Patient's Query
Hello doctor,
I am 30 years old and have had a history of tuberculosis for six years with pleural thickness, COVID-19, and a habit of chewing tobacco for nine years. I have symptoms such as left side chest discomfort, sometimes right, pain shifts from one place to another, pain in upper left shoulder and bicep, upper back pain, high heart rate and BP, weakness and dizziness, spell, and always the fear of death. Along with this, burping and nausea followed by stomach upset are also common. My ECG, Echo, and TMT are normal. CT and coronary angiography are also normal. HRCT shows pleural thickness with calcification on the left side, USG abdomen is normal, and serum calcium, potassium, Hba1c, LFT, and KFT are also normal. My BP is 130/90, my weight is -185 pounds, and my height - is 171 cm. Kindly suggest.
Hello,
Welcome to icliniq.com.
I understand your concern.
The most dangerous thing with chest pain is ischemia or heart attack, which is ruled out with coronary angiography or CT (computed tomography). Also, the ECG (electrocardiogram) and Echo make cardiac issues less likely. History of TB is there, but there is no cardiac repercussion as per evidence. Burping, nausea, and relief of these symptoms with burping point toward gastric issues. I would suggest starting the following trial of medication for three to five days, and if not relieved, please consult a gastroenterologist for further management.
I hope this helps you.
Thank you.
Patient's Query
Hello doctor,
Thank you for your suggestions.
But, I thought it was microvascular angina because my symptoms were so annoying, it felt like cardiac issues rather than gastritis. However, the symptoms are not regular. Somedays, I feel energetic and symptomless, but other days, I feel weird symptoms and the symptoms like indigestion, and left arm pain that spreads all over my left upper body causing a lot of discomfort, starting in the morning. This discomfort bothers me for five to six hours which comes and goes with intensity low and high. Kindly suggest.
Hello,
Welcome back to icliniq.com.
Microvascular angina is one of the differentials but it is down the list. You do not have any previous relevant comorbid and your TMT (treadmill test) was normal. You try the above medicine followed by the gastroenterologist's opinion. If not relieved then we can go for further tests like SPECT (single-photon emission computed tomography), MRI (magnetic resonance imaging), and invasive assessments like coronary flow reserve. I hope you find this useful.
Thank you.
Patient's Query
Hello doctor,
Is it possible to have all these symptoms due to anxiety disorder, because I have a history of anxiety disorder and panic attacks? Kindly suggest.
Thank you.
Hello,
Welcome back to icliniq.com.
Yes. This is a possibility but people with anxiety tend to have gastric symptoms too. Kindly tell me what you do. How much walking or exercise do you do? Do you smoke or have any other toxic habit?
Patient's Query
Hello doctor,
I do 45 to 60 minutes of yoga and walking. I consume pan masala, daily eight to 10 packets. I face gastric issues without reason.
Hello,
Welcome back to icliniq.com.
Fine. What are your dietary habits? Are you vegetarian? You will have to quit chewing pan masala and start using a medicine that I have suggested. You will feel better. Consume yogurt fresh vegetables and fruits. This also helps.
Patient's Query
Hello doctor,
Yes, I am a vegetarian. As per your experience, what is the main cause of these symptoms?
Hello,
Welcome back to icliniq.com.
Right now it seems more likely a gastric cause. I would suggest you to use the medicine I have told you. You can always consult with me after you have used those medicines as I have prescribed.
I hope this helps.
Patient's Query
Hello doctor,
I have one question is always bothers me. If pain is noncardiac then why does it radiate to the left shoulder or arm and left upper back and sometimes only left arm pain without chest pain? And my second question is that. If the pain is cardiac then why does the left shoulder pain move up and down and persist for 6 to 7 hours along with indigestion and the urge to go washroom and get relieved by using the washroom?
Hello,
Welcome back to icliniq.com.
Gastric issues sometimes act strangely and may resemble cardiac issues. I would recommend you to take medicine as advised. Also please consult someone for anxiety problems.
I hope this helps.
Thank you.
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Answered byDr. Wajahat
Medically reviewed byiCliniq medical review team
Same symptoms don't mean you have the same problem. Consult a doctor now!
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