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I'm having intermittent chest pain mid-sternum left sided,

Hello, I'm having intermittent chest pain...
Hello,
I'm having intermittent chest pain mid-sternum left sided, sometimes inside by my armpit (left side) thoracic area, and other times towards the apex of my heart. Tonight it started around 3pm and is still there but has moved location and each the pain was sharp when it was mid-sternum (only lasting mins to seconds each), now its by my armpit, more dull in intensity, and it's lasting. HX; of GAD and in a nursing program so I'm sure I have stress but don't feel anxious. Went to hospital 7 mo ago d/t same pain and was told EKG was negative. Have arrhythmia's as well, since as long as I can remember, and have had echo and wore a halter for 24 hrs and the tests were both negative but did show the arrhythmia (these tests were done more than 10 yrs ago).
I am a light smoker 4-5 ciggs p/d (trying to quit), I'm 41 and a female. I haven't been working out much d/t my studies, and am 140 pounds and 5'5. There is no HX of heart attack in my family, but my dad does have COPD and emphysema d/t heavy smoking. I am currently taking no scheduled meds, but do have PRN Ambien, T3, and Lorazepam.
I don't want to go to the hospital and be told nothing's wrong again, but am worried about the pain and what's causing it? Any suggestions?
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Answered in 3 minutes by:
4/11/2012
dr-lake
dr-lake, Board Certified Physician
Category: Cardiology
Satisfied Customers: 270
Experience: Cardiologist
Verified
dr-lake :

My best advice in cases like this (becaue I am a coward, and do not want to risk missing an important problem) is to seek medical attention ASAP, in an emergency room if necessary. If you would like to discuss other options, at your own risk, I have no problem with that, and would be glad to help.

Customer:

At my own risk is obviously where I'm at so we can proceed like that :) There is only the ED to go too on Maui and I've been there once like I said d/t this type of pain and because of hx of the anxiety I feel really stupid when they tell me they don't see anything. I know you can't diagnose but is there a possibility that it is GERD or gas?

dr-lake :

Could be, but first tell me more about your pains. Is there anything (especially exertion) that brings them on or makes them better or go away?
What are your risk factors for heart disease (other than your smoking!!!)? Blood pressure, cholesterol, diabetes or pre-diabetes?

Customer:

So, it comes on unexpectedly. Not during exertion and only once while sleeping. I've also been having undiagnosed tremors since Oct that no one can figure out as well (maybe not related but thought I'd mention it). NO other risk factors that I know of. Because of the other problems they've done the whole work up of lab values and all seem ok.

Customer:

bp is usually low and dont know bs

dr-lake :

Note that I cannot offer specific advice, as we have no doctor-patient relationship, and I've not examined you. But the symptoms you describe do not suggest to me any serious heart condition. Given your age, gender, and (other than smoking!!!!) no real risk factors for heart disease, it seems very unlikely to me that you need to be concerned about a cardiac cause of your symptoms. Unfortunately, I cannot offer alternative diagnoses, other than the usual possibilities (GERD, musculoskeletal strains/pains, evil humors, etc).

Customer:

ok thank you... so if continues just make a dr appointment then? or worsens go to the ER...

dr-lake :

Yes; going to the ER would be appropriate if your pains were more consistent with a heart attack. Symptoms from a heart attack are often not felt as a "pain" by the patient. Many heart attack victims report a "discomfort" or "pressure" sensation, and it's often not in the chest--the arms, back and jaw are common sites of the discomfort--any pain between the belly button and the nose could be from the heart. Regardless of where the symptoms are, the patient usually knows that something bad is going on, and may become sweaty or nauseated. These symptoms warrant a 911 call.

Customer:

thanks!

dr-lake :

But regardless, if your pains persist, they need to be evaluated.

Customer:

ok...

dr-lake :

If for no other reason than to get them to go away.

Customer:

true!

dr-lake :

Anything else?

Customer:

nope except when I accept it's for one question or another fee? not sure

dr-lake :

Accept is for what you've already paid or been told would be charged. No additional charge.

Customer:

ok... thanks and good night! I will rest more peacefully now without the 9 hour hospital wait! :)

dr-lake :

You're quite welcome!

dr-lake
dr-lake, Board Certified Physician
Category: Cardiology
Satisfied Customers: 270
Experience: Cardiologist
Verified
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dr-lake
dr-lake
dr-lake, Board Certified Physician
Category: Cardiology
Satisfied Customers: 270
270 Satisfied Customers
Experience: Cardiologist

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