A lady recently came into the office suffering from severe stabbing pain in her upper back between the shoulder blades. She had been under tremendous emotional stress that day. When the pain came on, she didn’t know what to do and her teenage daughter called the office and brought her in.

The upper back between the shoulder blades is an extremely common area to have musculoskeletal pain. Common causes are muscle strains, fascial tension, disc referral, joint dysfunction and stress.

When I first walked into the room and saw her something seemed off and like there were was more going on than muscle pain. I asked her a few questions and then sent her immediately to the Emergency Room to rule out any cardiovascular issues. She mentioned after being asked that she had some chest discomfort too, but didn’t pay attention to it since the back pain was so strong.

She was reluctant at first and asked me to please do something to relieve the pain. It broke my heart to refuse treatment to this sweet woman who was literally crying in pain, but the priority was to be safe and rule out anything more severe. I really didn’t think it was anything severe, but wanted to be absolutely certain.

She understood and went immediately to the hospital, and thank goodness because she had a heart attack. Had she not gone, it could have been catastrophic. Thankfully she is recovering and doing well.

There are two important lessons I took from this experience and felt the need to share with you:

1. Cardiovascular problems don’t always fit the classic presentation we think of – heaviness/pain in the chest particularly on the left side. Sometimes heart issues can present as:

• unexplained fatigue
• shortness of breath
• chest pain on the right side
• discomfort or pain in the throat, neck, jaw, upper back or EITHER arm.
• nausea/vomiting
• pain associated with heartburn

Women are also more likely to present with these atypical patterns.

2. If you or someone around you is in distress, take action steps immediately. In an emergency situation, call 911. It’s always best to err on the side of caution when it comes to health.

In this case, the lady and other people present didn’t realize it was an emergency and didn’t know what to do, so they did nothing. This is very common.

It was her awesome teenage daughter who took action. She realized something was wrong, reached out to someone who she felt could help and then physically brought her. She was nervous, scared, upset, unsure but still acted and literally saved her mother’s life. This is so important especially when every second counts.

I’m grateful for the positive outcome of this story and especially grateful for the life-saving critical care of modern medicine.

Dr. Robert Inesta