Talk to General Physician on Extreme Pain In Upper Back Shoulder

Complete medical history and case summary: My mother, Mrs. Ashi Shahid, aged 52 to 53, has diabetes and a pre-existing thyroid condition and is currently not taking thyroid medication. She has recurrent pain in her upper back around the shoulder blade, often after eating, accompanied by sweating, and the pain keeps returning despite multiple emergency visits and prescribed medications. Doctors have not identified the exact cause; today the ECG was normal, troponin was not done, and an echocardiogram has been recommended but not yet performed. Her thyroid test (NIH, Islamabad) shows elevated TSH at 10.938 µIU/mL, with normal free T3 and free T4. We would appreciate a careful review of all previous reports and prescriptions to determine why the pain continues despite treatment. Given her diabetes and post-meal pain with sweating, we understand that a normal ECG does not completely exclude a cardiac problem and would appreciate assessment to see if further cardiac tests such as troponin testing or an echocardiogram are needed. If a cardiac cause is excluded, please consider other possible causes such as gallbladder disease and whether an abdominal ultrasound or other blood tests are indicated. Please also advise on appropriate management of her elevated TSH since she is not currently taking thyroid medication. And importantly, if her pain or sweating returns, please seek emergency care immediately, even though the ECG was previously normal.