Left Shoulder Blade Pain And Heart Attack

What is a Heart Attack?

A heart attack, also known as a myocardial infarction, takes place when blood flow to the heart becomes blocked. This blockage can be due to a buildup of fat, cholesterol, or other substances which can create plaque formation in the arteries that deliver blood to the heart (known as the coronary arteries). A heart attack can be fatal; however, recently, there are treatments that have been effective for the condition. If you think you might be experiencing a heart attack, it’s critical to call for emergency medical help immediately. 

Causes and risk factors

Heart attacks occur due to a sudden interruption in blood flow to the heart. If a heart attack remains untreated, the heart muscles undergo irreversible damage. If a large part of the heart undergoes this damage, the heart can stop beating (known as cardiac arrest), leading to death.² 

The leading cause of heart attacks is coronary heart disease (CHD). In CHD, the main blood vessels that deliver blood to the heart (coronary arteries) become blocked. The blockage (known as plaques) is due to clogging in the arteries with cholesterol, fats and other substances. The plaque buildup can rupture, resulting in the formation of a blood clot at the ruptured site. The blood clot may then block the delivery of blood to the heart and thus leading to a heart attack. The risk factors of CHD include smoking, diabetes, a diet with a high intake of fat, high levels of cholesterol, high blood pressure (known as hypertension), and/or being overweight or obese. 

There are other causes of heart attacks that are less common than CHD, including: 

• Lack of oxygen in the blood (hypoxia) - The levels of oxygen being carried in the blood can decrease, if it continues to persist can cause damage the heart muscles, and triggers heart attack. Some of the causes of a decrease in blood oxygen levels include abnormal lung functioning or carbon monoxide poisoning.
• Misuse of drugs - The use of various stimulant drugs can increase the narrowing of coronary arteries. The narrowing of these arteries can restrict the blood flow to the heart, and trigger a heart attack. Examples of such stimulants include amphetamines (speed), methamphetamines (crystal meth), and/or cocaine.² 

Signs and symptoms 

The signs, symptoms, and severity of heart attacks vary from person to person, and some individuals do not experience any symptoms. Many individuals experience a  sudden onset of heart attack, although some will experience warning signs in advance of the event. The common signs and symptoms of a heart attack include: 

• Chest pain or discomfort (e.g. feelings of tightness, or squeezing or aching sensations in the chest) 
• Feelings of weakness, light-headedness
• Shortness of breath
• Pain or discomfort radiating from the chest to the the neck, back, or jaw; either arm and/or shoulder (e.g. squeezing or aching sensations in the arm) 
• Cold sweat
• Nausea or indigestion

The earliest warning of a heart attack is recurring chest pain or sensations of pressure in the chest (known as angina - caused by a temporary reduction in blood flow to the heart) which can be triggered by engaging in activity and improved by resting.¹ If heart attack symptoms are experienced, you need to act immediately by seeking emergency medical help.

What Can Cause Left Shoulder Blade Pain?

Musculoskeletal

Shoulder blade pain occurs commonly due to excess strain on the muscles. The muscle strain leads to the trapping of the tendons of the rotator cuff under the shoulder’s bony area. More information on different types of musculoskeletal injuries associated with shoulder blade pain can be found here. For a list of possible symptoms and associated causes of musculoskeletal shoulder pain, you can visit here. 

Cardiac

Experiencing pain between the shoulder blades and upper back can be a sign of  different heart disease-related conditions, including stroke and heart attack. A shoulder blade caused by cardiovascular issues is known as ‘referred pain’ - pain felt at a site that is distant and separate from the site causing the pain.³ 

Pulmonary

There are a number of pulmonary-related (or lung-related) conditions that can cause pain in the shoulder, many of which are examples of referred pain. Pulmonary tuberculosis (TB), pulmonary embolism (a blocked blood vessel in the lungs), pleurisy (inflammation of the tissue between the ribcage-also known as pleura-and the lungs), and some lung cancers are some well-known pulmonary conditions that can cause shoulder blade pain. 

Other 

Other causes of shoulder pain include poor posture and arthritis.  

Diagnosis

Diagnosis will be based on the symptoms and an examination of the shoulder. Some diagnoses may require:

• Blood testing
• X-rays, ultrasound, or magnetic resonance imaging (MRI) scanning
• Nerve conduction tests 

Treatment

If you seek advice from a doctor, they will examine you and figure out the cause of your shoulder pain. Treatment will depend on the cause and severity of your shoulder blade pain. You may be advised to get more tests (for eg., X-rays). Depending on the cause of the shoulder pain determined by your doctor, treatment options may include: 

• Physiotherapy and/or at-home exercises 
• Stronger medication to reduce swelling and manage pain
• Activities to keep away from to avoid the pain worsening
• Seeking further advice from a specialist 

When to Call a Doctor or 999

You should call the doctor if your shoulder pain is severe, unusual, and/or it doesn’t go away. If your shoulder pain is accompanied by the following symptoms, you may be experiencing a heart attack or another life-threatening event, and you must seek medical emergency immediately: 

• Chest pain
• Shortness of breath 
• Lightheadedness/dizziness
• Excessive sweating
• Paralysis on one side of the body 
• Sudden difficulty speaking 

If your shoulder pain is not a medical emergency, there are a number of things you can do at home to ease shoulder pain without receiving a diagnosis. However, if pain persists for about 2 weeks, it is advised to seek medical attention.

Reducing the Risk of a Heart Attack

There are many known ways to reduce the risk of experiencing a heart attack, including: 

• Avoid smoking and other forms of tobacco
• Increase physical activity 
• Improve diet to be more heart-healthy 
• Maintaining a healthy weight 
• Ensuring good quality of sleep 
• Getting regular health screenings 
• Managing stress 

Summary

Shoulder blade pain can be caused by a variety of conditions that vary dramatically in severity. Conditions range from common muscle strain problems to emergency, life-threatening situations such as a stroke and heart attack. In the latter, shoulder pain is a type of ‘referred pain’; Pain felt at a site that is distant and separate from the site causing the pain.³ In these situations, medical advice must be sought immediately.