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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Severe chest pressure radiating into arm and jaw, all reports normal. What could be wrong ?

Hi, I am a 37 year old woman, I smoke occasionally, I went to the er a few months ago with severe chest pressure radiating into my arm and up my jaw. They did an EKG , stress test, xrays, and lab work. All came back normal. They said it was my panic disorder . I went to my pcd and he told me my blood pressure was excellent, my pulse was good, yet I was still sick. I have been having severe abdominal cramping/pain for the last 4 months also. I have had 3 c-sections, a hysterectomy , umbilical hernia repair (which needs to be repaired again), and vertical banded gastroplasty. I have been loosing on average 10 -15 lbs a month unintentionally. I can t seem to eat. Even the smell of food makes me want to vomit. But this pain is getting to me, I stayed in bed today and woke up in a pool of sweat, literally soaking my bed and blanket. What could be wrong if it isn t my heart?
Mon, 10 Dec 2012
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Pulmonologist 's  Response
Hi

Your investigations done for the chest pain was reassuring. That ruled out heart problem. Your can still have an atypical chest pain called prinzmetal angina, which is basically spasm of your coronary arteries.

But more worrying is sweating excessively at night and weight loss. This can be due to infection like tuberculosis outside the lung and in few occasion due to disease of the lympnodes (lymphomas).

I am not sure where you live, but you need to have certain blood test like ESR, CBC, Liver profile, LDH, Beta 2 microglobulin. CT of the chest abdomen and pelvis. If there is any enlarged lymph node larger than 2 cm in size, you need a proper tru cut biopsy and NOT a needle aspirate which most often give false negative pictures. Get it checked out soon. Hope it is nothing serious. Best wishes.
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Severe chest pressure radiating into arm and jaw, all reports normal. What could be wrong ?

Hi Your investigations done for the chest pain was reassuring. That ruled out heart problem. Your can still have an atypical chest pain called prinzmetal angina, which is basically spasm of your coronary arteries. But more worrying is sweating excessively at night and weight loss. This can be due to infection like tuberculosis outside the lung and in few occasion due to disease of the lympnodes (lymphomas). I am not sure where you live, but you need to have certain blood test like ESR, CBC, Liver profile, LDH, Beta 2 microglobulin. CT of the chest abdomen and pelvis. If there is any enlarged lymph node larger than 2 cm in size, you need a proper tru cut biopsy and NOT a needle aspirate which most often give false negative pictures. Get it checked out soon. Hope it is nothing serious. Best wishes.