Twice I had what seemed to be a heart attack. Pain in breast bone radiating to upper left arm

07/15/08

Paula

On two separate occasions I had what "seemed" to be a heart attack. Severe pain in my breast bone between my breasts that radiated to my upper left arm and in between my shoulder blades. It also went up into my jaw bone. It was difficult to breath and the first time it happened I got nauseous with cold sweats and was as pale as a ghost. That attack lasted for a good 30 - 45 minutes. The second time it happened I was working on my job as a sales associate and trying as hard as I could to keep my composure that one lasted only 10 minutes or so. I did have a less severe attack about 5 months ago which took me to the ER and they took all kinds of tests which, thank God, were negative. After the first attack I had an ultra sound of my Gall Bladder which showed no gall stones. Could it still possibly be my gall bladder and nothing showed up on the ultra sound because the stones were too small? Or is it possible I have undetected heart disease? I did have elevated cholesterol and high tryglicerides also I was considered a pre-diabetic.

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Answers (1)

Wednesday, July 16, 2008

Martin Cane, M.D.

Paula,

Thanks for your question. Your episodes of chest discomfort are very impressive and need further investigation. They certainly could be caused by heart disease. I'm glad your gallbladder ultrasound was negative, but in rare cases, there still could be a problem, such as a stone in the tube that drains the gallbladder (cystic and/or common bile duct). There are also other problems that could cause your symptoms such as gastrointestinal disorders (hiatal hernia, esophagitis, ulcer disease), and pulmonary disorders.

Chest pain can be a difficult problem to sort out, but the most important one to rule out is heart disease. I suggest you make an appointment with your physician as soon as possible for a complete evaluation and EKG (electrocardiogram). He will probably suggest further studies such as a stress test. In your situation, you have additional risk factors of elevated cholesterol and triglycerides (lipids), and pre-diabetes. Other risk factors to consider are tobacco, excessive weight, high blood pressure, and family history of heart disease. If your heart checks out, then your doctor can proceed with other testing to find the cause.

Doctors take chest pain very seriously, and all patients are encouraged to seek medical attention should this symptom occur. If you get another episode such as those described, you should go to an emergency room immediately.

I hope this information has been helpful. Best wishes.

Martin Cane, M.D.