Chest Pain, Weakness, and Heart Health: Key Insights - Cardiology

Share to:

Chest tightness, chest pain, back pain, and limb weakness?


Hello, starting from the end of February, I have been experiencing persistent chest tightness, dizziness, weakness in my limbs, left chest and back pain, shortness of breath, and fatigue.
After seeking medical attention, blood tests showed normal thyroid function.
Two days later, due to the persistence of symptoms, I sought medical care again, but by the time of the visit, I had no symptoms.
An ultrasound, electrocardiogram (ECG), and X-ray were performed, with the following results:
- PA systolic pressure: 30 mmHg
- Pericardial effusion: mm
- LV Function:
- PLVSF
- Hypokinesia (Normal EPSS < 10 mm)
- Estimated ejection fraction of left ventricle: 75% (Teichholz method)
- RV Function:
- PRVSF
- Hypokinesia (Normal TAPSE > 20 mm)
- IVC: 14 mm (Normal < 20 mm)
- Oscillating Vegetation:
- Thrombus:
- Mass/Tumor:
Interpretation:
- Mild Mitral Valve Prolapse (MVP), anterior leaflet
- Mitral regurgitation: Minimal
- Tricuspid regurgitation: Mild
- Pulmonary regurgitation: Minimal
- Diastolic function of LV: E/A > 1
- No LV regional wall motion abnormality.
24-hour ECG:
1.
Sinus rhythm with a rate of 48-114/min and mean 72/min.
2.
Intermittent ectopic atrial rhythms were noted.
3.
One Atrial Premature Contraction (APC).
4.
No Ventricular Premature Contractions (VPCs).
5.
No pauses longer than 2.0 seconds.
6.
No ST segment deviation greater than 2mm.
7.
No entries of symptoms were made in the patient diary.
A month later, during a follow-up visit, blood tests showed cholesterol levels:
- Total Cholesterol (T-CHO): 239
- Triglycerides (TG): 70
- Low-Density Lipoprotein Cholesterol (LDL-C): 148
I was prescribed antiarrhythmic medication and statins, which I am still taking.
I continue to experience intermittent chest tightness, dizziness, weakness in my limbs, left chest pain, and left back pain.
Recently, I have also started experiencing sporadic muscle cramps that last less than a minute, as well as intermittent numbness in my limbs (from the knees down to the toes and in the fingers), resembling poor circulation.
The blood vessels have also become more prominent.

Could you please advise if this indicates a heart, blood, or other issues, and what further examinations should be conducted? Thank you.

Tzu, 40~49 year old female. Ask Date: 2024/05/10

Dr. Wu Xueming reply Cardiology


The echocardiogram and 24-hour Holter monitor did not show any significant abnormalities.
If the chest discomfort persists, it is recommended to consult a physician in the outpatient clinic to see if an exercise stress test can be arranged.

Reply Date: 2024/05/10

More Info


Your symptoms of persistent chest tightness, dizziness, weakness in the limbs, left chest pain, back pain, shortness of breath, and fatigue are concerning and warrant further evaluation. Although you have undergone various tests, including blood tests, echocardiograms, and electrocardiograms (ECGs), the presence of ongoing symptoms suggests that a more comprehensive approach may be necessary.


Understanding Your Symptoms
1. Chest Pain and Discomfort: Chest pain can arise from various causes, including cardiac, musculoskeletal, gastrointestinal, and psychological factors. Given your symptoms, it is essential to rule out any cardiac issues, especially since you have a history of mitral valve prolapse (MVP) and mild mitral regurgitation. These conditions can sometimes lead to symptoms like chest pain and palpitations.

2. Dizziness and Weakness: These symptoms can be indicative of several issues, including low blood pressure, dehydration, anemia, or even anxiety. Your reported systolic pressure of 30 mmHg is concerning and should be investigated further, as it may indicate a significant drop in blood pressure, which can lead to dizziness and weakness.

3. Shortness of Breath: This can be related to cardiac issues, especially if there is any fluid accumulation around the heart (pericardial effusion) or if the heart is not pumping effectively. Your echocardiogram shows a normal left ventricular function, which is reassuring, but ongoing symptoms should not be ignored.

4. Muscle Pain and Numbness: The intermittent muscle cramps and numbness in your limbs could be related to circulation issues, electrolyte imbalances, or nerve compression. Given that you mentioned these symptoms are accompanied by visible blood vessels, it may be worthwhile to evaluate your vascular health.


Recommendations for Further Evaluation
1. Cardiology Follow-Up: Since you have ongoing symptoms, a follow-up with a cardiologist is essential. They may recommend additional tests such as a stress test, cardiac MRI, or even a coronary angiogram to assess the blood flow to your heart.

2. Neurological Assessment: Given the numbness and muscle cramps, a consultation with a neurologist may be beneficial. They can evaluate for any potential nerve issues or other neurological conditions that might be contributing to your symptoms.

3. Blood Tests: A comprehensive metabolic panel, complete blood count, and thyroid function tests can help identify any underlying issues such as anemia, electrolyte imbalances, or thyroid dysfunction that could be contributing to your symptoms.

4. Holter Monitor: If you have not already done so, wearing a Holter monitor for an extended period can help capture any arrhythmias that may not have been detected during your previous ECGs.

5. Lifestyle Modifications: While awaiting further evaluation, consider lifestyle changes that can help manage your symptoms. This includes maintaining a balanced diet, staying hydrated, managing stress through relaxation techniques, and engaging in light physical activity as tolerated.


Conclusion
Your symptoms are multifaceted and could stem from a combination of cardiac, neurological, and possibly psychological factors. It is crucial to continue working closely with your healthcare providers to ensure a thorough evaluation and appropriate management plan. Do not hesitate to seek immediate medical attention if your symptoms worsen or if you experience new symptoms such as severe chest pain, fainting, or significant changes in your health status. Your health and well-being are paramount, and timely intervention can make a significant difference.

Similar Q&A

Understanding Chest Pain: When to Seek Further Heart Evaluation

Hello Dr. Bu, I have been experiencing heart pain since middle school, which I believe is caused by academic pressure. My symptoms include irregular heartbeats, a stabbing pain in the heart area, and a tight sensation in the back where the heart is located. I often feel weakness ...


Dr. Bu Shiyun reply Cardiology
Chest pain is not uncommon in young people, but most of the time it is not caused by heart problems. Sometimes it can be due to neuromuscular pain, and stress can also have an impact. It is advisable to engage in more physical activity to relax, maintain a regular lifestyle, ensu...

[Read More] Understanding Chest Pain: When to Seek Further Heart Evaluation


Understanding Chest Pain and Fatigue: A Guide for Patients with Diabetes and Hypertension

Hello Dr. Hsiao: I am 163 cm tall and weigh 130 kg. For a long time, I have been experiencing persistent dull pain in my chest near the heart, in my back near the heart, and in my left shoulder. I have diabetes and hypertension. I have seen specialists in cardiology, orthopedics,...


Dr. Xiao Yongxun reply Internal Medicine
Dear Mr. Anong: 1. Your height is 163 cm, weight is 103 kg, and your body mass index (BMI) is 48.9 kg/m², which classifies you as severely obese. Consequently, your risk of developing the following conditions is increased: hypertension, dyslipidemia, metabolic syndrome, type 2 d...

[Read More] Understanding Chest Pain and Fatigue: A Guide for Patients with Diabetes and Hypertension


Understanding Chest Pain and Palpitations: When to Seek Heart Care

Hello, doctor: I have been experiencing strong palpitations every time I wake up for the past six months. After waking up, I cannot go back to sleep because of the persistent palpitations. Today, I felt an unexplained pain in my left back, followed by chest tightness, shortness o...


Dr. Wu Xueming reply Cardiology
It is recommended that if these symptoms persist and worsen, you should go to the hospital for further examination.

[Read More] Understanding Chest Pain and Palpitations: When to Seek Heart Care


Understanding Chest Pain: A Student's Concerns About Heart Health

Hello, Doctor. I am a resident student. Due to being overweight, I use the treadmill for at least an hour each day at a speed of about 6 to 7 kilometers per hour. However, I have been inactive for a while, so I get quite breathless after running for a bit and need to take short b...


Dr. Hong Yuanbin reply Internal Medicine
Hello, based on your current condition, exercising is indeed your best option and will likely provide you with the most benefit. However, since you do not have a regular exercise routine, I recommend starting gradually. In terms of speed, you should run at a pace where you can ta...

[Read More] Understanding Chest Pain: A Student's Concerns About Heart Health


Related FAQ

Chest Pain

(Cardiology)

Angina

(Cardiology)

Chest Tightness And Pain

(Cardiology)

Heart Attack

(Cardiology)

Heart Failure

(Cardiology)

Chf

(Cardiology)

Breathing

(Cardiology)

Afib

(Cardiology)

Pulse

(Cardiology)

Chest Pain

(Family Medicine)