Chest Pain Right Side but Radiating to right Jaw

[Sheryl]

Very good news. So you can relax and perhaps chart the pain up to stress.

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[dennis123]

6 minutes ago, Sheryl said:

Very good news. So you can relax and perhaps chart the pain up to stress.

 

Thanks, now I can get the rest of my teeth fixed.

[jmd8800]

Money well spent ... even if it just confirms good health.

[SiamRose]

Did you tell the doctor about the chest pain? What did they say?

[dennis123]

1 minute ago, SiamRose said:

Did you tell the doctor about the chest pain? What did they say?

They said it might be stress, suggested I could make an appointment with the cardiologist but told them I would give it some thought first, wanted to check the price list as there are a few other tests, one that costs like 40-50k baht, and another around 10k if I remember correctly. Sometimes I have a hard time saying no so I figured I read the report in detail first, check the price list and then consider going back to perhaps a government hospital where I can have the same test at a lower cost.

[dennis123]

Additional tests are like a 128 slice CT scan that comes in combination with EKG & kidney function test for 13500 baht (but I already had the EKG & Kidney test).

 

Then on that same heart-page price list, I see:

 

Vascular Screen Test (ABI) 800 baht

CT Calcium scoring 2900 baht 

Echocardiogram 2600 baht

 

Lastly, Conventional Coronary Angiography CAG (which requires a hospital stay of 1 night) for 35000 baht.

 

So that's a total of almost 55000 baht extra which makes it worth shopping around a little bit more.

 

Because yeah it's all nice and well that all the other tests I've done indicate no problem but the problem is still there.

 

Also, I'm truly an edge case:

 

They suggest the 128 slice scan for people that have two of the following:

 

- high blood pressure (my blood pressure is a tiny bit too high)

- diabetes (border case)

- high cholesterol (my cholesterol is exactly 100, and above 100 is high cholesterol or so the doctor told me)

- smoking tobacco (yeah way too much, two packs a day)

- a family history of heart disease (don't think so).

 

So it wouldn't take a whole lot to get below those thresholds by adjusting my eating pattern, smoke a bit less, drink a little less, lose a bit weight by exercising more.

 

Also makes me wonder, are those small tests even needed if I do a 128 slice scan instead, and speaking of that, does anyone know if there's any government hospital in Pattaya or nearby that offers that test or would it be pretty much in the same ballpark?

Edited November 4, 2018 by dennis123

[SiamRose]

That's good news. I would think that whatever the cause, losing weight, smoking less (or not at all), exercising and drinking less has to be a good idea. Then see if your symptoms improve.  

[dennis123]

26 minutes ago, SiamRose said:

That's good news. I would think that whatever the cause, losing weight, smoking less (or not at all), exercising and drinking less has to be a good idea. Then see if your symptoms improve.  

I made an appointment with the cardiologist for tomorrow morning, he wasn't working today to see if he thinks a CT scan is necessary or not. I don't mind paying 13,500 baht.

 

Had a quick chat with one of the doctors about this 35,000 diagnosis with 1-night overstay but that's only for people with extreme symptoms like waking up at night and hardly being able to breathe, while those smaller cheaper services in the 800-2900 baht range weren't necessary because I already had these other tests done.

 

Maybe he can suggest some medication if that CT scan isn't necessary as this discomfort/burning sensation is definitely annoying. It's a strange feeling but so troubling that you hope its either gone soon or drop dead soon. Can't really describe it.

Edited November 4, 2018 by dennis123

[Sheryl]

The 35k thing is an angiogram and it is only done when there is a very high index of suspicion for coronary artery disease which is not at all your case, quite the opposite. Between your age and negative stress test, CAD is highly unlikely.

 

Gastric/duodenal pain (gastritis) can mimic cardiac pain, so closely that even doctors can't tell the difference without running tests to exclude heart disease.   That would be the most likely explanation IMO given negative cardiac work up.   Could see a GI doctor if cardiologist gives you clean bill of health as likely will.

 

If it is gastric in origin they should test for h.pylori

 

 

[dennis123]

1 hour ago, Sheryl said:

The 35k thing is an angiogram and it is only done when there is a very high index of suspicion for coronary artery disease which is not at all your case, quite the opposite. Between your age and negative stress test, CAD is highly unlikely.

 

Gastric/duodenal pain (gastritis) can mimic cardiac pain, so closely that even doctors can't tell the difference without running tests to exclude heart disease.   That would be the most likely explanation IMO given negative cardiac work up.   Could see a GI doctor if cardiologist gives you clean bill of health as likely will.

 

If it is gastric in origin they should test for h.pylori

 

 

Thanks as always Sheryl

 

I missed the appointment this morning ???? so will go another time.

 

One interesting thing the doctor said btw was that I should cut down on raw meat and seafood, but the last time I ate a steak medium rare must've been 1.5 months ago, and I haven't been to any seafood buffets for a long time either, besides a meal from Tops with a few tiny shrimps a couple of weeks ago. When I said that she looked at me like she didn't believe me, and went on with the list.

 

She also said to cut down on fatty meat, like pork and salmon, and chicken with skin.

 

So yesterday I went to Tesco, to buy food, tomatoes, cucumber, bananas, grapes, mandarins (tiny oranges), 0% fat yogurt, but at the meat department, there's literally nothing left to pick besides chicken filet. I definitely ain't gonna eat some meat replacement like tofu.

[kkerry]

On 11/4/2018 at 2:22 PM, dennis123 said:

high cholesterol (my cholesterol is exactly 100, and above 100 is high cholesterol or so the doctor told me)

 

There are different cholesterol measurement figures, but in all my tests in Thailand total cholesterol of 100 is rated low, 200-240 is borderline high. Normally you receive Total, HDL, LDL and Triglyceride figures in your Lipid profile. Maybe the doctor meant fasting sugar level, where 100 would mean you are approaching pre-diabetic levels so also need to take notice. Be aware 0% and low fat yoghurt often contain medium to high sugar levels (check the labels) so don't overdo the seemingly healthy 0% yoghurt. 

 

This is a lipid profile result from a couple of years ago to give you an idea (my fasting sugar is back in the low nineties again).

 

 

Depends on your age, but if they let your heart rate get to nearly 200 in the stress test they probably think you are ok heart wise. 

[dennis123]

39 minutes ago, kkerry said:

 

There are different cholesterol measurement figures, but in all my tests in Thailand total cholesterol of 100 is rated low, 200-240 is borderline high. Normally you receive Total, HDL, LDL and Triglyceride figures in your Lipid profile. Maybe the doctor meant fasting sugar level, where 100 would mean you are approaching pre-diabetic levels so also need to take notice. Be aware 0% and low fat yoghurt often contain medium to high sugar levels (check the labels) so don't overdo the seemingly healthy 0% yoghurt. 

 

This is a lipid profile result from a couple of years ago to give you an idea (my fasting sugar is back in the low nineties again).

 

 

Depends on your age, but if they let your heart rate get to nearly 200 in the stress test they probably think you are ok heart wise. 

Actually, I thought I read 195 or something, on the screen, but in the report it said a heart rate of 172 with a target heart rate of 164. That stress test though only taking 9 minutes completely exhausted me lol.

 

You're right about the sugar at 100 indeed, I used to drink 1.5ltr of Coke per day so I'm cutting that drastically, stop eating icecream, and any other sweet snacks. I'm a true sugar addict, and also eat a lot of bread so it's going to be a tough one.

 

Going to replace it with sweet fruits like grapes, bananas, mango, pineapple, and maybe start doing some smoothies where I mix vegetables with fruit and honey added. I suppose the sugar from honey is better than what they put in Coke and ice cream.

 

Actually honey is not much better but vegetable smoothies are disgusting as hell without added sugar.

Edited November 5, 2018 by dennis123

[GarryP]

16 minutes ago, dennis123 said:

Actually, I thought I read 195 or something, on the screen, but in the report it said a heart rate of 172 with a target heart rate of 164. That stress test though only taking 9 minutes completely exhausted me lol.

 

You're right about the sugar at 100 indeed, I used to drink 1.5ltr of Coke per day so I'm cutting that drastically, stop eating icecream, and any other sweet snacks. I'm a true sugar addict, and also eat a lot of bread so it's going to be a tough one.

 

Going to replace it with sweet fruits like grapes, bananas, mango, pineapple, and maybe start doing some smoothies where I mix vegetables with fruit and honey added. I suppose the sugar from honey is better than what they put in Coke and ice cream.

 

Actually honey is not much better but vegetable smoothies are disgusting as hell without added sugar.

If you don't mind me asking, how old are you? I just had the stress test at the suggestion of Sheryl and the results came back normal. However, they had me going for more than 10 minutes. Before the test they told me it would take between 7 and 9 minutes.  Also, they told me I would only have to walk but towards the end I was running.  I do quite high intensity exercise before work and at weekends so maybe that was the reason it was taking so long to get where they wanted it.   

[Ban Phe Dezza]

On 10/31/2018 at 6:29 PM, dennis123 said:

First five years it only happened like once every few months so I didn't take it very serious, then this year once every few weeks, still didn't think to much of it, but now multiple times a week. Before spending a fortune on tests in hospitals I was wondering if anyone here could provide some clues.

sounds like Angina or what they call T I A's  usually causes pain in left arm and Jaw but can cause the same symptoms in the right side Yep I have had both sides play up however mostly in my left side. I Carry tablets or spray with me Google this if your chest pain lasts longer than a few minutes and doesn't go away when you rest or take your angina medications, it may be a sign you're having a heart attack. ... If stable angina gets worse or changes, seek medical attention immediately.  the other possibility is a pinched Nerve in your neck or Shoulders

[dennis123]

29 minutes ago, GarryP said:

If you don't mind me asking, how old are you? I just had the stress test at the suggestion of Sheryl and the results came back normal. However, they had me going for more than 10 minutes. Before the test they told me it would take between 7 and 9 minutes.  Also, they told me I would only have to walk but towards the end I was running.  I do quite high intensity exercise before work and at weekends so maybe that was the reason it was taking so long to get where they wanted it.   

I'm in extremely poor condition when it comes to exercise, most of the day I sit on the chair, I always take my car even for just 300-400mtr out of my village to do grocery shopping so at 8 minutes I told them is this enough? They said please hold on for another minute, then I started to count but probably I counted to fast as I just see in my report that it took 8 min 32 seconds and I was really ready to hit that red stop button lol.

 

I'm 42 btw, during the last 2.5 minutes they increased the speed to 5.7km/hour but they also change the angle so in the beginning, I started jogging because I thought the treadmill was at a higher speed but then I tried walking real fast and that worked fine, I'm tall so long enough legs to walk. At what speed did they set it for you after 9 minutes?

 

[dennis123]

20 minutes ago, Ban Phe Dezza said:

sounds like Angina or what they call T I A's  usually causes pain in left arm and Jaw but can cause the same symptoms in the right side Yep I have had both sides play up however mostly in my left side. I Carry tablets or spray with me Google this if your chest pain lasts longer than a few minutes and doesn't go away when you rest or take your angina medications, it may be a sign you're having a heart attack. ... If stable angina gets worse or changes, seek medical attention immediately.  the other possibility is a pinched Nerve in your neck or Shoulders

I usually take propanolol when it starts to hurt, can last from 15-60 minutes and obviously, it takes just as long for the propranolol to do its work but well.

 

What's the name of the medicine you use?

 

I never have pain in my left arm, when this happens but I do have something else.

 

One morning I woke up, about four months ago, with extreme pain in my arm/shoulder, and now four months later I can still not pull my left arm up high enough and it hurts when I have to put on a shirt but its getting less by the day.

 

I think that's something totally unrelated though but it's plain weird, as I can't find a cause but it's almost over now, must've stretched a muscle somehow without realizing it. Never saw a doctor for it, that's me.

Edited November 5, 2018 by dennis123

[TPI]

Go to a hospital immediately, you are having heart attacks, on one of these occasions you will die?

[dennis123]

3 minutes ago, TPI said:

Go to a hospital immediately, you are having heart attacks, on one of these occasions you will die?

Thread is getting old, already been, done all the test, nothing wrong with me, only thing that's left to do is possibly a 128 slice CT scan. The exercise stress test, EKG, X-ray, Ultrasound, are all near perfect. They did find a tiny lung infection from a long time ago and told me nothing to worry about that. That probably explains why I was coughing for like months a couple years ago ????

Edited November 5, 2018 by dennis123

[GarryP]

48 minutes ago, dennis123 said:

I usually take propanolol when it starts to hurt, can last from 15-60 minutes and obviously, it takes just as long for the propranolol to do its work but well.

 

What's the name of the medicine you use?

 

I never have pain in my left arm, when this happens but I do have something else.

 

One morning I woke up, about four months ago, with extreme pain in my arm/shoulder, and now four months later I can still not pull my left arm up high enough and it hurts when I have to put on a shirt but its getting less by the day.

 

I think that's something totally unrelated though but it's plain weird, as I can't find a cause but it's almost over now, must've stretched a muscle somehow without realizing it. Never saw a doctor for it, that's me.

That sounds like shoulder impingement. Been there, done that. There are a few exercises you can do that will get you back to normal quicker. I think you will find though that you won't get back the full motion you used to have.  I found the second exercise in the below video worked wonders for me. But unrelated to the OP

 

[kkerry]

1 hour ago, dennis123 said:

Actually, I thought I read 195 or something, on the screen, but in the report it said a heart rate of 172 with a target heart rate of 164. That stress test though only taking 9 minutes completely exhausted me lol.

If you're seeing 195 it's probably your systolic blood pressure (easiest screen to see while you're on the treadmill). I've had mine as high as 212 (test was then halted) but my most recent test I only hit 181 (13 mins).

 

I'm surprised some have said they were told nine minutes for their test. When I checked on the internet I found twelve minutes was the standard target, continuing to 21 minutes if you are able. Google Bruce treadmill protocol if you want to know more but here's the standard test figures in stages. I could have made 15 minutes but the steepness killed me more so than the speed. You're allowed to run. The final stage increases to 9.7kph and to walk that fast on level ground you would have to be very fit so running is what most people do. I can walk 6.5km in an hour on the flat and that I know is faster than many people. Unfortunately no hills where I live.

 

 

[GarryP]

59 minutes ago, dennis123 said:

I'm in extremely poor condition when it comes to exercise, most of the day I sit on the chair, I always take my car even for just 300-400mtr out of my village to do grocery shopping so at 8 minutes I told them is this enough? They said please hold on for another minute, then I started to count but probably I counted to fast as I just see in my report that it took 8 min 32 seconds and I was really ready to hit that red stop button lol.

 

I'm 42 btw, during the last 2.5 minutes they increased the speed to 5.7km/hour but they also change the angle so in the beginning, I started jogging because I thought the treadmill was at a higher speed but then I tried walking real fast and that worked fine, I'm tall so long enough legs to walk. At what speed did they set it for you after 9 minutes?

 

I'll check when I get home. Not sure whether the speed figures were included in the printed report. 

 

Normal ways of calculating the maximal heart rate are 220 - age or 208 - (0.7 x age). So for me 164 or 169 depending on the method used (not sure which method they use in Thailand). I think they had me up to 143 bpm which they rated as 87% of my maximum, which would indicate the former method. But more than 10 minutes to get there. 

[Ban Phe Dezza]

1 hour ago, dennis123 said:

I usually take propanolol when it starts to hurt, can last from 15-60 minutes and obviously, it takes just as long for the propranolol to do its work but well.

 

What's the name of the medicine you use?

 

I never have pain in my left arm, when this happens but I do have something else.

 

One morning I woke up, about four months ago, with extreme pain in my arm/shoulder, and now four months later I can still not pull my left arm up high enough and it hurts when I have to put on a shirt but its getting less by the day.

 

I think that's something totally unrelated though but it's plain weird, as I can't find a cause but it's almost over now, must've stretched a muscle somehow without realizing it. Never saw a doctor for it, that's me.

 Hi I definitely have Angina attacks, Bypass and stents as well The medicine i have is called Isorem 5 You can buy in strips of ten or a box of 100  about 25 baht for a strip of ten. there should be a few of the bigger pharmacies carry it. Basically it increases blood flow, you place a Tablet under your Tongue and let it dissolve fairly quick acting and Non addictive, can do no harm even if your issues are not Cardiac  dont place too much reliance on Stress tests  I passed all of them until i collapsed    a angiogram  found i had 95% blockages  so definitely required a bypass  Not saying that is your issue only what happened to me back in 96.

AS a side remark when i lived in the Philippines expats had a saying if in pain catch the Plane

[GarryP]

3 hours ago, dennis123 said:

 

 

I'm 42 btw, during the last 2.5 minutes they increased the speed to 5.7km/hour but they also change the angle so in the beginning, I started jogging because I thought the treadmill was at a higher speed but then I tried walking real fast and that worked fine, I'm tall so long enough legs to walk. At what speed did they set it for you after 9 minutes?

 

 

2 hours ago, GarryP said:

I'll check when I get home. Not sure whether the speed figures were included in the printed report. 

 

Normal ways of calculating the maximal heart rate are 220 - age or 208 - (0.7 x age). So for me 164 or 169 depending on the method used (not sure which method they use in Thailand). I think they had me up to 143 bpm which they rated as 87% of my maximum, which would indicate the former method. But more than 10 minutes to get there. 

For some reason they measured it in mph. Probably a machine from the US. They put me up to 4.2mph (6.76kmh) at 16% incline at 9 minutes. I was at that level for 1 minute 21 seconds when I reached the targeted bpm of 144. 

[dennis123]

33 minutes ago, GarryP said:

 

For some reason they measured it in mph. Probably a machine from the US. They put me up to 4.2mph (6.76kmh) at 16% incline at 9 minutes. I was at that level for 1 minute 21 seconds when I reached the targeted bpm of 144. 

Impressive at your age, or perhaps normal for people that actually regularly exercise ????

[dennis123]

2 hours ago, Ban Phe Dezza said:

 Hi I definitely have Angina attacks, Bypass and stents as well The medicine i have is called Isorem 5 You can buy in strips of ten or a box of 100  about 25 baht for a strip of ten. there should be a few of the bigger pharmacies carry it. Basically it increases blood flow, you place a Tablet under your Tongue and let it dissolve fairly quick acting and Non addictive, can do no harm even if your issues are not Cardiac  dont place too much reliance on Stress tests  I passed all of them until i collapsed    a angiogram  found i had 95% blockages  so definitely required a bypass  Not saying that is your issue only what happened to me back in 96.

AS a side remark when i lived in the Philippines expats had a saying if in pain catch the Plane

Hmm... did you have a 64 slice CT can? I don't think they had 128 or 256 slices back in '96, and if so did that show anything?

 

Angiogram is rather expensive and requires an overnight stay, but it's the only test where they can say with 99.9% certainty what's going on.

[Sheryl]

You should NOT be self medicating with proponolol.

 

And if you had taken it near to the time of the stress test it will have thrown off the measurements.

 

When you see the doctor be sure you tell him the whole story including the bit about using proponolol.

[dennis123]

16 minutes ago, Sheryl said:

You should NOT be self medicating with proponolol.

 

And if you had taken it near to the time of the stress test it will have thrown off the measurements.

 

When you see the doctor be sure you tell him the whole story including the bit about using proponolol.

It's for my anxiety, clinic recommended it in combination with diazepam, so yeah I took it before I went to the hospital.

 

I'm sure I told them when they asked for it but you see so many different doctors during the tests that I don't know if it ended up with the right person that does the stress test.

Edited November 6, 2018 by dennis123