Thank you for your query at DoctorSpring.com
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
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