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Heart Disease (Expert Forum)
Chest Pain
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Chest Pain
by Heather2001, Jun 13, 2001 12:00AM
Hello.
In december 2000 I went to the ER with severe pain in my chest and back. After having an EKG, chest X-Ray and blood work (all which was normal) I was diagnosed with viral pericarditis and was sent home with instructions to take a recommended dosage of advil. While the advil releaved some of the pain, by the end of January I returned to the ER. At this time another chest X-Ray and EKG was done (both which were normal). The docter listened for the pericarditis but didn't hear it. Assuming that it had not complelty cleared up I was put on Toridol for 5 days. An appointment was lined up for me to see an Internal MEdicine Specialist for the next week. Upon visiting with him another EKG was done, along with blood work, chest x-ray and echocardiogram, all which turned up normal. I was diagnosed with a heart murmur, but nothing to explain the pain I was having. I have not heard from this doctor since.
In MArch I went to my family doctor who diagnosed me with intercostal never inflammation. He diagnosed this simply by noting that the pain I was feeling ran from my breast bone in the middle of my chest, around the left side of my body, to my back. I also felt pain under my left breast and in my left armpit. My chest was, and still isn't tender to the touch. I work at a supermaket which involves lifting bags of groceries and some heavy items which my doc explained may cause the pain. It is now June and I am still feeling pain in my chest, sometimes when I move the worng way, other times when I am lying still. Some times I am awaken at night by the sharp pain in the side of my chest. Other times when I don't have the pain I feel a sort of hollowness in my chest, which may simply be a feeling that occurs when the pain which i have become used to is not there. Do you recomment returning to my doctor to order more tests, or does this sound like intercostal never pain to you? HOw can you explain the hollow feeling? I should also note that I am an active 20 year old female that has no history of illness or alergies. My grandfather had a mild heart attack about 15 years ago, but he is fine now. My blood pressure has been normal when checked. I would just like your take on this situation. Thank you for your time.
In december 2000 I went to the ER with severe pain in my chest and back. After having an EKG, chest X-Ray and blood work (all which was normal) I was diagnosed with viral pericarditis and was sent home with instructions to take a recommended dosage of advil. While the advil releaved some of the pain, by the end of January I returned to the ER. At this time another chest X-Ray and EKG was done (both which were normal). The docter listened for the pericarditis but didn't hear it. Assuming that it had not complelty cleared up I was put on Toridol for 5 days. An appointment was lined up for me to see an Internal MEdicine Specialist for the next week. Upon visiting with him another EKG was done, along with blood work, chest x-ray and echocardiogram, all which turned up normal. I was diagnosed with a heart murmur, but nothing to explain the pain I was having. I have not heard from this doctor since.
In MArch I went to my family doctor who diagnosed me with intercostal never inflammation. He diagnosed this simply by noting that the pain I was feeling ran from my breast bone in the middle of my chest, around the left side of my body, to my back. I also felt pain under my left breast and in my left armpit. My chest was, and still isn't tender to the touch. I work at a supermaket which involves lifting bags of groceries and some heavy items which my doc explained may cause the pain. It is now June and I am still feeling pain in my chest, sometimes when I move the worng way, other times when I am lying still. Some times I am awaken at night by the sharp pain in the side of my chest. Other times when I don't have the pain I feel a sort of hollowness in my chest, which may simply be a feeling that occurs when the pain which i have become used to is not there. Do you recomment returning to my doctor to order more tests, or does this sound like intercostal never pain to you? HOw can you explain the hollow feeling? I should also note that I am an active 20 year old female that has no history of illness or alergies. My grandfather had a mild heart attack about 15 years ago, but he is fine now. My blood pressure has been normal when checked. I would just like your take on this situation. Thank you for your time.
Doctor's Answer
by CCF-M.D.-CRC, Jun 15, 2001 12:00AM
Dear Heather,
There are many causes of chest pain. The one that doctors worry about the most is cardiac because it has the potential to be life-threatening. Once this is ruled out the work-up can proceed at a more leisurely pace.
Amongst the cardiac causes of chest pain are: ischemia (due to blockages - including both stable and unstable angina and acute heart attack and coronary artery spasm), pericarditis (inflammation of the sack around the heart), myocarditis (inflammation of the heart), cardiomyopathy (heart failure) and rarer causes such as coronary artery dissection, acute rupture of the heart and valves and infections of the pericardium.
Gastrointestinal causes of chest pain include reflux (acid from the stomach washing back into the esophagus), gallstones, esophageal spasm, esophageal rupture, varicose veins of the esophagus, strictures of the esophagus, tumors of the esophagus and other less common GI problems.
Pulmonary (lung) causes include pneumonia, pulmonary embolus, pneumothorax, pleuritis and bleb rupture.
Other potential causes are aortic dissection, back and spine problems and musculoskeletal (muscle strain, rib fracture, etc.).
Psychological causes of chest pain are common and include panic attacks, anxiety, stress and mental duress.
As you can see the list of potential causes in long and may take a little bit of time to determine the precise cause. A good Internal Medicine doctor should be able to work through the potential causes of your symptoms.
There are many causes of chest pain. The one that doctors worry about the most is cardiac because it has the potential to be life-threatening. Once this is ruled out the work-up can proceed at a more leisurely pace.
Amongst the cardiac causes of chest pain are: ischemia (due to blockages - including both stable and unstable angina and acute heart attack and coronary artery spasm), pericarditis (inflammation of the sack around the heart), myocarditis (inflammation of the heart), cardiomyopathy (heart failure) and rarer causes such as coronary artery dissection, acute rupture of the heart and valves and infections of the pericardium.
Gastrointestinal causes of chest pain include reflux (acid from the stomach washing back into the esophagus), gallstones, esophageal spasm, esophageal rupture, varicose veins of the esophagus, strictures of the esophagus, tumors of the esophagus and other less common GI problems.
Pulmonary (lung) causes include pneumonia, pulmonary embolus, pneumothorax, pleuritis and bleb rupture.
Other potential causes are aortic dissection, back and spine problems and musculoskeletal (muscle strain, rib fracture, etc.).
Psychological causes of chest pain are common and include panic attacks, anxiety, stress and mental duress.
As you can see the list of potential causes in long and may take a little bit of time to determine the precise cause. A good Internal Medicine doctor should be able to work through the potential causes of your symptoms.
I, too, suffer from chest