Symptoms: Tongue Numbness, Facial Weakness, and Chest Tightness

Tongue numbness, facial heaviness, chest tightness?

Hello, Dr.
Zhong! I would like to ask about some symptoms I've been experiencing over the past two to three weeks.
Around noon, I often feel numbness under my tongue, a sensation of a foreign body below my throat, tightness in my chest, and a dull feeling on the left side of my face (including my eyeball).
Additionally, my left arm and fingers also feel dull.
This is not the first time I've experienced these sensations; I recall having similar feelings occasionally over the past year or two.
Should I be concerned that this might be a precursor to a stroke?
At the end of last year, both my standard electrocardiogram and exercise stress test indicated myocardial ischemia, but perfusion scans and coronary angiography showed no signs of blockage in my cardiovascular system.
My echocardiogram was normal, and my blood pressure typically ranges between 120-130/80-90.
I weigh 86 kg and am 172 cm tall, with normal high/low-density cholesterol ratios.
I have also had two normal chest X-rays at the end of last year and mid this year.

Could the aforementioned symptoms be related to cardiovascular issues, or is it more likely to be a neurological problem? Additionally, how often should I follow up with a cardiologist?

Mr. Hsieh, 40~49 year old female. Ask Date: 2004/09/25

Dr. Zhong Yuxun reply Cardiology

Dear Mr.
Hsieh,
The interpretation of an electrocardiogram (ECG) is quite subjective and often has discrepancies, so it should be used for reference only.
In contrast, nuclear perfusion scans and cardiac catheterization provide more detailed and accurate information.
If there are no vascular blockages, there should be no significant issues.
It is advisable to manage your weight and blood pressure (with diastolic pressure ideally below 80 mmHg) and to follow up with a cardiologist every six months, unless symptoms arise.
Regarding the symptoms you mentioned, it is recommended to consult a neurologist for further evaluation.
Sincerely,
Dr.
Chung Yu-Hsuan

Reply Date: 2004/09/25

More Info

Hello! Thank you for reaching out with your concerns regarding your recent symptoms of tongue numbness, facial weakness, chest tightness, and sensations in your left arm. Based on your description, it’s understandable to be worried about the possibility of a stroke or other serious conditions, especially given your previous heart-related issues.

Firstly, the symptoms you are experiencing—specifically the numbness in your tongue and left side of your face, along with the tightness in your chest and sensations in your left arm—can indeed be concerning. These symptoms can be indicative of several conditions, including neurological issues, cardiovascular problems, or even anxiety-related responses.
1. Neurological Concerns: The combination of facial numbness and weakness, particularly if it is unilateral (affecting one side of the body), can be a sign of a transient ischemic attack (TIA) or stroke. TIAs are often referred to as "mini-strokes" and can present with similar symptoms to a stroke but typically resolve within a short period. Given that you have experienced these symptoms intermittently over the past couple of years, it is crucial to consult a neurologist for a thorough evaluation. They may recommend imaging studies, such as an MRI or CT scan, to assess for any underlying issues.

2. Cardiovascular Issues: Your history of myocardial ischemia (heart muscle oxygen deprivation) is significant. While your recent tests show no blockages, the symptoms of chest tightness and arm numbness could still be related to cardiac issues, especially if they occur during exertion or stress. It’s essential to monitor these symptoms closely and discuss them with your cardiologist. They may suggest further testing, such as a stress test or echocardiogram, to evaluate your heart function more thoroughly.

3. Anxiety and Stress: It’s also worth considering that anxiety can manifest physically, leading to symptoms such as chest tightness and numbness. Stress can cause hyperventilation, which may lead to sensations of tingling or numbness in various parts of the body. If you find that your symptoms correlate with periods of stress or anxiety, it may be beneficial to explore stress management techniques or speak with a mental health professional.

4. Follow-Up Care: Given your history and current symptoms, it would be prudent to have regular follow-ups with both your cardiologist and a neurologist. The frequency of these visits can depend on your symptoms and any new developments. Generally, if your symptoms are stable and not worsening, a follow-up every 6 months to a year with your cardiologist may be appropriate, while a neurologist may want to see you sooner if they suspect any neurological issues.

In conclusion, while your symptoms could be related to various causes, including neurological and cardiovascular issues, it is essential to seek medical attention promptly. A comprehensive evaluation by specialists will help determine the underlying cause of your symptoms and guide appropriate treatment. Please do not hesitate to reach out to your healthcare providers to discuss your symptoms further and ensure you receive the care you need. Take care!

Similar Q&A

Understanding Facial Pain and Tension: Anxiety's Impact on Nerve Health

Recently, due to some issues at home, I often feel easily tense. When I am tense, I experience symptoms such as rapid heartbeat, chest tightness, increased body temperature, slight dizziness, and tingling or numbness in my cheeks. Occasionally, I also experience muscle twitching....

Dr. Jiang Junyi reply Neurology
Dear Mr. Chiu, The symptoms you mentioned may be related to hyperventilation, which can lead to decreased carbon dioxide levels in the blood, resulting in an increased pH and systemic reactions and symptoms. Common manifestations include vasoconstriction and decreased calcium le...

Understanding Morning Numbness: Causes and Solutions for Facial and Hand Tingling

I usually don't eat anything in the morning, so I get hungry until noon. However, today during class, after sitting for an hour or two, I started to feel my mouth getting numb and a bit dizzy. Eventually, my mouth, nose, and eyes all felt numb, and my hands began to feel num...

Dr. Jiang Junyi reply Neurology
Hello: Your symptoms may suggest hyperventilation. This condition leads to a decrease in carbon dioxide levels in the blood, resulting in an increased pH, medically referred to as "respiratory alkalosis." This can trigger systemic reactions and symptoms, with common man...

Understanding Chest Tightness, Digestive Issues, and Scalp Numbness

Hello, doctor. Recently, I have occasionally experienced a tingling sensation on the left side of my scalp, similar to goosebumps. Additionally, over the past two weeks, I have had the following symptoms: 1. A feeling of tightness in my left chest and upper back, with sharp pain ...

Dr. Liao Yaopan reply Family Medicine
Hello, the symptoms mentioned above are quite non-specific. Given your long history of medication use, I recommend discussing with your psychiatrist whether these symptoms may be related to the long-term effects of the medications. Additionally, reassess if you need assistance fr...

Understanding Numbness and Weakness: Possible Neurological Disorders

Initially, there was severe bloating and irregular bowel movements, with increased frequency. About two months later, there was numbness in both legs, itching on the soles of the feet, like being bitten by ants. Subsequently, both legs became numb and weak. A week later, there wa...

Dr. Ye Boshou reply Neurology
Hello: The symptoms are very similar to Guillain-Barré Syndrome (GBS). Please see a neurologist for an examination as soon as possible.