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Respiratory Disorders (Expert Forum)
15 y/o with chronic mild chest pain, please help!
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15 y/o with chronic mild chest pain, please help!
by ERgrl4eva, Sep 11, 2004 12:00AM
I'm a 15 y/o girl that has been having chronic mild chest pain. I do have moderately severe asthma that has been controlled, and I had a spontaneous pneumothorax four years ago. About two years ago I began having chest pain...a sharp stinging pain that would worsen when I breathed in. It became increasingly frequent, occuring nearly every five or ten minutes. The doctor said I had pleurodynia and that it would go away. It did get better, but every once in a while I would experience the same pain. A few months ago I began having similar pain again. Both my chest x-ray and EKG were fine, and the doctor suggested it was from reflux. For one week it got pretty bad. The pain changed to more of a crampy pain, or a another type of pain that was kind of dull, but I could pinpoint it's location. I also got headaches everyday. Once I was shopping and got a bad headache, crampy chest pain, broke out in a clammy sweat and felt very lightheaded/dizzy...something that's never happened before. I had some bloodwork done that showed nothing was wrong. The pain got better after that week but since then for the past two months I've still been having pain. I can pinpoint where it is, normally on the left under the breast, but sometimes on the right or in the middle. It will last anywhere from a few minutes to a few hours and has no correlation to eating,exercising,or anxiety. Antacids don't help. It doesn't interfere with my daily life. Often times I feel like it's in my head cuz I can't find an explanation, but it's definitely there, and it's definitely pain. Please Help!
Doctor's Answer
by National Jewish, Sep 21, 2004 12:00AM
, Sep 21, 2004 12:00AM
The diagnosis of pleurodynia was probably correct. Pleurodynia is an infection of the chest caused by a Coxsackie virus. Other names for this problem are Bornholm's disease and the devil’s grip. The virus causes inflammation of the sac that holds the heart. Although this would cause chest pain usually there is also fever. Since this is a viral infection, antibiotics would not help. Your current pain is probably not pleurodynia.
You should have your heart checked by a cardiologist to see if this could be the cause of your pain.
Gastroesophageal reflux disease (GERD) is the back flow of stomach contents, including digestive juices, into the esophagus or food tube. This is most commonly called reflux or heartburn. Your pain could be caused by reflux. However having a headache, crampy chest pain, breaking out in a clammy sweat, and feeling very lightheaded and dizzy are not typical symptoms of reflux. Reflux can cause the following symptoms:
· Heartburn or a sour taste in the mouth;
· Pain occurring in the middle of the chest;
· Coughing and/or choking while lying down;
· Increased trouble breathing while asleep; and
· Even no symptoms at all. This is called “silent reflux” and it is common.
Please check with your doctor about this possibility. Even though you have taken an antacid, it is possible that it has not helped your symptoms because it is not controlling the reflux. A pH probe is the best test to find out if you truly have reflux and/or if the medicine is controlling it. This test measures the acid in your esophagus to see if digestive juices are coming up from your stomach. Please read our Gastroesophageal Reflux Disease MedFact at http://www.nationaljewish.org/medfacts/reflux.html for more information about things to do to lessen reflux. A gastroenterologist is the type of specialist to let you know if further testing is needed to identify reflux and the best treatment.
You should have your heart checked by a cardiologist to see if this could be the cause of your pain.
Gastroesophageal reflux disease (GERD) is the back flow of stomach contents, including digestive juices, into the esophagus or food tube. This is most commonly called reflux or heartburn. Your pain could be caused by reflux. However having a headache, crampy chest pain, breaking out in a clammy sweat, and feeling very lightheaded and dizzy are not typical symptoms of reflux. Reflux can cause the following symptoms:
· Heartburn or a sour taste in the mouth;
· Pain occurring in the middle of the chest;
· Coughing and/or choking while lying down;
· Increased trouble breathing while asleep; and
· Even no symptoms at all. This is called “silent reflux” and it is common.
Please check with your doctor about this possibility. Even though you have taken an antacid, it is possible that it has not helped your symptoms because it is not controlling the reflux. A pH probe is the best test to find out if you truly have reflux and/or if the medicine is controlling it. This test measures the acid in your esophagus to see if digestive juices are coming up from your stomach. Please read our Gastroesophageal Reflux Disease MedFact at http://www.nationaljewish.org/medfacts/reflux.html for more information about things to do to lessen reflux. A gastroenterologist is the type of specialist to let you know if further testing is needed to identify reflux and the best treatment.
http://www.emedicine.com/MED/topic1845.htm
Pleurodynia
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Regarding antacids for GE reflux; that's not the best drug. Try Prilosec, now OTC. See:
http://asthma.nationaljewish.org/about/relationships/gerd.php
Gastroesophageal Reflux Disease
"Medications that may be prescribed to help this condition:
Antacids after meals and at bedtime.
Tagamet® (cimetadine), Zantac® (ranitidine), Pepcid® (famotidine), Axid® (nizatidine)
Prilosec® (omeprazole), Prevacid® (lansoprazole)
Reglan® (metoclopramide) "
============================
"Physical measures:
Elevate the head of the bed 6-8 inches, by placing blocks under the legs of the head of the bed.
Avoid lifting heavy objects.
Avoid bending forward at the waist.
Avoid wearing tight fitting clothing."
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Rather than elevating the head of bed, you can use a slanted foam wedge pillow. One I like is available at www.medslant.com
"Acid Reflux Wedge Pillow by MedSlant™"