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Ask Dr. Gott 11/10

Shoulder pain could indicate cardiac problem

DEAR DR. GOTT: I am a white male, 73 years old. My problem is that sometimes my left arm muscle really hurts, and my left shoulder, too, for two to three minutes, and then that goes away. At the same time, my sternum hurts also, for about the same time. My wife and I try to walk 3 miles a week. We don't eat much red meat. We eat salads, veggies, baked potatoes, etc. In 2004, I had a stent. I've been to three doctors, with very little help. At times I can walk 30 feet or so, and the pain occurs, and then I rest two to three minutes and continue what I was doing. I can be watching television and the pain will come back. Other than this, I feel pretty good. We both try to stay fairly busy.
    DEAR READER: Left upper arm, shoulder, chest or jaw pain is often caused by angina, a cardiac-muscle spasm that is exercise-related and can cause damage. I see from your letter that you have had a stent in the past, suggesting that your coronary circulation is deficient, a situation the stent should have relieved.
    I also note that you have chest pain when exercising and even watching TV.
    This pattern is grounds for emergency evaluation. You need a "cardiac work-up," medicalese for an exam and testing (including a stress test) to rule out significant coronary blockage -- the exact situation that I suspect led to your stent years ago.
    Because this situation is so important, I have written you personally -- something I rarely do -- to urge you to see your cardiologist for further testing.
    If my recommendation is inappropriate, I'm sorry -- actually, I'd be quite happy and relieved! -- but I'd hate to have you get into trouble because of a heart ailment that was not identified in time to prevent serious cardiac damage.
    Let me know what happens.
    To give you related information, I am sending you a copy of my Health Report "Coronary Artery Disease."

    DEAR DR. GOTT: At a friend's urging, I tried soymilk a few months ago and have developed a fondness for it. Is there any particular harm or benefit to this product instead of regular cow's milk?
    DEAR READER: None of which I am aware, except that soy contains no cholesterol or fatty acids, so it is probably more healthful than cow's milk.
    To give you related information, I am sending you a copy of my Health Report "Understanding Cholesterol."

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