Heart attack symptoms in left vs right arm
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Heart Attack Symptoms: Left Arm vs Right Arm Pain
Arm Pain as a Symptom of Heart Attack
Pain radiating to the arms is a well-known symptom of heart attacks (acute myocardial infarction, AMI). Traditionally, left arm pain has been emphasized, but research shows that pain can radiate to either arm, both arms, or even just the right arm 12346.
Diagnostic Value of Left vs Right Arm Pain
Recent studies have found that pain radiating to the right arm is actually a stronger predictor of heart attack than pain radiating to the left arm. In one large study, right arm or shoulder pain had a higher odds ratio (OR = 3.0) for predicting AMI compared to left arm or shoulder pain (OR = 1.7) . Another meta-analysis confirmed that pain radiating to the right arm (diagnostic odds ratio, DOR = 5.17) and to both arms (DOR = 2.95) are more strongly associated with heart attack than left arm pain alone . Similarly, another study found that right arm pain (adjusted OR = 2.23) and pain in both arms (OR = 2.69) were more predictive of AMI than left arm pain, which did not significantly increase the likelihood of a heart attack .
Classic Descriptions and Patient Experience
Historically, left arm pain has been described as a classic symptom of angina and heart attack, often described as cramp-like, squeezing, or tightness, and usually felt on the ventral and medial surfaces of the arm, sometimes extending to the fingers 34. However, pain can also radiate to the right arm, both arms, shoulders, neck, jaw, or even the back. In rare cases, pain may be felt only in the right arm 34.
Other Key Symptoms and Considerations
While arm pain is important, other symptoms such as chest pressure, pain worsened by physical activity, and sweating are also strong indicators of heart attack 126. The absence of chest wall tenderness is another useful sign . It is important to note that the duration of symptoms does not help distinguish heart attacks from other causes of chest pain .
Conclusion
Both left and right arm pain can be symptoms of a heart attack, but recent evidence suggests that right arm pain, or pain in both arms, may be even more predictive of a heart attack than left arm pain alone. Chest pain, especially with radiation to the arms and associated symptoms like sweating, should always be taken seriously and prompt medical evaluation.
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