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Disturbing Symptoms, insight please!

3 Recommendations

Hello all! I am new to this board and found it by googling "left arm pain 30 year old". Well, anyways I am 30 (soon to be 31) and I have a 2 year old (soon to be 3) son. While I was pregnant with my son in 2006 I kept having episodes of left arm pain and chest pressure/tightness/discomfort (never pain), and dizziness. I went for a lot of tests to r/o heart problems/blood clots. My son was finally delivered via c-section 13 days late. Still no relief...

Fast forward now almost 3 years. I still have left arm pain/discomfort, still have chest discomfort, still have dizziness, the left arm pain feels like it is in my bicep and tip of my elbow primarily. My chest discomfort is dead center of my chest above my breasts. I also get the sensation that something is stuck in my throat from time to time. I have been to 3 cardiologists since giving birth to my son. All 3 agree that my symptoms are "atypical". I have had numerous EKG's, numerous echoes, all 3 types of stress tests, CT scans of my chest, SO MUCH bloodwork. The only thing I haven't had was a cardiac cath, because all my other tests were unremarkable no one will do it.

I don't know what to do!! I've been dealing with this for 3 years and no one knows why. I do have a hiatal hernia and thoracic outlet syndrome on my left side, but everytime I google my symptoms it comes up HEART ATTACK! I know that I am not too young. I do not have a family history, I'm not overweight, my BP and cholesterol are great, but I did just recently quit smoking.

My symptoms: left arm discomfort, chest discomfort, abdominal pain, dizziness, pain in middle of my back, shoulder pain, sharp head pains, fatigue, muscle weakness, and overall not feeling well.

Like I said I have had so many tests (heart related and not heart related) and the only thing they found was a hiatal hernia and thoracic outlet syndrome, which from reading both of these "could" mimic heart problems. Does anyone have any insight? The fact that I have been to 3 different cardiologists and had all these tests is it safe to rule out a heart problem? Thank you all and I'm sorry this is so long!

37 replies

The only way to rule out cardiac issues 100% is to have a heart cath. Find another doctor and if that one won't do one, find another. Eventually someone will listen. I passed ECGs, ECHOs and even stress tests. Stress tests are known for giving false negative readings in younger women. I passed a stress test 2 days before I went back to the ER and demanded a cath. They did one to "put my mind at ease". Things went crazy in that cath lab when they found a 98% blockage of the LAD and stented it. On paper I looked healthy but I had a time bomb in my chest. I tell you this not to scare you - just to tell you to keep pursuing this. Listen to what your inner voice and your body are telling you. You just might save your own life.

Since that first stent at age 39, I have had to demand each cath that subsequently saved my life. I received my 2nd stent at 40 and 41 brought triple bypass surgery followed by a heart attack and third stent. I am now on my 5th cardiologist because when they stop listening, I move on and I am alive because of that.

Take care and best of luck to you -

Dianna

Dianna,

Thank you for your response. I have asked about both a cardiac cath or one of those 64 slice cardiac CT's and I was told "no" by all 3 cardiologists. They said based upon my test results, my risk factors and my age that my insurance company will not cover either one of them and unfortunately I do not have the money to pay for the test out of pocket. I have been pretty much dealing with this everyday for the past 3 years, and I have been told (by more than 1 doctor) that if it was my heart I would it would've killed me by now.

Not really sure what to think. Oh, and I forgot to mention that I have seen 3 cardiologists since I had my son, saw 2 prior to giving birth. So, 5 cardiologists telling me that it is not my heart....but then what is it? What else mimics angina/heart pain exactly? Has anyone been dealing with anything like this? I'm really starting to lose my mind.....

Hi Shell, you wrote-
I do have a hiatal hernia and thoracic outlet syndrome on my left side.

Both mimic the symptoms of a heart attack, including the feeling that you have something stuck in your throat. Are you having treatment? If you google those symptoms it will always throw up Heart Attack but since you've actually been diagnosed with two conditions that together and separately can cause identical symptoms it's more complicated.
You also say you've been to 3 cardiologists and had numerous tests and 'the only thing they found was 'a hiatal hernia and thoracic outlet syndrome' so they must have been thorough and they must have concluded that they'd found the cause of your symptoms and yet you're still not convinced. If you're taking medication for the hiatal hernia and have had treatment for thoracic outlet syndrome and you're still having the same symptoms then do what Dianna said and listen to your inner voice. If you believe it's your heart then keep on badgering your doctors.
Sorry, none of us can really answer your question 'Is it safe to rule out a heart problem?'
Hugs,
Lidia xx

Hey shell,

Sorry you are having such a wacky time of it. Try the term 'SCAD' in the Find it search window here....lots of info there. You will also find other women here your age with these same symptoms. If you repost this same discussion and place SCAD in the title, they will quickly find you.

"My symptoms: left arm discomfort, chest discomfort, abdominal pain, dizziness, pain in middle of my back, shoulder pain, sharp head pains, fatigue, muscle weakness, and overall not feeling well."

This symtom cluster meant heart attacks for me in my 30s and a whopper by 41. Same as you, no family history, not overweight........no outstanding bad habits... You do have one stand out high risk heart attack behavior however. The smoking.

From the info you offered I came up with 5 things that place you (young female,pregnancies) in high risk for heart attack now: (I'm not a doctor)

1. All those symptoms you listed above. Just because their TESTING methods haven't found it doesn't mean nothing is wrong. Not with the female heart.

2. Smoking. It's been a known acute heart attack risk for over a decade now. This one is up to you. The way you choose to handle yourself on this one will contribute to the seriousness with which cardiologists will treat your symptoms. This is the only risk factor under your control.

3. Young female. Gender bias is rampant towards younger women and heart problems. You need to be aware of this and do your best to stay fairly calm while you firmly insist on getting into a cath lab. It is the ONLY way to rule out that you are not having heart attacks or dissections (which may be stentable). If you were a male w the above symptoms you would have been whisked right into a cath lab and stented years ago. I consider (from personal experience and much irreparable damage as a result) current medical culture bias towards females a risk factor just as dangerous as any other. This bias blocks women from testing and cath procedures....and has nothing to do what is actually going on inside a woman's body.

4. The docs are testing you are far as insurance will allow as a young female....which means both doctors and insurance are now blocking your access to a cath procedure to investigate this alarming symptom cluster. (Don't fall for doctors putting the blame completely on insurance companies.....Insurance companies put together their 'approved procedures' lists from panels of retired doctors. At this time, AMA still excludes younger women (under 55) from being at high risk for heart attacks).

5. Chest pain in center that isn't going away and doctors are denying is cardiac related. As a young female, I found the opposite to be true. You may be hearing 'musculoskeletal'.....the new replacement for 'fibromyalgia' that was frequently used by doctors to 'diagnose' chest pains in younger women.

Wish I had a more positive outlook to offer you..........but at this time, it is important to keep seeking help. You are a young mother, with young kids and you are suffering chronically enough that you've been trying to get help. That is very responsible behavior on your part. You need help now. Most of the women here have had to push hard for aggressive treatment.....not just the testing side of things.

You are doing everything RIGHT. If possible, have your partner go with you to the next cardiac visit and push for real answers on your behalf. Keep educating yourself on-line and from the experiences of other women here.

Hang in there. So glad you found this site. It will help you soar up this learning curve! (smile)

take care,
Jaynie

Jaynie,

Thank you for your response. I did look up "SCAD" and I don't really think that is what I'm dealing with. I have had my pains for over 3 years on and off, I have just been on an "on" for about 4 months now. That was one thing I forgot to mention, I can go as long as 5 months with no symptoms, then get them again for 4 months. I go to my PCP today because at my last cardiology appointment he suggested maybe going to a rheumatologist because he believes I may have an autoimmune disease that is causing me to have flares. I also made an appointment with another cardiologist (will be #6 since I was pregnant with my son) for another opinion. If this one clears my heart should I just leave it alone??

I can literally not have 1 symptom for months, then BAM!!! I get the dizziness, left arm pain, chest discomfort, abdominal pain/pressure, globus sensation in my throat, joint pain on right side. It's very discouraging, especially since I want to have another child, but all of this started when I has pregnant with him 3 years ago....

Lidia,
Thank you for your response. I went on the internet last night and I typed in my symptoms and added either "hiatal hernia" or "thoracic outlet syndrome" and you were absolutely right. I see many specialists right now and each one blame it on something different. GI doc blames it on my heart, Vascular doc blames it on my hernia, and my cardio blames it on my thoracic outlet syndrome. My PCP tells me anyone of those could be causing your problems but that my symptoms seem "atypical" for cardiac origin. I have been told that by ALL 5 of the cardiologists I have seen in the past 3 years. It's funny, I read your reply and I actually feel a "little" better, but then I read the other replies and I feel worse....hmmmm. The mind is a person's worst enemy.

I just want to feel better. I wake up and BAM I have all the symptoms. I was actually laying there this morning and I could feel my esophagus (at least I think so) spasming in my chest. Didn't hurt but it was a weird feeling. I don't see my GI doc until July 24, aaarrrrggggghhhhhh!!!

Here is a curve ball. I know nothing about hiatal hernia or thoracic outlet syndrome, but I do know about Prinzmetal syndrome or cardiac spasms because I have been diagnosed with These cause the same angina as other heart problems, arm pain, chest tightness, shoulder blade pain, shortness of breath. Just you saying that you woke up with spasms is exactly how I wake up many mornings. If you are having spasms at the time of an EKG, then the spasms show up as an unsual T wave. Have you ever had an EKG exactly when you were having the cardiac symptoms? Unless your heart and arteries are in the process of the spasms there is no detection of anything wrong. I have done excellently on stress-echos and also had a heart attack on one. Read about Prinzmetal on the internet. I can go along with nothing for awhile and then I have days or weeks of constant symptoms. The shaking is very common to me.....I feel weak in my trunk because of it. I wonder if your PCP could re-read your EKGs and see if there was ever an unusual T wave that was dismissed as something else. Even an angiogram usually does not detect the spasms unless they happen right then. It could be you have more than the GI problem........possibly you could have the cardiac spasms. Just more info.
Joyce

Hi, shell1925

Please read all the symtoms of TOS This is the easiest website to read that I could find.

and here are the symtoms of a Hiatal hernia

Maybe some Physical therapy and if the Doctors just would follow up on your problems with a hiatal Hernia. You might feel better about their Diagnoses. And not feel anxious about a heart problem.

I have had a heart attack and also have different problems that have very similar symptoms of a heart attack. It makes you feel crazy at sometimes not being able to communicate with your doctors what your needs are.

But an angiogram just to rule out a heart problem when you are already diagnosed with the other problems is not without risks.

Danger Of Angiogram & Risks Of Angiography
According to the Mayo Clinic, there are some risks associated with angiograms. “As with most procedures done on your heart and blood vessels, coronary angiography does pose some risk. Major complications are rare, though. Among the potential risks and complications are:

Heart attack
Stroke
Trauma to the catheterized artery
Irregular heart rhythms (arrhythmias)
Allergic reactions to the dye or medication
Perforation of your heart or artery
Kidney damage
Excessive bleeding
Infection
Blood clots
Radiation exposure from the X-rays

Each time I google my problems it says go straigt to the ER, wow, I would be there everyday. especially when you click the symptom checker from WebMd

Try and get treatment for the diagnoses you have and if you still feel it is your heart, make sure you get the an angiogram...

Take care, Vrolijk

shell,
"My symptoms: left arm discomfort, chest discomfort, abdominal pain, dizziness, pain in middle of my back, shoulder pain, sharp head pains, fatigue, muscle weakness, and overall not feeling well."

Again, these symptoms meant real heart attacks in my case. I was told they were 'fibromyalgia events' by my rheumatologist.....he ran a full battery of autoimmune lab tests which came back negative...because I didn't have any autoimmune activity...was having heart attacks. The specialists will only test you for what they are allowed to diagnose and bill for....which may have zilch to do with what is truly going on with you. It is good that you will be tested for autoimmune (lupus, etc)....but if they all come back negative, please request the dr send copies to your cardio's office too.
And ask for your own copies. Heart attacks are flare ups and random just like autoimmune flareups. All of it is hard on the heart.

I hear how incredibly frustrating this is for you. We can't get those tests done fast enough and so often they missed whatever happened...so test results may show 'it didn't happen'.....but it did. You are living it. The hardest aspect to get used to is the barely there, disengaged behavior of medical staff, no one the least concerned that you are suffering and scared out of your mind.

If you continue to go back to doctors every time you are hit with a new wave of symptoms, there is a better chance something accurate will be picked up in the testing. Hopefully will before you get to the acute phase and damage becomes permanent. Do your best to keep it 'all about you' when seeking help. Your job is to protect your life and progressively seek help to preserve the highest quality of life possible....so brush aside worries you are bothering anyone if that is the case.

hang in there and keep a personal chart of your own...document on a calendar what symtoms, when they begin and end. Over time, you may see patterns that make sense to you....and that you can insist are real when dealing with physicians.

take good care now,
Jaynie

While they are looking at the heart, you may also want them to check your upper cervical disc area C3 - C7/8. Your symptoms could also be caused from pressure on the spinal cord from a herniated/slipped, etc. disc or ostephyles on the cervical discs. This causes difficulties with swallowing, feeling in the arms, etc.

I just wanted to add one thing. I agree with everything the women on here have said. Just because all your cardiac tests came back normal/negative, doesn't necessarily mean you have no cardiac issues. I would still see if you can find a heart doctor that will do a cath - the only true way to check for blockage. Having said that, I too, have a hiatel hernia and I have had esophageal spasms, very similar feeling to a heart attack and very scary. It is possible that your hernia is worse and causing those kind of spasms. When was the last time you had an endoscopy to check on the hiatel hernia? You trust yourself and how you are feeling and push your doctors if you have to. That is what I had to do. All of mine were putting it on the other ones.
Let us know!

Hello!
Do some research on Prinzmetal's Angina (also known as coronary vasospasms). I cycled in my pain, too. All of what you described and I also got the EXACT SAME LINE "If this was your heart, it would have killed you by now." I went outside my network to see a woman's heart specialist in L.A. (Dr. Bairey-Merz, many of us have seen her or heard of her) and she looked through my records and gave me a clinical diagnosis of Prinzmetal's. I have had NOT ONE positive EKG or any other indication that there is something wrong with my heart but since I started calcium channel blocker therapy, my life has improved dramatically. If this is in fact what you have, it can go into spontaneous readmission for months or even years (my longest so far has been 10 glorious weeks).

Do some research on this condition--it won't take you too long because it is highly under-researched in my opinion. You have an uphill battle ahead of you because you are a young woman. Even WITH my cardiac diagnosis on my records, I am still treated in a condescending manner by any doctor I go to with the rare, rare exception.

I know this is getting really long, but I wanted to share: This January, I was in the ER with palpitations, chest pressure, dizziness and tachycardia. They gave me Ativan. It didn't work, so they gave me a big dose of Cardizem through the IV. I responded immediately and got my heart rate down finally, hours after I'd entered the ER. I was like, "Ha! I told you I wasn't anxious!" And then I immediately realized how twisted that is--excited to prove to someone that your heart is the problem? Oh well, these are the situations we are put in...

Good luck to you and keep fighting!
Sarah

Thank you all for your responses! I went to my PCP yesterday, telling him all about my symptoms (AGAIN!!) and I was shrugged off (AGAIN!!!) and given a Rx for Prozac. I feel really awful today and I don't know what to do. I have an appointment with a different cardiologist on Tuesday morning (6th one in 3 years) and I'm hoping I just don't get brushed off again. My pain is real and no one will listen to me! I'm so scared of dying of a heart attack because no one will do any tests on me besides an EKG, stress test, and an echo. They all came back normal, along with any bloodwork I've had done. Is it possible that this is all anxiety? I know it is giving me anxiety. I keep having the chest pressure, left arm pain, constant dizziness, sharp head pains, shoulder pains, back pain between shoulder blades and now I am having right sided jaw pain. I just hope I can make it to my appointment on Tuesday.....

Hi Shell,

We hear you!! We are either right where you are or have been there many time over.

Anxiety is am important component of helping you stay attuned to what is going on....it is pushing you to get help, or to rest for a while. It can be part of female heart ischemia and attack symptoms.

Consider printing this out so you will have a reliable time line + your doctor prescribing Prozac (antidepressant) for 'anxiety'. I'm truly sorry you are being told the exact same things I was 15 years ago. Because ALL the symptoms you have listed here can be heart attack related (singly or in combinations), I am sticking with urging you to keep going for medical help (which you are already doing). Chart medical dismissals right now...it will help you get a clear picture of what IS going on and what IS NOT being done to help you....over time.

While you wait for your Tuesday appointment, I hope you will take deliberate steps to calm yourself down slowly....because it will help YOU manage whatever else you need to do.

Some things that have helped many of us are preparation steps (just in case : )....Pack a small hospital bag (doesn't matter if you never need it) w a fresh change of clothes, deodorant, shampoo, comb, ipod, books, lip gloss, several changes of warm soft comfy socks, a journal for writing your thought or notes...one of your favorite lucky charms, photo of your precious child (smile). Stuff copies of your posts here and any medical record copies you have in a side pocket w contact info/phone numbers/medical directive statements. Just knowing you have all that ready to go will be a comfort to you.

And then.....hold your son close and read him bedtime stories...don't miss a moment of time with him. Screw the dirty dishes, get on the floor with him and laugh and play, sing songs together. Brush the dog, pet the cat.

My #1 calmer downer: I always shower the second I rise and just before hitting the sack, keep legs shaved....because THAT is what drove me bonkers about being stuck in the hospital for a 7 days, 5 in CIC.
I can endure anything but not being able to shower and wash my HAIR (smile). So girly I know : ) But it helps me calm down somewhere deep inside to make these simple preparations....no matter how crappy I'm feeling.

We are all here for you. Keep checking in and letting us know how it is going.

Hugs to you,
Jaynie

Hello all! I just wanted to update everyone in regards to my dr's appt with my new cardiologist on Tuesday. I had my records from my PCP and another cardio sent to him. He does agree with them that he doesn't believe this is coming from my heart, but he also doesn't think it is anxiety. I'm going for another echo on Tuesday and he is also doing a cardiac cath on me. I'm scared about the cath but I'm glad that I finally found one that will do it. I don't know how it's not my heart because all of my symptoms SHOUT heart problem which he does agree with. I got the "well your age pretty much protects you", but after reading what you ladies have wrote I don't believe that.

Can you ladies please tell me what to expect with the cath. I'm really scared about it because I have been told by other cardios that they won't do it on someone my age because of the risks. Thanks in advance!!

I can only speak for myself, I have had two heart caths within a month of each other. Obviously, by the 2nd one, I knew what to expect, which was good. However, both experiences for me were good. I had to fast overnight, then went in and they prep you, IV, etc. and then they took me back to the cath lab (no clothes on? just the hospital gown and then once in the cath lab, they open the gown up and put some kind of towel over my groin area (that I didn't know would happen and the techs were male, one female) and shaved part of the area too (even though I did that myself ahead of time). They gave me something to relax me (and it did), I even watched some of the procedure. Doesn't hurt at all, and I was relaxed. The 2nd time around they must have given me more relaxant, because I didn't remember a thing. Afterwards, you have to lay flat for about 4 to 5 hours. That is the hardest part but you can get through it. I had a kind nurse who brought me coffee because I had a killer headache. My hospital brings a lunch too and you just have to eat it laying down flat. My doctor is conservative. I didn't get to leave before 5pm and I was in there around 6am, long day. I have heard that other doctors let their patients go home earlier. But all in all, a good experience.
I am glad that you are finally having one as you need answers and I hope this will finally give you some. Please, please post and let us know, ok?
Hugs,
Colleen

I had similiar symptoms, not as severe as yours, for years. My cardiologist finally sent me for a fast cat scan for calcium scoring that led to days later to an angio gram (1) stent inserted into by LAD.

What a difference. Finding a Cardiologist that will listen and prescibe the approriate tests is key.

You are comming to the best place for info and support.

God Bless

I had a cath last month when I had a heart attack.
I am 30 years old, very active, and was in the best shape of my life.
I was terrified when they told me that I had a heart attack and even more when they informed me of what the cath is and that it had to be done. They gave me some meds for the anxiety which was amazing because I was pretty freaked out. It wasn't that bad though.
One thing, my large arteries were clear.
Thank God my cardiologist is up to date on women's heart health. After consulting a specialist in L.A., he told me that I have microvessel disease.
I am still learning about this disease and learning how to cope with it.
I had all of your symptoms for years, and always felt like a hypochondriac. Even on the day of my heart attack, my GP still suggested it was indigestion.
I wish you better luck with this cardiologist. If your cath does come back normal, ask him/her about microvessel disease. From what I have read, it is diagnosed through exclusion.
I pray it is not your heart but the symptoms definitely sound familiar.
Good luck to you!
You are in my prayers.

My sister had the exact same symptoms and also had a hiatal hernia. After three years of going back and forth to every cardiologist in her county they sent her for the hiatal hernia repair and all her symptoms went away.

hi...i know what you are going thru...went thru the same....in and out of hospitals monthly due to chest pain, arm pain, etc...all tests were fine, until finally one cardiolgist from the hospital said let's send her to the heart hospital and do a cardio cath...great...we did that...and sure enough, one artery was 99% blocked and another was almost 70%....they then continued and put 3 stents in....if the dr. didn't recommend that I go, i could have had an attack or who knows....not to scare you, but please follow up with a cath...then you can rest easily knowing for sure....good luck...Judi

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