Chest Pain

Hello, I am a 39 year old women 213 pounds 5'4 and I have rencently lost 60 pounds.  I have been diagonsed with a hiatal hernia and for the past month have suffered dull chest pain over my left breast and left shoulder and arm aching as well.  I did have some stomach pains but those disapated after starting prilosec 10 days ago.  For a  couple of days after starting priolsec I felt no chest pain at all, then 5 days into it they were back.  Sometimes I feel a stitch in my left middle portion of my back as well.  My question is, is it possible that I am not taking enough prilosec.  I am taking the 14 day course OTC.  Also should I contiue to take it even after the 14 days?  I am eating 5 small meals a day and exerciseing and doing yoga daily to try and remove the excess weight, but every day about an hour after I wake this dull pain starts up again.  I try to work through it, but it has started to affect everything I do.  I can't relax for one minute without feeling like maybe I am going to have a heart attach. After researching I do not feel this is heart related, I feel like it has to do with my stomach problem, but I just dont' know how to find relief.  I hope you can shed some light on this for  me.  Thanks so much.

[Kevin Pho, MD]

Prilosec OTC will help in cases of GERD or esophagitis.  It is safe to take longer than 14 days, if indicated.  A higher dose can also be discussed with your personal physician.

An upper endoscopy can be considered to better evaluate the upper digestive tract, as well as possible diagnose an ulcer or inflammation.

If negative, a 24-hr pH study needs to be done to confirm the diagnosis and quantify the severity of the reflux.

Cardiac testing can be considered if the GI tests remain negative.  An exercise stress test with echocardiogram would be a reasonable start.

These options can be discussed with your personal physician.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin Pho, M.D.
www.kevinmd.com
www.twitter.com/kevinmd