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Ask Vivek Pillai Your Own Question
Vivek Pillai
Vivek Pillai, Doctor
Category: Health
Satisfied Customers: 150
Experience:  M.B.B.S, M.D.( GENERAL MEDICINE).
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Ive been having heart palpitations, left arm, and chest pain

Customer Question

I've been having heart palpitations, left arm, and chest pain over the past week. I've been to the ER twice, once last Monday and yesterday, and both times they've
said the ECG was normal, and my blood pressure and temp are normal. However, I am having problems sleeping at night-
last night I felt a shortness of breath and couldn't fall asleep. I've also had a lingering
pain in my left arm, in the forearm and above the elbow. I also have chest pain in the upper
left pectoral, and what feels like numbness at times in my chest and left arm. All of the pains come and go, and
are not sharp or overwhelming. I would call the pain itself "minor" except for where it is.
The ER doctor said they couldn't do anything for me because the ECG was normal, and
said I need to follow up with a doctor- however, I don't have insurance and I don't have a
doctor, so I don't know what to do. I also had a small amount of red blood in my stool
today. Please help, thanks.
Submitted: 8 years ago.
Category: Health
Expert:  Vivek Pillai replied 8 years ago.

hi...

left arm pain along with diffuse chest pain and palpitations is likely to be cardiac in nature... please note a one off ecg may not pick up the cause of palpitations....the suspicion of cardiac disease is heightened when you said you had shortness of breath during sleep...so here is what you should do...try to get a HOLTER( an ambulatory 24 hour ecg done) and also an echo cardiogram .

as for the red blood in the stool if it persists and defecation is painful it is likely to be a local cause like a fissure in ano... also please note if the colour is red or really a dark red..because that may be useful in determining the site of bleeding... however in the meanwhile, you should take a high fiber diet and plenty of fluids to avoid constipation, it should help....

if you are satisfied with my answer kindly press the ACCEPT button so that i may receive the payment to be credited to me....please feel free to ask any more queries.. all the best,

vivek

Customer: replied 8 years ago.
Vivek,
I guess I'm wondering how long these kind of things go on before it's critical-
since the ER said they couldn't do anything further (I forgot to mention, the second time I went to the ER they monitored my heart for over a half an hour and said they didn't see anything abnormal). I can't get a holter monitor or an echo cardiogram until I can get a doctor's appointment, which may not be for a month since I don't have insurance and don't have a doctor here. So do I just wait until I have a heart attack and then call 911? Or should I just be a bit more persistent with the ER doctor next time? As for the blood, is was bright red, not dark.
Expert:  Vivek Pillai replied 8 years ago.

dear jfilm,

dont get distressed !...watch whether the pain increases in intensity, if it is constant you can wait ...but if it is increasing in intensity call 911...there is no harm being persistent with the ER doc, after all it is your health!... and do try some local application like diclofenac gel over the left pectoral and see if the pain decreases, then most likely it is musculoskelatal and not cardiac in nature....as for the stool being bright red the most likely site of bleeding is the lower gastrointestinal tract... watch for a couple of days...if there is still blood in the stools, meet a doctor, in all likelihood it could be a fissure in ano if painful,..... all the best vivek