Chest/back pain

Hello!

My partner and i are both in college--she supports herself and has a mediocre healthcare plan through work so it's very expensive and difficult to get even a basic doctor's visit.

She experiences intense chest pain, like one might experience after working out--like the muscle between/in front of the lungs is being contracted. It is really painful when she tries to breathe deeply. This is accompanied by bad pain in the mid-back. It's so bad that she has to lay down for an hour or two, ideally sleep if possible, even though that doesn't actively relieve any of the pain. Sometimes she throws up. Tylenol, Ibuprofen, and Advil aren't very effective at all. A heating pad on the chest or back helps a little.

She's been healthy all her life. She does get panic attacks occasionally (but this is not the same thing) and is under a lot of stress. She's 5'3" with a DD-cup, which is painful at times.

She did go to the doctor's office almost two months ago. The doctor did a breathing/lung expansion test and checked her heart, prescribed her some basic painkillers, and sent her on her way.

Is there any way we can figure out what exactly is causing this before another expensive, useless doctor visit? This is incredibly disruptive to both our lives!

Thank you

[J T Junig, MD PhD]

She MUST get a chest x-ray if she hasn't had one;  she doesn't fit the profile (at all!) for Marfan's syndrome or tertiary syphillis (syphilis), but an aneurysm of the aorta will cause those symptoms, and rupture is a uniformly fatal event (the conditions I mentioned are associated with increased risk of aortic aneurysm).  

Depending on her age and risk factors, cardiac pain is quite serious, and needs to be 'ruled out' by an EKG during severe pain or a stress test.  If she is under 40, the likelihood for cardiac causes is much lower.

Finding the cause will require more info-- what causes it, how often it occurs, what makes it better, what makes it worse, the time of day it usually happens, changes if any in bowel habits, associated symptoms, family history, etc... and also, unfortunately, a physical exam and x-ray.  I suggest you take a good look at the insurance;  most have a cheaper route of care if you see certain docs or 'gatekeepers', get prior authorization, etc.  If she has already paid some fees, she may benefit by doing everything in one policy year, to pay only one deductible.