[50F] Experiencing chest pain, numbness, and sweating

Patient Description

A 50-year-old female has been experiencing chest tightness, rated 7-8/10 in severity, primarily while sitting at work. This has been ongoing for a few months. She also reports numbness in both arms and fingers during sleep, which wakes her up frequently. The numbness improves with changes in position or shaking the arms and hands. Additionally, she has been experiencing sudden sweats and hot flashes. The patient was diagnosed with hypothyroidism in October 2023 and is currently taking Levothyroxine 50mg and Atorvastatin 40mg daily. She reports feeling tired frequently, mood changes, and night sweats. No other pre-existing conditions or medications were reported.

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Arora's Assessment

What might be happening

Based on the information you have provided, here are some potential explanations for your symptoms:

  • Angina or Coronary Artery Disease: The chest tightness and pain you are experiencing, especially when sitting, could be related to angina or coronary artery disease. This is a condition where the heart muscle doesn't get enough oxygen-rich blood. Given your history of hyperlipidemia (high cholesterol) and hypertension (high blood pressure), this is a possibility.

    • Treatment: This typically involves lifestyle changes, medications to manage cholesterol and blood pressure, and sometimes procedures like angioplasty or surgery. It's important to see a doctor for a full evaluation.
  • Carpal Tunnel Syndrome: The numbness in your arms and fingers, especially at night, could be due to carpal tunnel syndrome. This condition occurs when the median nerve, which runs from your forearm into the palm of your hand, becomes pressed or squeezed at the wrist.

    • Treatment: Treatment may include wrist splinting, medications, and possibly surgery. Changing your sleeping position and avoiding repetitive wrist movements can help alleviate symptoms.
  • Hypothyroidism: Your hypothyroidism could be contributing to your symptoms of fatigue, mood changes, and night sweats. Hypothyroidism can cause a wide range of symptoms, including those you are experiencing.

    • Treatment: You are already on Levothyroxine, which is the standard treatment. It may be necessary to adjust your dosage, so follow up with your healthcare provider is important.
  • Peripheral Neuropathy: The numbness in your arms and fingers could also be due to peripheral neuropathy, which is a result of damage to the nerves outside of the brain and spinal cord.

    • Treatment: Treatment focuses on managing the underlying condition causing the neuropathy and relieving symptoms. This may include medications, physical therapy, and lifestyle changes.

What you can do

  1. Consult a Doctor: Given the severity and duration of your symptoms, it is crucial to consult a healthcare provider for a comprehensive evaluation. They may recommend tests such as an ECG, stress test, or blood tests to determine the cause of your chest pain and numbness.

  2. Lifestyle Changes: Adopt a heart-healthy lifestyle, including a balanced diet, regular exercise, and avoiding smoking and excessive alcohol consumption. These changes can help manage both your heart health and hypothyroidism.

  3. Manage Stress: Stress can exacerbate symptoms of both heart disease and hypothyroidism. Practice stress-reducing techniques such as mindfulness, meditation, or yoga.

  4. Monitor Symptoms: Keep a diary of your symptoms, noting when they occur, their severity, and any potential triggers. This information will be helpful for your healthcare provider.

What you should look out for

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

  • Severe Chest Pain: If your chest pain becomes severe, or if it spreads to your jaw, neck, or arm, seek emergency medical care immediately as these could be signs of a heart attack.
  • Difficulty Breathing: If you experience shortness of breath, dizziness, or fainting, seek medical help right away.
  • Worsening Numbness: If the numbness in your arms and fingers worsens or is accompanied by weakness, see a doctor promptly.

Remember, while this information can help you understand potential causes of your symptoms, it is not a substitute for professional medical advice. Please see a healthcare provider for a formal diagnosis and treatment plan.

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7 mo ago

People Also Ask


What are the common symptoms of angina or coronary artery disease?

Common symptoms of angina or coronary artery disease include chest pain or discomfort, which may feel like pressure, squeezing, or fullness. It often occurs with physical activity or stress and may radiate to the arms, neck, jaw, shoulder, or back. Other symptoms can include shortness of breath, nausea, and fatigue.


How can carpal tunnel syndrome be managed or treated?

Carpal tunnel syndrome can be managed with wrist splinting, especially at night, to keep the wrist in a neutral position. Nonsteroidal anti-inflammatory drugs (NSAIDs) can help reduce pain and inflammation. In some cases, corticosteroid injections or surgery may be necessary to relieve pressure on the median nerve.


What are the effects of hypothyroidism on mood and energy levels?

Hypothyroidism can lead to symptoms such as fatigue, depression, and mood swings due to the body's slowed metabolism. It can also cause difficulty concentrating and memory problems. Proper management with medications like Levothyroxine can help alleviate these symptoms.


What lifestyle changes can help manage high cholesterol and blood pressure?

Lifestyle changes to manage high cholesterol and blood pressure include adopting a heart-healthy diet rich in fruits, vegetables, whole grains, and lean proteins. Regular physical activity, maintaining a healthy weight, quitting smoking, and limiting alcohol intake are also important. Stress management techniques such as meditation or yoga can further support heart health.


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1 Comments


Prerana#31484

7 mo ago

Given your history of chest tightness and associated symptoms , it is important for you visit the ER as soon as possible and rule out the possibility of a heart attack. Hopefully you feel better soon.

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