on 2 occasions. It woke me up both times. Then after a few minutes it went away & I feel back asleep.
2. So I went to the emergency room the next day & they gave me an EKG/ECG & they gave me blood tests to test my enzymes & said everything was ok.
3. Last night I awoke while asleep because my left shoulder blade was hurting but no chest pain; so I changed positions while lying down & then pain got better.
4. I'm wondering if all these symptoms suggest something serious? Like a heart condition? What do you recommend?
1. Last week I had some pain in the middle of my chest while asleep on 2 occasions. It woke me up both times. Then after a few minutes it went away & I feel back asleep.
2. So I went to the emergency room the next day & they gave me an EKG/ECG & they gave me blood tests to test my enzymes & said everything was ok.
3. Last night I awoke while asleep because my left shoulder blade was hurting but no chest pain; so I changed positions while lying down & then pain got better.
4. I'm wondering if all these symptoms suggest something serious? Like a heart condition? What do you recommend?
Brief Answer:
I would recommend as follows.
Detailed Answer:
Hello,
Your symptoms are not typical of any cardiac disorder. You should know that cardiac chest pain is usually triggered by physical activity.
The normal test results, including the ECG in the ER are another argument to exclude any cardiac issues.
The fact that the chest pain occurs only during sleep could indicate a possible gastro-esophageal reflux or musculo-skeletal pain.
The fact that the change in body position modulated the pain in one episode could be indicative of a musculo-skeletal pain.
Coming to this point, I would recommend taking an anti-acid or PPI (Omerprazole, Pantoprazole) and see if your situation improves.
If your situation improves after trying these drugs, I would recommend performing a fibrogastroscopy.
Otherwise, I would recommend performing further tests to investigate for the possible causes underlying your symptoms:
- A chest X-ray study
- Complete blood count, PCR, ESR for inflammation
Hope you will find this answer helpful!. I remain at your disposal whenever you have any other questions!
Regards,
Dr. Iliri Sharka
Cardiologist
I would recommend as follows.
Detailed Answer:
Hello,
Your symptoms are not typical of any cardiac disorder. You should know that cardiac chest pain is usually triggered by physical activity.
The normal test results, including the ECG in the ER are another argument to exclude any cardiac issues.
The fact that the chest pain occurs only during sleep could indicate a possible gastro-esophageal reflux or musculo-skeletal pain.
The fact that the change in body position modulated the pain in one episode could be indicative of a musculo-skeletal pain.
Coming to this point, I would recommend taking an anti-acid or PPI (Omerprazole, Pantoprazole) and see if your situation improves.
If your situation improves after trying these drugs, I would recommend performing a fibrogastroscopy.
Otherwise, I would recommend performing further tests to investigate for the possible causes underlying your symptoms:
- A chest X-ray study
- Complete blood count, PCR, ESR for inflammation
Hope you will find this answer helpful!. I remain at your disposal whenever you have any other questions!
Regards,
Dr. Iliri Sharka
Cardiologist
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dr- thank you for your response
1. As a follow up question, and I know I have asked you this before, but sometimes after strenuous work day and/or workout, after I awkake from sleep, I feel a sensation in my chest; it feels like something is moving/beating rapidly; it last for a few seconds or minutes then subsides
2. Do u think this type of symptoms are determintal to heart health? Should I cut back or curtail my activities/daily routine so that I don't have such symptoms?
3. Or do you believe that these symptoms are harmless?
Thank you again.
1. As a follow up question, and I know I have asked you this before, but sometimes after strenuous work day and/or workout, after I awkake from sleep, I feel a sensation in my chest; it feels like something is moving/beating rapidly; it last for a few seconds or minutes then subsides
2. Do u think this type of symptoms are determintal to heart health? Should I cut back or curtail my activities/daily routine so that I don't have such symptoms?
3. Or do you believe that these symptoms are harmless?
Thank you again.
Brief Answer:
My opinion is as follows.
Detailed Answer:
Hello,
These symptoms do not seem to be related to any cardiac disorders.
You should know that it is quite normal to have some palpitations during physical activity or emotional stress.
This is a normal physiological reaction, related to the activation of the sympathetic nervous system, leading to increased circulating levels of adrenaline and noradrenaline, causing increased heart rate and even ectopic heart beats.
This reaction does not indicate any serious medical condition.
In my opinion there is no need to limit your daily physical activity. I would just recommend avoiding straining physical activity, which may trigger this clinical situation.
Anyway, considering your age, I would recommend performing an ambulatory 24-48 hours ECG monitoring (Holter) to examine your heart rhythm trends during the day and exclude any possible cardiac arrhythmia.
It is also necessary performing the above mentioned tests (complete blood count, PCR, ESR, blood electrolytes, chest X ray study).
You should discuss with your doctor on the above issues.
Hope I have answered your query. Wishing you good health.
Regards,
Dr. Iliri Sharka
Cardiologist
My opinion is as follows.
Detailed Answer:
Hello,
These symptoms do not seem to be related to any cardiac disorders.
You should know that it is quite normal to have some palpitations during physical activity or emotional stress.
This is a normal physiological reaction, related to the activation of the sympathetic nervous system, leading to increased circulating levels of adrenaline and noradrenaline, causing increased heart rate and even ectopic heart beats.
This reaction does not indicate any serious medical condition.
In my opinion there is no need to limit your daily physical activity. I would just recommend avoiding straining physical activity, which may trigger this clinical situation.
Anyway, considering your age, I would recommend performing an ambulatory 24-48 hours ECG monitoring (Holter) to examine your heart rhythm trends during the day and exclude any possible cardiac arrhythmia.
It is also necessary performing the above mentioned tests (complete blood count, PCR, ESR, blood electrolytes, chest X ray study).
You should discuss with your doctor on the above issues.
Hope I have answered your query. Wishing you good health.
Regards,
Dr. Iliri Sharka
Cardiologist
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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