Chest and Left arm pain while running

[EAL1979]

Hi, I wasn't sure where to post my question so if this is not the appropriate place please let me know.  I am a 30-year old female, 5'7" 126 lbs.  I am in pretty good shape.  I have run in the past, but stopped when I got pregnant with my son.  He is now 1 1/2 years old and I have been running regularly again for about 3 months.  I average 3 days a week and usually run 3 miles each time.  Usually I have no problems at all, other than feeling a little short of breath, but this is under much better control since I've become better conditioned.  (I was diagnosed with asthma several years ago, but haven't needed an inhaler for 3 years now.)  Now my question:  2 times during the past 3 months of running I have experienced strong pain in my chest that radiated down my left arm.  Both times I have continued running and it has gone away after about 3 minutes, but it is a strong enough pain (5 out of 10) that it makes me pretty worried.  I am in the health care field, so I know that I should seek medical advice, but the first time I just figured it was a 1 time thing.  After it happened the second time I realized that it could be more serious.  Especially considering those stories you hear about elite athletes dropping dead on the field/court because of an unknown heart condition.  Any suggestions/advice as to the cause?  There is a family history of heart disease on my dad's side of the family, but both people were smokers and had heart attacks.  I know that it isn't something to mess with.  Any advice is greatly appreciated.

[NTB]

well, just thinking out loud again: another possibility was Prinzmetal's angina (coronary artery spasm) - though that isn't usually triggered by exercise.

But you say you have asthma plus hypothyroid, so maybe some sort of auto-immunity is involved with the possible heart ischemia - and so that might make diagnosis more complicated.

Did your pain come at the beginning of the run? IOW, did the possible heart ischemia occur before exercise induced vasodilation kicked in?

Or maybe more albuterol would solve the problem by vasodilating the lungs - or maybe the albuterol is causing the problem, either directly through activating beta2 receptors, or maybe because of potassium loss.

But if it was me, I wouldn't continue running. During the periods of pain, you might be damaging your heart muscle. Or, if you do run again and get the pain again, you might get to the ER immediately and they can draw blood to look for cardiac enzymes.

[EAL1979]

NTB,
Thank you for this information!  I am reading through it and it is rather interesting because I was diagnosed with exercise-induced asthma several years ago.  I had a pulmonary function test which showed normal results so my doctor just determined that the exercise was what was causing the symptoms and gave me an albuterol inhaler to use.  Also, I have hypothyroidism which I take medication for daily.  Before being diagnosed I had shortness of breath and chest pain at 25 years old!  When I finally got on the medication these symptoms resolved, but now with running more regularly maybe I've made things worse?  I don't know, but all sorts of possibilities are running through my head.  I've called to make an appointment with a PCP (I haven't had one for a few years because I've been healthy (?)).  I'm waiting to hear back.  I don't know where to begin with choosing a cardiologist and most of them require a referral.  Guess I'll just have to wait.  Good thing I don't have a major emergency because getting a return call is like waiting for paint to dry.  Thank you again for your help!  I'll post any info I receive.

[NTB]

>> Especially considering those stories you hear about elite athletes dropping dead on the field/court because of an unknown heart condition.

Hi, just going from memory: The lost likely cause in those cases is inherited HCM, in which chest pain is a symptom. But you'd think this would have manifested in you years ago.

http://www.4hcm.org/WCMS/index.php?screening

If an EKG showed abnormal, then an echo would show for sure. But conversely, some minor percentage with HCM do have normal EKG, so false negatives are possible.


The 2nd leading cause is myocarditis, in which chest pain is usually not a symptom (unless the person also has pericarditis). Did you have a bad cold before your heart symptoms started?

[Jerry_NJ]

Get checked by a doctor.   It may be sufficient to just see your primary care if they have the capability to do an EKG reading.

As you said: "..it isn't something to mess with."  I agree.