Chest Pain - Cardiac?? HELP PLEASE

[Pengipen]

I would like to know if it is possible that my chest pain is cardiac in origin or if it is costochondritis as my doc's seem to think. I am 23, female, no family history of heart probs, non smoker ocassional drinker. It is on the left side of my chest, radiating out, down my left arm and up my neck into my jaw. Occasionally my left arm will feel numb as will the left side of my face. Usually it will start with no real cause, but i have felt it start sometimes when i get scared of something or nervous. The tests i have had performed are several ECG's (last in august) echocardiogram (nov 2006) chest x rays, brain MRI, blood tests (all the usual ones also D Dimer, Troponin, ANA Antibodies, Inflammation etc) Every test has been normal. I saw the cardiologist in 2006, he didn't find any problem. I had this pain in 2006 for a few months. It cleared up, and came back again 6 months ago and i haven't had a lot of relief since. Sometimes the pain is bad, sometimes i am just aware i have an ache in my chest arm and jaw. I have been to the emergency dept twice this year with this pain had ECGs bloods and chest x ray all fine so i was sent home. In 2006 i must have been to hospital with the pain about 10 times. My GP is investigating me for fibromyalgia as i suffer with other various aches and pains, fatigue amonst other symptoms. Can costochondritis cause these symptoms? Would any heart problem have been found in my tests? In your opinion do you think i can relax about my heart worries? Any info would be appreciated. Thank you for your input and time to answer me.

I had all this typed out in the expert forum but by the time i clicked submit two other people got there before me. I thought if you got onto the page to type the question, no other people would be able to take your place?

[Pengipen]

Hi

Thanks both for your replies. Jon - i'll try that other cardiology forum tomorrow, its full up today. I understand they get 'reset' for new questions at certain times every day? Its a bit difficult for me as i live in the UK so with the time difference etc...

kenkeith - would it be possible for every ECG to be negative? I must have had at least 20 of them and 80-90% of them whilst i have the pain. I know the last one when i was in A&E in august was reviewed by the coronary care department, apparently that is the procedure if you go to the hospital with chest pain, so i guess my other ones were reviewed by them too.
This chest pain, whatever it is, costochondritis or my heart, did come on suddenly as i woke one night with it 2 years ago. It persisted for 6 months, disappeared then came back a year or so later in May this year and hasn't really gone away since. It hasn't been so severe this time, but still just as scary

[kenkeith]

An EKG can easily be false negative.  For instance one may have had a variant angina attack (chest pain, etc), the EKG will not read any abnormality unless (possibly) if an episode happens at the time of the test.  

An echo, unless assoicated with a stress test, may not show any blood flow problems when related to the vascular system abnormality that could restrict normal blood flow to heart cells.

Tietze syndrome usually comes on abruptly, with chest pain radiating to your arms or shoulder and lasting several weeks.  It differs from chostochondritis as Tietz syndrome involves inflammation...should show with blood tests, and apparently the blood tests are negative!

If those tests are normal and your physical exam is consistent with costochondritis, your doctor will diagnose costochondritis as the cause of your chest pain. It is important, however, for adults with chest pain to be examined and tested for heart disease before being diagnosed with costochondritis. Often it is difficult to distinguish between the two without further testing. The condition affects females more than males (70% versus 30%). Costochondritis may also occur as the result of an infection or as a complication of surgery on your sternum.
Tietze syndrome is often referred to as costochondritis, but the two are distinct conditions. You can tell the difference by noting the following:

For some insight, "Tietze syndrome is accompanied by a localized swelling at the painful area (the junction of the ribs and breastbone).
Costochondritis can be an independent condition by itself or sometimes be a feature of a more widespread disorder. Examples of illnesses that can feature costochondritis include fibromyalgia, psoriatic arthritis, ankylosing spondylitis, reactive arthritis,
Coronary artery spasm may occur spontaneously, or it may be caused by exposure to cold, emotional stress, or vasoconstricting medications. Cocaine use can cause severe spasm of the arteries while at the same time increasing the energy requirements of the heart. Variant angina is a syndrome, probably involving coronary artery spasm, where the angina pain does not have the usual triggering activities. It most often affects women under 50."

[erijon]

Don't forget there is an Interventional Cardiology Expert forum as well, they take 3 questions per day as well.

Good luck!

Jon