sharp electrical like pain

[Robfromwales]

I experienced two sharp and sudden pains in left upper chest recently. We I say pain but more really unusual sensations lasting say 3-5 seconds. Only thing similar , but different in location and duration, was about a year ago with pain more diffuse in location but again electrical like feeling. That time i went to an and e given their duration and turned out I was in afib which I stayed in for 12 days before returning to Sinus rhythm. I have an ascending aortic aneurysm 4.9-.5.2 and bi cuspid valve and seeing surgeon for possible graft and valve repair in a couple of months. I have previously had loads of echo cardio grams and Ct and mri. Any thoughts on pains like that?

[Jalia]

Hi Rob. It may be Christmas day but any chest pain should be investigated sooner rather than later. Phone 111 for advice.

[Cliff_G]

Agree with Jalia. Chest pain needs attention. I had similar sorts of pain in the same area, some time (years) before my dissection. Turns out they may have been a PAU - Penetrating Atherosclerotic Ulcer, one of the three presentations of Acute Aortic Syndrome. When I was opened up for my repair, the surgeon found a PAU in the arch, below the left subclavian artery. The only doubt is whether it was the cause of my earlier pains - I personally think it was highly likely, due to the location.

I don't know how easy they are to spot on a CT scan - probably not very. They can last for years before an emergency event.

Having also had AF, and knowing very well when I'm in AF or sinus, and what they feel like, the pains I had were clearly nothing to do with AF.

How long ago was your last CT? If you get further attention (which you should) ask them to rule out by CT (or confirm) a PAU. I'm not saying you have one, just that it needs properly considering and that it's easy to either not consider or to miss

[Robfromwales in reply to Cliff_G]

thanks Cliff and Jalia. It happened weds night. CT sept 2021 and Mri Nov 2021. Saw thoracic surgeon dec 7 2022 and having another CT next month and angiogram Feb and see surgeon March for possible surgery. Aneurysm on CT 5.1; mri 4.9 and last echo sept 2022 was 5.2 and hence with BAV in front of surgeon. Cliff remind me of dissection symptoms?

[Cliff_G in reply to Robfromwales]

Sounds like a timely CT and visit to the surgeon. I'm sure you'll raise your concerns there.

AD symptoms are usually extreme chest, back, neck or abdominal pain that comes on suddenly. A very small % (2%?) have little or no pain. The pain often migrates from one place to another and / or recedes, perhaps to nothing. The only way to rule in or out is a CT. MRI is an alternative but too slow in an emergency setting. More info at thinkaorta.net

Suggest with your history you should consider a med alert bracelet, or other foolproof way of alerting emergency staff to your aortic issues. I failed to do this and was initially diagnosed as a heart attack.

[Robfromwales]

thanks Cliff. I am sure we have interacted before and your experience and advice is always thoughtful and helpful. What would you suggest is put on a medical alert bracelet. I guess a member of public wouldn’t understand TAA and for that part would enery paramedic? I presume it should also say BAV although I guess ( as not in any stenosis ) that’s not so important. As we know TAA is meant to be asymptomatic but when I had arythmia back last year that’s the closest the feeling was but that was like an electrical pulse across the chest but that lasted hours. I don’t think that’s what arythmia feels like so was surprised when Truro an and e ( we were on hols) told me what it was . This discomfort/ short burst happened twice like a zap I guess but not a ripping sensation or heaviness - just strange. Perhaps as many other posts on all heart related topics have said heart related issues aren’t always classic and sometimes us or medics can’t explain it but maybe the body knows something is there that shouldn’t be! Only thing other than dissection that I understand a taa causes is pain if growing rapidly ( more thsn .5 cm a year). Thanks again for engaging Cliff. By the way would radiologists know about PAU?

[Cliff_G]

Radiologists should know about PAU but they might need a clue to look for such, not common.

I'd suggest perhaps BAV and Ascending Aortic Aneurysm on a med bracelet? BAV is actually quite important, as it is a risk factor for aneurysm and dissection. Worth wording it to direct suspicion to the thoracic, as AAA is more common. A proper med alert company will keep your full details on record for parameds / A&E to consult, if you're somewhere where they can't get your notes.

I'm not sure if a PAU would cause pain, I suspect it might (it is an ulcer after all). I would have called the pains I had long ago as "strange".

Best wishes!

[Cliff_G in reply to Cliff_G]

On second thoughts "Thoracic Aortic Aneurysm" (in full) would avoid potential confusion over AAA

[Robfromwales]

I had thought that as well but thanks! Remind me - did you not know you had TAA before it dissected? And given previous posts am I recalling correctly that it was well under the 5.5 normal threshold ( with the exceptions of symndromes plus bav) ?

[kocoach]

I sincerely hope you don't have Chostocondritis such as myself. It is the inflammation of the sternum and rib cage (not necessarily at the same time ) and it can surely mimic a heart attack. I have had it for around 50 years now and the only wayI have coped with it, is every episode I had I would go to the ER and I mean years of getting checked out. After a while I was able to discern the different pains and a Heart specialist told me "if you can touch the area and it hurts by pressing on it is usually not a heart issue". In time I learned to differentiate between muscular and body pain from pain related to other issues but as I say it's very unnerving even to this day when I get a sudden pain in my chest until I press on it and it hurts tremendously, then I take a sigh of relief. Praying You get help and ease the anxiety.

[Robfromwales in reply to kocoach]

thanks - I don’t think it’s that but thanks for replying