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Neurology (Expert Forum)
Possible sources of chest pain
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Possible sources of chest pain
by celowe, Nov 23, 2005 12:00AM
Hi doc. I've been posting here and in the cardio forum, because about year ago I had a single bout of Atrial Flutter and shortly there after, 48 hours, I developed chronic chest pain and palmer hyperhidrosis. I'm still searching for an answer. I can live with the sweaty hands, but the chest pain I can not. My heart, stomach, and anxiety have been ruled out as possible causes. I've also had a ct scan of my lungs and a bone scan of my chest, both were normal. The ct of my lungs showed some scarring, which was probably an artifact of having had pneumonia when I was a kid. My PFT was normal and no Pulmonary Hypertension. My doctor has also done an examination of my chest and there is no tenderness or there is no pain associated with her pressing on it. Unfortunately, the pain does not respond to any conventional pain meds. My best description of the pain is it feels very similar to the pain associated w/ an asthma or pneumonia and it is just to the right of center my chest up into the lower part of my neck. The pain does not get worse with exertion, I can lift weights, run on a treadmill or hit my punching bag and it does not have any effect.
Is there any other procedure(s) that you could think of that might be helpful in a diagnosis. Could the pain be referred pain, could it be originating in my thoracic spine? As you can see I'm at a loss and very frustrated.
Thank you.
Is there any other procedure(s) that you could think of that might be helpful in a diagnosis. Could the pain be referred pain, could it be originating in my thoracic spine? As you can see I'm at a loss and very frustrated.
Thank you.
Doctor's Answer
by CCF-Neuro-M.D.-PW, Nov 29, 2005 12:00AM
There are nerves in the chest, but they are predominatantly for organ function and are not sensory nerves, ie that can cause pain. Pain can be referred down into the shoulder, neck area from pinched nerves in teh neck - an EMG of the shoulder area or an MRI of the cervical spine could evaluate for this. Central spinal cord pain can result in a poorly localized, difficult to control pain, but is usually after some kind of injury or inflammation of the cord, and seem to have nothing to suggest this. Otherwise, I'm not sure if I can help you any further, apart from exploring further pain management control options with a specialist.
A few weeks ago she started to get those symptoms again, the short breath, the heart palpations but this time she only felt o.k. as long as she way lying down,but when she would stand up, she would feel like she wanted to vomit. She says it was a mission just to even sit in the car and drive from one location to another. She was like this for about a week. I told her to go to the emergency room (she has no health insurance) and they took blood tests and told her that her blood was o.k., she had a urinal tract infection which she knew nothing about, and they didn't really do much of anything else, they told her that she didn't sound like she had asthma and they could find nothing wrong with her. They prescribed antibiotics something like Bactrin which I read is good for urinary tract infection, pneumonia and I forget what the other thing was.
They basically told her that she had stress. I was wondering if this sounds like more than stress and if related to Mitral Prolapse?