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Forum Name: Cardiology Symptoms

Question: left upper side chest and innerleft arm pain


 rcamp - Mon Jan 07, 2008 3:30 am

Hi, i'm 30 years old and in pretty good health besides this. I was wondering if you could tell why i would have these symptoms. When i go for walks with my husband after just a few minutes i get an acheing pain in the upper left side of my chest and it radiates to the inside of my left arm.
 John Kenyon, CNA - Sun Aug 10, 2008 8:22 pm

User avatar Hi there -

While there are a number of very benign potential causes of your discomfort (such as trapped gas, most likely at the splenic flexure of your colon, on the left side, which causes pressure up against the bottom of the diaphragm and can send referred pain to the area you describe. This is probably the most likely cause. It could also be pleuritic-like pain due to heavier breathing during the walk, caused by some mild pleuritic friction. This is less likely but still possible.

While I strongly suspect you'll find the problem is caused by one of these annoying and harmless things, and even though your pain is rather atypical for heart-related pain, there are several reasons I'd advise bringing this to the attention of an internist or cardiologist in order to be safe rather than sorry (and that, I feel, is always worth the trouble and expense): women frequently present with atypical heart symptoms (pain in the "wrong" place, etc.); further, while heart attack pain is rarely felt in the left chest, exertional angina often is felt there. You describe an "aching pain" which is far more like cardiac-related pain than sharp, stabbing pain, which is almost never heart-related. Also, this pain radiates to the inside of your left arm, which is classic ulnar nerve pathway radiation pain for cardiac causes. This certainly does not mean I think it is heart related. What I do think is that where there is any question as to whether or not the symptoms in question are heart-related, and especially in women (and young women even more especially) this needs to be ruled out. I say young women in particular because they can have heart disease (structural as well as coronary) even though they are less likely than post-menopausal women. The problem is that many medical people, because of the relative youth of the patient and the fact that it is a woman (there is still an impression among some medical professionals that women "just don't get heart disease" -- totally baseless, but old notions are slow to die off). So for all those reasons, I would hope you would have at least an EKG and possibly an echocardiogram, maybe even a stress test -- just to rule out any possibility of hidden structural disease or early coronary disease causing this problem. If your mind is at ease about that then you can continue your healthy, pleasurable walks and take your time figuring out what innocent thing is causing what would then be only an annoying problem.

I hope you'll follow up with us here and let us know how things go. Good luck to you and please don't feel I'm suggesting you have a heart problem. I just feel the investment in ruling it out is more than worth the time and trouble.

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