[50F] Experiencing chest pain, arm tingling, and shoulder pain

Patient Description

A 50-year-old female presents with a dull chest pain in the upper left chest and shoulder, rated 2 out of 10 in severity, which worsens when lying down and being still. This has been occurring on and off for a few weeks. Additionally, she reports a pins and needles sensation in her left arm, from shoulder to fingertips, lasting for about 10 minutes. She also experiences a dull pulling shoulder pain, rated 4 out of 10, persisting on and off for weeks, with no recent injuries reported. The patient has a longstanding history of severe depression, characterized by feelings of guilt and perceiving herself as a burden, especially when alone. Her medical history includes diabetes diagnosed 10 years ago, and she has a known latex allergy. Current medications include Fluvoxamine 150 mg, Atorvastatin 40 mg, Buspar 15 mg, and Basiglar 20iu. No additional medications or allergies have been reported.

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Arora's Assessment

What might be happening

Based on the information you've provided, possible diagnoses include:

  • Angina: This is chest pain or discomfort caused when your heart muscle doesn't get enough oxygen-rich blood. It may feel like pressure or a squeezing pain in your chest. The pain may also occur in your shoulders, arms, neck, jaw, or back. It can feel like indigestion. Angina is a symptom of coronary artery disease (CAD), the most common type of heart disease.

    • Treatment may include lifestyle changes, medicines, medical procedures, and cardiac rehabilitation (rehab).
  • Heart Attack: Some heart attacks are sudden and intense, but most start slowly, with mild pain or discomfort. Pay attention to your body and call 911 if you experience chest discomfort; discomfort in other areas of the upper body; shortness of breath; and other signs such as breaking out in a cold sweat, nausea, or lightheadedness.

    • Treatment for a heart attack usually includes medications, surgical procedures, and lifestyle changes.
  • Anxiety or Panic Attack: Anxiety can cause physical symptoms like pain, a pounding heart, or stomach problems. It can be a normal reaction to stress, or it can happen in people who have a disorder called generalized anxiety disorder. Panic attacks are sudden periods of intense fear that may include palpitations, sweating, shaking, shortness of breath, numbness, or a feeling that something terrible is going to happen.

    • Treatment may include psychotherapy (a type of counseling), medication, and lifestyle changes.
  • Dercum's Disease: This is a rare disorder characterized by multiple, painful growths consisting of fatty tissue (lipomas) that occur just below the surface of the skin. The lipomas associated with Dercum's disease are most often located on the trunk, the upper arms and upper legs, and are found in a symmetrical pattern on both sides of the body.

    • Treatment is symptomatic and may include surgery, medication, and lifestyle changes.

What you can do

  1. Seek immediate medical attention: Given your symptoms of chest pain and tingling in your arm, it's important to seek immediate medical attention. These could be signs of a serious condition like a heart attack, which requires immediate treatment.

  2. Monitor your symptoms: Keep track of when your symptoms occur, how long they last, and any factors that seem to trigger them. This information can be helpful to your healthcare provider.

  3. Maintain a healthy lifestyle: Regular exercise, a healthy diet, and stress management can help manage many conditions, including heart disease and anxiety.

  4. Follow your treatment plan: If you have a diagnosed condition, it's important to follow your treatment plan. This may include taking prescribed medications, attending regular check-ups, and making lifestyle changes.

What you should look out for

  • If your chest pain or arm tingling worsens or you experience other symptoms such as shortness of breath, dizziness, or nausea, seek immediate medical attention.
  • If your feelings of anxiety or depression worsen or you have thoughts of harming yourself, reach out to a mental health professional right away.

Please remember that while I strive to provide accurate and helpful health information, this advice is intended to be general in nature, and specific causes may not apply to your situation. Always consult with a healthcare provider for appropriate examinations, treatment, testing, and care recommendations.

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11 mo ago

People Also Ask


What are the common symptoms of angina and how is it treated?

Common symptoms of angina include chest pain or discomfort, which may feel like pressure or squeezing. The pain can also occur in the shoulders, arms, neck, jaw, or back. Treatment often involves lifestyle changes, medications, medical procedures, and cardiac rehabilitation.


How can anxiety or panic attacks manifest physically, and what are the treatment options?

Anxiety or panic attacks can cause physical symptoms such as chest pain, a pounding heart, stomach problems, sweating, shaking, shortness of breath, and numbness. Treatment may include psychotherapy, medication, and lifestyle changes.


What should I do if I experience chest pain and tingling in my arm?

If you experience chest pain and tingling in your arm, it is important to seek immediate medical attention as these could be signs of a serious condition like a heart attack.


How can depression affect physical health, and what are the treatment options?

Depression can lead to physical symptoms such as fatigue, changes in appetite, and sleep disturbances. It can also exacerbate chronic conditions like heart disease. Treatment options include medication, psychotherapy, and lifestyle changes such as regular exercise and a healthy diet.


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