Can chest pain be linked to the heart?

Question

Hi doctor,

I am a 35-year-old female. I experience intermittent sharp pain in the left upper chest. Sometimes, it radiates to the neck, and at other times to the shoulder and upper arm. My ECG (electrocardiogram), blood tests, and chest X-ray were all normal. Given these test results, is it likely to be related to the heart? Movement does not seem to influence the pain. Occasionally, I also feel a bit dizzy. The pain appears to occur randomly. The doctor prescribed Diclofenac 50 mg three times a day. What else could it be? A colonoscopy was performed recently due to a family history of cancer, and the result was clear. The ultrasound of the abdomen was also clear.

Please help.

Answer 1

Hi,

Welcome to icliniq.com.

I have carefully reviewed your case and understand your health concerns. Thank you for uploading the details of some laboratory reports (attachments removed to protect the patient's identity). Your blood pressure and other parameters seem to be normal. Pain in this area can be related to the heart, especially when it radiates to the shoulder as well. As you mentioned, it can also be due to a pancreatic infection. However, there are additional symptoms, and the laboratory reports provide evidence that makes this less likely. A physical examination of the abdomen and auscultation of the heart may provide better clues about this issue.

Your body mass index (BMI) is high. The normal range is 18.5 to 24.9, and a high BMI is a risk factor for cardiac diseases. The tests you described are not conclusive enough to rule out heart conditions. We need to consider more sophisticated and specific tests like an exercise tolerance test (ETT) and possibly angiography if indicated after the ETT. Central obesity is particularly concerning. Belly fat is more detrimental compared to fat in other parts of the body, as it is associated with a higher risk of heart disease than overall obesity.

You should consult a cardiologist and ask for an ETT, echocardiography, and, if necessary, angiography to determine if there is heart disease. Heart disease refers to coronary artery disease (CAD), which involves the obstruction of blood supply to the heart muscle. Management will be based on the findings. Until then, continue with your current medications.

I hope this helps.

Thank you.