Heart Disease?????

[Farida25]

I need some help here please. My mother (65 years old) passed out yesterday while she was shopping. Afterwards she vomited a number of times. We took her to the hospital and the doctors gave her medications for her stomach and some fluids before letting her go citing a not so severe form of gastritis. This is all well and good except that she stated that prior to passing out she experienced pain in her right arm and in the back of her neck. Also she was sweating excessively and felt very cold while at the hospital. Her EKG was normal and her BP was 110/70, which is somewhat high for her (yes high) given that she normally has a much lower BP (chronically stuck at 90/60). Her blood sugar (fasting because she hadn't eaten) was 148.

Historically, my mother has never experienced heart problems (although her brother has a heart condition) she also has a low blood pressure and does not suffer from diabetes or any other chronic condition. She's only taking Cipralex for mild depression. She has been taking it for a year and a half now.

I understand that it was a hot day and that it might have been the effect of her not having eaten for a while or even a drop in her BP. It has been almost 24 hours since this happened and her stomach is feeling just fine which completely negates the hospital doctors' theory. I am really worried though, especially since it was not her stomach and especially given the pain in her arm and neck (the pain disappeared the moment she started feeling dizzy and it did not recur, she did not experience any tightness in her chest and the pain has not recurred since).

My mom has experienced migraines in the past where she experienced similar symptoms (dizziness, vomiting) but never arm or neck pain and it was never this bad.

So what are the chances of it being heart disease?? Also what other conditions might it be?

Also what kind of tests can we run now that it is more than 24 hours after the incident?

[achillea]

This is interesting, probably not to you or your mother, but interesting.

First, the arm and shoulder pain associated with heart attacks is almost always felt in the center of the chest and in the LEFT arm,, related to the way our nervous systems are set up in embryonic development.  Some women have reported pain in both arms, though.  I am not sure that I have ever heard of right-sided pain in this situation, but it is possible under some circumstances.

The sweat and cold sensation were probably caused by shock with a brief , intense fall in blood pressure (not recorded as it was occurring), as was the vomiting.  This is predictable. Her BP likely rose as she came back to consciousness and became alarmed.

If your mother truly had not eaten anything and was therefore fasting, her blood sugar should have been no higher than 100 to 126.  This should be looked into, because it is weird.

So, if this were my mom, I'd get her promptly to an appointment for a workup with a cardiologist, to investigate the whole episode plus that strange right-arm pain.  There are also various tests for enzymes and such that cardiologist can do to ascertain heart damage after an attack.  The doc will probably also want to do a stress test and so on, not a bad idea for anyone who is around 65 years old.

I'd also want to question her regular doc about that relatively high fasting blood sugar.