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Chest pain, pins and needles in body. Treatment?

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I'm a 38 year old man experiencing chest pain. Non smoker, moderate drinker, exercise regularly, varied and fairly healthy diet, arthritis in spine and joints since 19 years old. Until last year hadn't taken medication or sought medical attention for approx 10 years. 3 episodes of chest pain since December 2014.

First episode of chest pain late December 2014
# Some milder symptoms before 21st. 21st December woken by pain (tightness sensation) in centre of chest accompanied by pain (pins & needles sensation) in chest, upper stomach, upper arms, shoulders, neck and lower face.
# 21st a general practitioner at hospital examined chest and gave me painkillers (not sure which type).
# 23rd pain in throat and chest when breathing in cold air. Later pain (tightness) in chest, struggled to breath causing difficulty with speech, slumped forward from chair onto table, brief head ache and dizziness before regaining breath.
# Unable to sleep for several consecutive nights until chest pain went, regularly saw blood when blowing nose and dry blood in nose, noticed blue lips and red nose with hard skin.
# Medication during this period: Arcoxia (anti-infammatory) taken for about a week (60mg/day started 19th increased to 120mg/day on 24th). No medication taken in 2015.

Second episode began late February
# 26th February pain (pins and needles) in left side of chest that started when out in cold weather and worsened when swimming to extend all way down arms.
# Chest pain became worse during night 26th - 27th when falling asleep and waking shortly after falling asleep. Again pain (pins and needles) in parts of body, this time including groin and genitals. Rapid twitches of small areas in different parts of body, and many in face. Facial muscles were difficult to move, and, after one twitch above upper lip, temporarily unable to raise upper lip on the left side when trying to smile.
# 27th my GP pressed on and listened to chest diagnosing chest inflammation.
# Symptoms continued the following night 27th - 28th and included pain (sharp pinching sensations) in penis and a small area (above middle) of left calf. Sometime later when standing erect penis pointed to right and was higher and firmer on left side than right. Pain eased in calf but continued for weeks as milder pain.
# Morning 28th pulse repeated pattern of two beats very close together then a pause.
# Constant pain (aching) in all teeth, occasional painful movement of throat when speaking and unable to sleep until chest pain eased when resting in evening 2nd march.

Third episode began early March
# 5th March chest pain (felt deep in chest slightly higher and slightly more central than left nipple, which seemed to cover an area slightly smaller than my fist) when walking outside, followed by chest pain (constant aching) on left side that continued for many days.
# 25th half awake felt left side of chest beating a repeated pattern: approx 8 beats - discomfort (pressure sensation) - no beats felt - beating resumes and discomfort eases.
# More occasions of waking with pain (pins and needles) in chest and also in legs, hands and feet. Left side of chest pounding heavily when at rest during day on more than one occasion in March. Pulse sometimes visible in different places around body: side of neck, inside of arm opposite elbow, inside of ankle, back of hand, inside of thigh.

Sorry for including so much detail; I'm not sure which details are important and which aren't. Please could you tell me if any of these symptoms suggest a heart problem?

Category: Cardiologist

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Category: Cardiologist
 27 Doctors Online

Hello,
Thank you for your query at DoctorSpring.com
I understand your concern.
I also apologise for the delay in the reply.
The isolated episodes of chest pain could be due to a lot of different reasons such as costochondritis, GERD, gastric ulcer, pinched nerve, or cardiac problems. Here, from your history, since there are other systemic symptoms present too like throat pain, pins and needles sensation, it does not seem like related to the heart. In cardiac causes, the other associated symptoms would be difficulty in breathing, palpitations, more shortness of breath on lying down, blood pressure instability, e.t.c
Did your physician mention your BP when he examined you? Chest inflammation is not a diagnosis, as it could mean either chest muscle inflammation or inflammation in the ribs, e.t.c
It is better you get an ECG and 2D ECHO done to rule out cardiac problems. Since there are so many systemic symptoms, a complete blood panel including CBC, LFT, RFT, Serum electrolytes, ESR, and CRP will give further clue towards the diagnosis.
Hope this was helpful,
Please get the tests done and send the reports and I will get back to you.
Regards.


Dr. Vivek Mahajan
Category: Cardiologist
Experience: 
Fellowship: DM, Cardiology, PGIMER, 2013
Residency: MD, Internal Medicine, AIIMS, 2007
Internship: King Edward Memorial (KEM) Hospital, 2003 
Medical School: MBBS, Seth G.S. Medical College, 2002
Dr. Vivek Mahajan and 4 other Medical Specialists are ready to help you

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