Emergency Cases

Shoulder pain could be a symptom of heart attack


Mark, 35, decorator, was a basketball lover with smoking habit. One evening, he and his friends went to play basketball after work. While they were in a 3x3, Mark felt pain in his left shoulder all of a sudden when he was on the defense, but he paid no attention to the pain as physical collision and sprain were not involved in that block.

However, Mark decided to go home earlier because the pain persisted, and the condition did not get any better after he took a shower. “It’s strange,” thought he. "The pain is so obvious this time and has lasted for such a long while. In the past, I should have felt no pain after the play was over even though I got hit during the game."

Unfortunately, the situation worsened. Mark could only turn to the emergency room for doctor’s consultation. A doctor on duty, after learning of his medical history, arranged an electrocardiogram test for him, and the result took Mark by surprise: the cause of the pain was neither over-fatigue in muscle nor sprain caused by violent exercise, but heart attack!

"What?! I’m afraid you’ve made a mistake, doctor. I just got pain in my shoulder and felt nothing wrong with my heart." Shocked by the news, Mark kept doubting about his record being wrongly identified. The doctor, nonetheless, emphasized that the test had found one of his coronary arteries being completely blocked, which is a major cause of heart attack.

Discomforts in the shoulder, neck and jaw could be signs of heart diseases

Why shoulder pain is a symptom of heart disease? Doctor’s explanation is that the shoulder, neck and jaw are possible reflective areas of heart disease, which could thus cause pain to those parts, as well as the back.

Actually, cardiologists have suggested that people who do not have a history of heart disease but are of high risk factors, such as high blood cholesterol, high blood pressure, diabetes and central obesity, and heavy smokers like Mark should undergo regular medical checkups. Early consultation is highly recommended if pain occurs for unknown reasons.

Angioplasty is an effective treatment

For cases like Mark’s, "balloon" angioplasty is usually applied. Its principle is to squash the atheromas which block the artery to let blood flow more easily. Meanwhile, a stent, inside which a balloon is in place, is inserted into the blocked section. As the balloon is inflated, the stent expands and holds the narrowed blood vessel open, enabling the blood flow to become more fluently.

During the operation, the patient requires local anesthesia before an aperture is made on an artery at the thigh or wrist. Then a catcher is passed into the blood vessel and is pushed up slowly to the coronary artery where blockage is found. When the tube reaches the location, a balloon attached to it is inflated in order to squash atheromas and expand the coronary artery.

Nowadays, the techniques and experience of angioplasty have been mature in Hong Kong as proven by the high level of satisfaction and success rate of the operation. The likelihood of complications is remote in general. The stent to be inserted into a coronary artery during angioplasty can reduce the possibility of a recurrence of blockage. By and large, drug-eluting stents deliver a better efficacy than normal stents.

Angioplasty and other kinds of operations can be possible alternatives if patients timely discover their coronary arteries become narrowed again for the sake of preventing heart attacks due to complete blockage of the blood vessels. In the cases of smokers like Mark, a doctor’s advice on quitting smoking as soon as possible is always necessary. Grateful for small mercies, Mark gave up his dismissive attitude towards smoking cessation and even testified to his friends, saying, "Life is invaluable after all. I’ve learned that lesson well from the terrifying experience."

He really kept his word. Mark has stopped smoking since he left from hospital. Six months later, he showed noticeable improvements in his basketball techniques and physical strength, attributable to his weekly basketball practice, not to mention the benefits of quitting smoking.