Many people want to know what is the cause for chest pain, when the ECG is normal, especially when there is breathlessness and sever left arm pain, and the ECG is normal. The causes for chest pain apart from heart attack is pulmonary embolism, dissection of aorta. All these are serious issues which may not get diagnosed using ECG. So whenever these symptoms present themselves, you need to find out the cause. You need to visit an emergency room if it is sudden onset. If this kind of symptom is coming repeatedly, common cause can be an anxiety disorder, generalized anxiety disorders with panic attacks. It is a psychiatric illness. It requires treatment. Better to seek medical help and examined thoroughly. Valvular heart disease can also present like this with chest pain, palpitation, dizziness etc. So these symptoms are cardiac in nature, but always may not mean heart attack.

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