Cause of Arms/Chest Pain during heart Attack?
David Longley
I'd be interested to know (in some neurological detail) what
accounts for pains in the left arm etc during a heart attack. Is
the neurology completely understood?
--
David Longley
Longley Consulting London, UK
Behaviour Assessment & Profiling Technology,
Research, Data Analysis and Training Services,
Small IT Systems http://www.longley.demon.co.uk
David Sacco
On Sat, 18 Apr 1998, David Longley wrote:
> I'd be interested to know (in some neurological detail) what
> accounts for pains in the left arm etc during a heart attack. Is
> the neurology completely understood?
I don't know if anything in medicine is completely understood. :)
But this area is well studied. It deals with something called "referred
pain." The simple explanation is this: visceral (from the organs)
sensations are carried along the same routes as those from the more
superficial nerves on the skin and muscles. You're better at detecting
sensation from the superficial nerves, so your body is tricked into
thinking the sensations are coming from there. Thus, pain in certain
organs is mapped to specific locations. In angina, pain from the heart is
mapped to the left chest and may radiate to the left shoulder and arm.
Dave Sacco
ms-ii, pitt med
http://www.pitt.edu/~drsst37/applicants
David Longley
I'd be interested to know (in some neurological detail) what
accounts for pains in the left arm etc during a heart attack. Is
the neurology completely understood?
Todd
It's called referred pain.
If I remember my anatomy, the autonomic (sympathetic) innervation to the
heart arises from segments T1-T5, synapsing in the superior, middle,
inferior, and stellate cervical ganglia (or close to that...) When pain is
caused to the heart, (or any other structure, for that matter) it is
referred via the sympathetic nerves.
The left pectoral region, left arm, and even some of the right side is the
segmental distribution (dermotomes, if you will) of T1-T5.
-Todd
BUSM 2001
David Longley
In message <353debfa....@smtp.tconl.com> wi...@tconl.com (bill dailey) writes:
> yes it iss completely understood however i need to know where you are
> as far as neuro goes before i can explain in detail...know anything
> about referred pain/nerve root origins etc? actually there are two
> competing theories as to exactly why it happens but the basics of
> ischemic pain to the heart referring to the left shoulder is
> understood...in other words the exact mechanism isnt absolutely clear
> but the reason it refers to the shoulder is.
>
> let me know and i'll try to help.
>
Hi..
I did a 4 year PH.D. at the National Institute for Medical
Research, Division of Neurophysiology/Neurophramacology 1979-1983
(though still haven't submitted it). Worked on CNS monamines and
neuropeptides. I don't have my functional neuroanatomy texts here
so can't look anything up. So, as much detail as you can muster.
I was having dinner with someone a week ago, and they claimed
that Jonathan Miller (Dr) on a TV programme was saying that the
pains one experienced were not understood - and then started
babbling something about Chinese energy lines etc.... I said I
thought we should be doubting Miller, not conventional medicine
which I recalled did have a pretty sound conventional explanation
in terms of referred pain.
>
>
> On Sat, 18 Apr 98 19:04:14 GMT, in misc.education.medical you wrote:
>
> >I'd be interested to know (in some neurological detail) what
> >accounts for pains in the left arm etc during a heart attack. Is
> >the neurology completely understood?
>
>
--
David Longley (check end reply line #)
Kerry Thornbury
It's all about dermatomes. These are areas of the skin that are
innerveted segmentally by specific nerves. The nerves that supply the
heart also supply dermatomes or areas of skin. The dermatomes
supplied by heart nerves are thiose that conduct pain also from the
shoulder and left arm.
Kerry
On Sat, 18 Apr 98 19:04:14 GMT, Da...@longley.demon.co.uk (David
Longley) wrote:
>I'd be interested to know (in some neurological detail) what
>accounts for pains in the left arm etc during a heart attack. Is
>the neurology completely understood?
>--
>David Longley
>
>Longley Consulting London, UK
>Behaviour Assessment & Profiling Technology,
>Research, Data Analysis and Training Services,
>Small IT Systems http://www.longley.demon.co.uk
>
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
The trouble with the world is that the stupid are cocksure,
and the intelligent are full of doubt
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Marc Wasserman
David Longley (Da...@longley.demon.co.uk) wrote:
: I'd be interested to know (in some neurological detail) what
: accounts for pains in the left arm etc during a heart attack. Is
: the neurology completely understood?
It's sort of twofold:
There's a nerve that passes alongside the heart on both sides called
the phrenic nerve. When the heart is having troubles, some impulses
get carried into that nerve.
But - the body is divided into sections called "dermatomes" that each
are supplied by a major nerve coming off the spinal cord. The area around
your shoulder, chest, and upper neck is referred to as "C3, C4, and C5."
And the phrenic nerve *also* carries impulses into C3, C4, C5.
So, when your heart is in trouble, your body doesn't quite know how
to react to the pain. It's not used to pain being inside - the brain
understands pain from the outside much better. Since the impulses are
in the C3, C4, and C5 dermatome, your brain interprets the pain as coming
from the shoulders, neck, chest, and arm.
Marc Wasserman
Medical Student
mwas...@mcw.edu
gal...@wadsworth.org
In article <6hlffc$h...@wiscnews.wiscnet.net>,
mwas...@post.its.mcw.edu (Marc Wasserman) wrote:
<SNIP>
> So, when your heart is in trouble, your body doesn't quite know how
> to react to the pain. It's not used to pain being inside - the brain
> understands pain from the outside much better. Since the impulses are
> in the C3, C4, and C5 dermatome, your brain interprets the pain as coming
> from the shoulders, neck, chest, and arm.
.... yeah, it's the same way with an "ice cream" headache which is due to cold
in the esophagus, but is felt in the forehead area. Damn I hate those....
Jason
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Jean Guy Grenier
>Very interesting... could someone also comment on some arythmia problem? my
wife should undergo an operation soon.
gal...@wadsworth.org a écrit dans le message
<6hodgf$ibu$1...@nnrp1.dejanews.com>...