How to Know if Left Arm Pain Is Heart Related

Three Parts:Recognizing a Heart AttackEvaluating Your PainConsidering Non-Heart Related Causes

Pain in the left arm can be due to many conditions, ranging from run of the mill muscle pain to a severe heart attack. Abnormalities of the skin, soft tissue, nerves, bones, joints and blood vessels of the arm can all cause pain. There are a number of factors to consider in order to determine whether your left arm pain is heart-related or not.

Part 1
Recognizing a Heart Attack

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    Evaluate the quality of your pain.[1] Pain that relates to a heart attack most often feels like a pressure, or squeezing, sensation. It can range from mildly painful, or not painful at all (in what are called "silent heart attacks"), to full pain that people would rank a 10 out of 10 in intensity. The pain is often in the chest area, and may radiate down your left arm, to your jaw, or to your back.
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    Look for non pain-related symptoms.[2] In addition to pain in your arm, jaw, neck, and back, there are other symptoms you may see during a cardiac episode, as well. These include:[3]
    • Nausea
    • Lightheadedness or dizziness
    • Cold sweating
    • Shortness of breath or difficulty breathing due to chest tightness
    • If you are experiencing any of the above symptoms in conjunction with your pain, it is best to see a doctor as soon as possible to rule out the possibility of a heart attack.
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    [Call Emergency Medical Services] (911) if you are experiencing the above symptoms.[4] If you are in doubt about your current condition, it is safer to call 9-1-1 or triple zero (000) or the Emergency Medical Services number for your area for quick transport to the hospital and further management. Always remember that if you have a heart attack, time is very important and not a second should be wasted because your life is at risk.[5]
    • As you wait for emergency medical personnel to arrive, take 2 baby aspirins (180mg total) as these can diminish the severity of a heart attack.[6] Aspirin works by preventing further blood clots, and it is a blood clot in one of the coronary arteries (the arteries surrounding the heart) that causes a heart attack to begin with (so aspirin helps to prevent this clot from getting worse).
    • Also take nitroglycerin if you have it on you as you wait for the ambulance to get there.[7] This can diminish chest pain and help you to cope with the symptoms until you get to the hospital (at which point the doctors can offer you additional pain medications such as morphine).
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    Undergo a series of diagnostic examinations.[8] If you suspect you may be having a heart attack, your doctor will perform a number of tests in order to determine and to confirm the diagnosis. You will receive an electrocardiogram (an ECG) to evaluate your heart's rhythm; abnormalities will show up in the case of a heart attack. You will also receive blood tests, mainly to check for an elevation of cardiac enzymes in the blood stream which is indicative of strain on the heart.
    • Depending upon your symptoms and how clear the diagnosis is to your doctors, you may or may not receive additional diagnostic tests including: an echocardiogram, a chest x-ray, an angiogram, and/or an exercise stress test.

Part 2
Evaluating Your Pain

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    Note the duration. If your left arm pain has a very short duration (seconds) it is very unlikely to be caused by the heart. Along the same lines, if the pain has persisted for a long time (for days or even weeks), it is also unlikely to be heart-related. If it lasts in the realm of a few minutes to a few hours, however, it may be a heart attack. If your pain is recurring in short intervals, take note of all the durations and intensities of the pain on a piece of paper to bring to your doctor. This could also be heart-related and warrants prompt medical attention.
    • When the pain is released or accentuated by movement of the thorax (mid-spine region), it is probably due to a spinal degenerative disc disease, especially in older patients. This type of pain is unlikely to be caused by the heart.
    • Similarly, when the pain appears after a vigorous exercise with your arms, it is probably muscular in origin. Look at your daily patterns. What seems to aggravate it?
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    Consider that your left arm pain could relate to angina. Angina is a pain that occurs when there is insufficient blood flow to the heart.[9] Angina is often a squeezing or pressure sensation; you may feel pain in your shoulders, your chest, your arms, your back, or your neck. It may also resemble the feeling of indigestion.[10]
    • Although it is atypical for angina to appear only in the left arm, it is possible.
    • Angina is usually worsened or provoked with stress - either physical stress (such as exertion, like after climbing a flight of stairs), or emotional stress (such as after a heated conversation or a disagreement at work).[11]
    • If you suspect you may have angina, it is important to see a healthcare provider sooner rather than later.[12] It is not life-threatening like a heart attack, but it nevertheless requires appropriate evaluation and treatment.
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    Consider other symptoms. In addition to the pain in your left arm, take note of any other areas that you are experiencing pain. This is one of the most accurate ways to tell whether your left arm pain is heart-related or not (and if it's serious). A heart attack is likely to be accompanied by: [13]
    • Sudden and excruciating chest pain that radiates down to your left arm. It can be experienced on both arms but it is usually felt in the left arm because it is nearest to the heart.
    • Pain and tightness in the jaw that is usually felt in the lower jaw; it can be in one side only or on both sides.
    • Radiating pain in the shoulders that feels like a heaviness and pressure around the shoulder and chest area.
    • Dull back pain caused by the presence of pain in the chest, jaw, neck and arm.
    • Note that a heart attack may also be "silent," in that it presents without serious pain.

Part 3
Considering Non-Heart Related Causes

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    Check for pain related to neck movement.[14] If your pain is worsened when you move your neck or upper back, cervical spondylosis may be to blame. This is one of the most common causes of left arm pain. More than 90% of people older than 65 have evidence of cervical spondylosis. This is a general term for age-related tears affecting the disks in your spine (particularly in your neck area). As the disks dehydrate and shrink, cervical spondylosis develops. It tends to worsen with age as the back wears out.
    • Moving your neck and upper spine can determine the cause of the pain. When movement increases your pain, this is probably related to cervical spondylosis.
    • Heart attack pain is not lessened or worsened by movement or applying pressure on the spine or neck.
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    Check for pain when you move your shoulder.[15] If the pain flares up in your arm when you move your shoulder, it could actually be shoulder arthritis. Many patients that come into the emergency department with the fear that they're having a heart attack are actually suffering from this condition. This is a disease that destroys the smooth outer covering (cartilage) of the bone. As the cartilage disappears, the protective space decreases between the bones. During movement, the bones rub against each other, causing shoulder pain and/or pain in the left arm.
    • Although no definitive cure exists for arthritis of the shoulder, many treatment options are available to relieve the pain. If this describes you, don't worry. It sounds serious, but the progression can be stopped.
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    Consider that you may have a nerve injury. If you lose the function in your arm, it's most likely to be a nerve-related injury.[16] The arm nerves arise at the spinal cord level in the lower neck and form a nerve bundle, called the brachial plexus. This bundle splits, giving rise to the nerves of the arm. Arm nerve damage from the shoulder to the hand causes varying pain, but usually this is associated with a loss in arm function (such as numbness, tingling, or decreased range of motion). Your arm pain could be on the nerve level and have zero to do with your heart.
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    Check your blood pressure and pulse. If these are affected, peripheral arterial disease may be the cause. This is due to atherosclerosis and is more common amongst smokers.[17]
    • To determine if this is the culprit, a quick visit to your doctor and getting your blood pressure and heart rate checked will solve the puzzle.
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    Consider alternative diagnoses for arm pain.[18] Think back to see if you can remember any recent injuries you may have sustained. Your left arm pain could be related to an arm or shoulder injury from recent trauma. Speak to your doctor if your arm pain is ongoing and if you cannot find any logical reason for it.

Sources and Citations

  1. https://www.nlm.nih.gov/medlineplus/heartattack.html
  2. https://www.nlm.nih.gov/medlineplus/heartattack.html
  3. http://www.heart.org/HEARTORG/Conditions/HeartAttack/WarningSignsofaHeartAttack/Warning-Signs-of-a-Heart-Attack_UCM_002039_Article.jsp
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Categories: Health Care and Medical Information | Cardiovascular Health and Blood Pressure