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Acid reflux, sharp pain in chest, right shoulder, head and jaw. Had TIA. Taking aspirin. Related to blood condition?

I am a 32 year old female and am not sure if I had a mild heart attack last night or if it was acid reflux. After dinner I had sharp pain in my chest, right shoulder, head and jaw. It lasted for about 15 minutes. I threw up, and then felt fine about 5 minutes later. I had a TIA in April 2009 and they discovered I am heterozygous for the prothrombin gene mutation, and that coupled with birth control caused a clot. I take 81mg of aspirin daily. I am being investigated for reflux since I have had nausea/vomiting for 3 years with no underlying cause. (endoscopy is scheduled for June) So, I am confused....could last night have been related to a blood condition (i.e. clot or heart attack) or from reflux?
Asked On : Tue, 23 Apr 2013
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Cardiologist 's  Response
Dear Ma'm
Thanks for writing to us.
A pain which is in mid chest and comes always on exertion and relieves by rest is likely to be anginal or cardiac or heart pain. But if the pain comes suddenly, comes as a sudden very sharp pain, lasts for less than a minute, can be elicited by touch or pressure, does not comes up on exercise/running/exertion, it is more likely to be non-cardiac (non-anginal). in your case i would like to keep the possibility of a stomach upset first rather than heart attack. because pain was sharp, it radiated to head and relieved in 5 minutes of vomiting. these things do not favor heart attack. moreover at age of 32 , in a female, even if she has an underlying propensity for blood clot formation an episode of full heart attack (STEMI) would be much more plausible than an episode of angina lasting for 15 minutes, pathologically. but keep in mind that these are only theoretical possibilities based on history. since you must be examined and some basic investigation like ECG should be done, i would request you to see your doctor.
feel free to discuss further.
sukhvinder singh
Answered: Tue, 23 Apr 2013
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