my mom aged 83,non diabetic,weighing 38 kgs had MI SIX MONTHS AGO .SHE WAS THROMBOLYSED AND RECOVERRED WELL.SHE IS ON 10 MG NICORANDIL TWICE A DAY, STATINS 10 MG ONCE, PROLOMET XL-25MG ONCE,RANOZEX 500 MG TWICE,CLOPILET-75MG ONCE A DAY.POST DISCHARGE CORONARY ANGIOGRAM REVEALED HER AGASTAN SCORE AS 400 PLUS, NO BLOCK ON LCA,60-70 % BLOCKAGE ON RCA & RCA.CONSIDERING HER AGE DOC SUGGESTED ANGIOPLASTY NOT NEEDED AND CAN BE MEDICALLY MANAGED.HER ATTACK PATTERN WAS SHOULDER PAIN RADIATING TO LEFT ARM.THERE WAS NO OTHER SYMPTOM.AFTER ATTACK SHE RECOVERRED WELL. FIRST 3MONTHS ECHO SAID REGIONALWALL MOTION ABNORMALITY, EF-56% ,SLIGHT DIASTOLIC DYSFUCNTION.ECGS ARE NORMAL AS PER DOC,

15 DAYS BACK AGAIN SLIGHT PAIN STARTED SAME AREA BUT NOT SEVERE .NOW PAIN COMES AND GOES ON THE UPPER SHOULDER AREA.AGAIN DOC TAKEN ECG ,SAID NORMAL.TOOK ECHO ALSO .THIS TIME NOW SIXMONTHS SINCE MI,REPORT SAID NO REGIONAL WALL MOTION ABNORMALITY,EF 61%, MILD DIASTOLIC DYSFUNCTION,ADEQUATE LF SYSTOLIC FUCTION.DOC INTERPRETED THE REPORT SATSISFACTORY WHEN COMPARED TO LAST 3 MONTHS .

BASED ON THE ECG AND ECHO FOR THE PAIN NOW SHE IS HAVING, DOC SAID DUE TO AGE COULD BE MUSCULAR PAIN AND SAID TO TAKE IMOL & NICEP-MR ONCE A DAY.WITH THESE PAIN MEDICINES SHE IS OK ,SINCE PAIN S MILD IN NATURE.DURING MORNINGS NO PAIN AT ALL,SHE TAKES NICEP-MR DURING NIGHT TIME AND IMOL MORNING.

OUR QUERRY IS WHAT IS THIS PAIN???IS THIS MUSCULAR PAIN OR PAIN RELATED TO HEART,??SINCE LAST TIME DURING THE EPISODE OF MI ,SAME PAIN STARTED AND PROGRESSED..LEADING TO ATTACK.

PL NOTE THIS PAIN WHAT SHE IS REPORTING ON THE LEFT SIDE SHOULDER ,IS ON THE LAST 15 DAYS ONLY WHICH COMES AND GOES.DOC TOOK TWO TIMES ECG DURING THIS TIME AND SAID NOT TO WORRY AS HE VIEWS THIS A MUSCULAR ONLY.

HOW TO INTERPRET THIS PAIN??SHE IS ON THE MEDICATION AS MENTIONED EARLIER AND SHE TOLERATES THESE MEDICINES WELL.SHE REPORTS BP OF 70/100 AND AT TIMES IT GOES TO 120/130.WHILE THE LOWER BP READING IS ONLY AT 60-70 LEVELS.

WE NEED OPINION ON THIS PAIN???IS THIS NORMAL MUSCULAR ONE???AS SAID ABOVE DURING THIS PERIOD THAT IS WHILE SHE IS HAVING SLIGHT PAIN ON SHOULDER ,DOC TOOK ECG TWICE AS WELL AS ECHO.DOC SAYS NOTHING TO WORRY.BUT WE ARE CONCERNED SINCE THE PAIN LAST TIME ALSO HAD ORIGINATED AT THE SAME PLACE MORE OR LESS.HOW TO PROCCEED???