Most people know that left arm pain is one of several common symptoms of a heart attack or another serious heart problem. As such, new pain in your left arm should never be ignored. However, arm pain occurs with many conditions, ranging in severity from a pulled muscle to a massive heart attack. While it can be tricky to determine whether left arm pain is heart-related, several features can help distinguish between cardiac and noncardiac arm pain.
Accompanying Chest Pain or Discomfort
Although not always present, chest pain or discomfort -- such as pressure or heaviness -- is the most common symptom of a heart attack. Therefore, the presence of left arm pain accompanied by chest pain or discomfort significantly raises the possibility of a heart attack or another serious heart problem. The combination of left arm and chest pain signals a medical emergency, requiring immediate evaluation. While these symptoms are not diagnostic for a heart problem, they should never be ignored. Most people with heart-related chest and arm pain report that the chest pain radiates into the shoulder and down the arm. The pain might also radiate to the neck, jaw, back or right arm.
Presence of Other Possible Heart-Related Symptoms
Real-life heart attack symptoms are often more subtle and vague than what is typically depicted on television or in the movies. However, the presence of these symptoms in combination with left arm pain increases the likelihood that the pain is heart-related. Signs and symptoms that raise the possibility that left arm pain is associated with a heart attack or another serious heart problem include:
-- shortness of breath
-- excessive sweating or clammy skin
-- nausea, vomiting or indigestion
-- dizziness, lightheadedness, fainting or loss of consciousness
-- a racing or irregular heartbeat
Lack of Tenderness and Relationship to Movement
Heart-related pain in the left arm typically occurs suddenly, remains relatively constant, and is not tender to the touch. Therefore, left arm pain that is brought on or aggravated by moving the arm in certain ways is generally unlikely to be heart-related. Additionally, tenderness when you press on the arm points toward a musculoskeletal condition rather than a heart-related cause of left arm pain. Musculoskeletal injuries and conditions are common culprits for arm pain. Everyday activities, such as lifting weights or moving heavy furniture, and sports injuries frequently cause a strain or inflammation in the arm muscles or joints. These conditions often cause tenderness and are aggravated by specific arm movements.
Short-Term vs. Long-Term Pain
Given that heart-related left arm pain typically develops suddenly, longstanding arm pain is usually not due to a heart problem. Conditions such as rotator cuff tendinitis, and shoulder or elbow arthritis and bursitis typically persist for months or even years, with gradually progressive pain and decreased joint mobility. Therefore, long-term arm pain is much more likely to be due to a musculoskeletal problem than a heart condition. Additionally, since heart-related pain tends to be relatively constant once it starts, short bursts of sharp arm pain are most likely to be associated with noncardiac causes -- especially if brought on by moving the arm or neck.
Warnings and Precautions
Left arm pain that gets worse with activity and improves with rest should prompt immediate medical attention, as this may be a sign of a serious heart problem -- especially if the pain is deep and the arm is not tender to the touch. Left arm pain that appears suddenly while at rest, such as when watching television, could also be due to an unstable heart condition. Finally, if arm pain is accompanied by any combination of chest pain, nausea, vomiting, dizziness, passing out, shortness of breath, unusual sweating, abdominal bloating, coughing or wheezing, seek emergency medical attention.
Reviewed and revised by: Tina M. St. John, M.D.