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Pain in chest, left arm with HEART ATTACK in ECG.

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Dear Doctor,

I am very urgently seeking for advice and consultation. I am a student in the UK, and my parents live in central Africa, specifically in Congo (D.R.C). Due to the circumstances of this 3rd world country, not many medical help is available and in dangerous cases people do need to leave the country to seek medical attention elsewhere. My mother aged 47, recently had a cardiac test and a blood test, she received the results but with no consultation from a doctor, the only thing mentioned was a ''minor heart attact''. She has had an operation in the neck and has removed her Thyroid gland and since then has been in medication. The cardiologist stated that it was cause of the thyroid drugs that the heart undergone stress. There are not many clear answers and me and my mother are very worried. We want to know whether she needs to arrange immediate travel plans and seek medical attention and what is her actual condition.I have attached both her heart and blood test. it has been 7 straight days now that she experiences pain in chest,back and left arm. Her heart beat raises and falls. She has been given Tenormine and Aspirine for now. That with many other symptoms along the last 2 months. I can provide you any other details you may require, I kindly ask for your help as we are worried extremely much. 

Category: Cardiologist

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Category: Cardiologist
 18 Doctors Online

Thank you for your query at

The ECGs uploaded by you show RBBB ( Right Bundle Branch Block - in the conduction system of the heart -slight blockage)and are more or less normal. It doesn't show any major abnormality. The blood test that is done shows some abnormalities in liver. If she has heaviness or choking or vague discomfort in her chest or left arm or back at rest then she requires early angiography to rule out blockages in her heart arteries.
Can you describe the pain its nature whether pricking or heaviness or burning or choking. Does the pain occur at rest or on walking.
Does the pain come along with sweating nausea. For the time being she should continue her aspirin and tenormin.
Kindly let me know the details of the pain so that I may advise you as to what further action you need to take.
Dr Vivek Mahajan
DM Cardiology

Patient replied :

Dear Dr. Vivek,
Before approximately 2 months, after a travel to Europe she had a heavy chest pain, with her left hand and shoulder completly sensless and her veins swollen up. She had some diffuculties breathing because of the weight that she felt on her chest and pain asociated with it. Recently, anytime that she is exposed to sunlight for a while her heart races very fast and feels like fainting. The past 7 days she is just experiencing pain in her chest, back and left arm where it comes and goes. Her left generally has a tingling sensation and some sort of pulling. When walking for a few miles also experiences a lack of breath. When sitting, she feels discomfort in the back and at the bottom of the left breast. Is there a big concern for the liver? Is there generally a threat? Thank you doctor for all the help and information provided. We just wish to get a resolution the soon as possible and get her feeling better again. Many thanks and waiting your response.
Best regards, George

Hello Mr George,

The pain described by you doesn't match the description of angina exactly. For example there is no tingling or numbness in arms on exertion just heaviness or pain.
The pain in chest or the heaviness in chest or back is usually only exertional. Nevertheless many aspects of pain are similar to angina like exertional pain and shortness of breath. So i would suggest a coronary angiography for her. Thereby we could rule out any life threatening coronary artery disease. There could be other reasons for such pain like neurological or musculoskeletal. If the angiography turns out to be normal we could look for other causes. As far as the liver is concerned its difficult to tell from a single blood test and a gastroenterology opinion would be valuable.

Dr Vivek Mahajan
DM Cardiology

Dr. Vivek Mahajan
Category: Cardiologist
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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