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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Palpitations, Dizziness , Heavy Left Arm And Chest Tightness With Mild Pains. Ecg, Chest X-ray, Blood Work Normal. No Improvement With Propranolol. Anxiety Or Heart Problem?

just over a week ago, i was admitted to a&e after suffering palpitations, dizziness , heavy left arm and chest tightness. They performed an ecg , chest x ray and full blood work including thyroid and eveything was normal. My blood pressure and pulse rate was also normal. They have diagnosed me with anxiety at the moment but are referring me to a cardiologist just in case they want to do any more tests. Since then, my left arm aches every now and then and i have very mild pains occassionally in the left side of my chest. I m really worried that there is a problem with my heart and this seems to be making me more anxious. The doctor has started me on propranolol tablets but i haven t noticed any difference yet. Does this sound like just anxiety to you?
Mon, 25 Jun 2012
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Cardiologist,  's  Response
Hello! After careful evaluation of your description of the agony you have, it does not appear to be of cardiac origin. I would have repeatedly taken a series of your ECGs by myself, & this itself would have been enough to exclude the diagnosis of ischemic heart disease.

However it is surely what is known as 'Cervical Rib Syndrome' from your description of the symptoms.

There is no point in having X-Ray, because the first type of the cervical rib syndrome which is completely bony, although visible in an X-Ray, does not cause any symptoms.

It is the second type, 'Fibrous cervical rib' which is responsible for your symptoms & the definitive way to manage it is decompression by operating the extra fibrous rib.

Thanks & wishing you a successful treatment!

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Palpitations, Dizziness , Heavy Left Arm And Chest Tightness With Mild Pains. Ecg, Chest X-ray, Blood Work Normal. No Improvement With Propranolol. Anxiety Or Heart Problem?

Hello! After careful evaluation of your description of the agony you have, it does not appear to be of cardiac origin. I would have repeatedly taken a series of your ECGs by myself, & this itself would have been enough to exclude the diagnosis of ischemic heart disease. However it is surely what is known as Cervical Rib Syndrome from your description of the symptoms. There is no point in having X-Ray, because the first type of the cervical rib syndrome which is completely bony, although visible in an X-Ray, does not cause any symptoms. It is the second type, Fibrous cervical rib which is responsible for your symptoms & the definitive way to manage it is decompression by operating the extra fibrous rib. Thanks & wishing you a successful treatment!