[37F] With left arm and jaw pain, associated with panic and fatigue

Patient Description

A 37-year-old female presents with pain in the left arm and both sides of the jaw, with the jaw pain being the most bothersome. The jaw pain is constant, rated as a 6 out of 10 in severity, and occurs simultaneously with the arm pain, lasting only about 2 minutes each time. The pain does not worsen with any specific activities or at any particular time of day. Additionally, the patient has experienced slight chest pain, pain radiating to the chest, neck, back, and arms, and associated symptoms like sweating, nausea, and vomiting. She is not currently experiencing shortness of breath or palpitations. Other symptoms include feelings of panic and fatigue. The patient's medical history includes recurring shingles, post-herpetic neuralgia, and immune deficiency, all diagnosed in 2005. She has allergies to penicillin, amoxicillin, ceclore, bactrim, haldol, vistaril, and doxycycline. Current medications include Xanax (1mg, three times daily) since 2005 and Percocet (10mg, three times daily) since 2013. No other prescription medications, over-the-counter drugs, or supplements are being taken.

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Arora's Assessment

What might be happening

Based on the information you've provided, here are some possible explanations for your symptoms:

  • Angina or Heart-Related Issues: The combination of left arm pain and jaw pain, especially when associated with chest pain, sweating, nausea, and vomiting, can be indicative of angina or other heart-related issues. Angina occurs when the heart muscle doesn't get enough oxygen-rich blood. This can be a warning sign of a heart attack.

    • Treatment: Immediate medical evaluation is crucial. Tests like an ECG, blood tests, and possibly a stress test or angiography might be conducted. Treatment could involve medications, lifestyle changes, or procedures to improve blood flow to the heart.
  • Temporomandibular Joint (TMJ) Disorders: TMJ disorders can cause pain in the jaw and surrounding muscles. However, TMJ disorders typically do not cause arm pain.

    • Treatment: Management may include pain relievers, muscle relaxants, physical therapy, or dental splints.
  • Referred Pain from Cervical Spine Issues: Problems with the cervical spine (neck) can sometimes cause referred pain to the jaw and arm.

    • Treatment: This might involve physical therapy, medications, or other interventions aimed at the cervical spine.

What you can do

Given the potential seriousness of your symptoms, it is important to seek medical attention promptly. Here are some steps you can take:

  1. Seek Immediate Medical Attention: Given the potential for heart-related issues, it is important to see a doctor as soon as possible. If the pain is severe or you experience additional symptoms like shortness of breath, call emergency services immediately.
  2. Monitor Symptoms: Keep a record of when the pain occurs, its duration, and any other associated symptoms. This information will be helpful for your healthcare provider.
  3. Avoid Strenuous Activity: Until you have been evaluated by a healthcare professional, it is best to avoid strenuous activities that could exacerbate your symptoms.

What you should look out for

Seek immediate medical attention if you experience any of the following:

  • Chest Pain: Especially if it is severe, crushing, or associated with shortness of breath, sweating, nausea, or vomiting.
  • Shortness of Breath: Difficulty breathing or feeling like you can't get enough air.
  • Severe or Worsening Symptoms: If your symptoms become more severe or frequent.

Remember, while this information can help guide you, it is not a substitute for professional medical advice. Please see a healthcare provider for a formal diagnosis and appropriate treatment.

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6 mo ago


People Also Ask


What are the common symptoms of angina or heart-related issues?

Common symptoms of angina or heart-related issues include chest pain or discomfort, pain in the arms, neck, jaw, shoulder, or back, shortness of breath, nausea, fatigue, and sweating. These symptoms can be warning signs of a heart attack and require immediate medical attention.


Can temporomandibular joint (TMJ) disorders cause pain in areas other than the jaw?

TMJ disorders primarily cause pain in the jaw, face, and around the ear. However, they can sometimes lead to headaches or neck pain. TMJ disorders typically do not cause pain in the arms.


How can cervical spine issues lead to referred pain in the jaw and arm?

Cervical spine issues, such as herniated discs or nerve compression, can cause referred pain due to the interconnectedness of nerves. This can result in pain radiating to the jaw, shoulders, and arms, as the nerves in the neck can affect these areas.


What should I do if I experience severe chest pain or other alarming symptoms?

If you experience severe chest pain, shortness of breath, or other alarming symptoms like sweating, nausea, or vomiting, it is crucial to seek immediate medical attention. Call emergency services or go to the nearest hospital to ensure prompt evaluation and treatment.


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