Chest Pain

[PR]

Other than CAD, what would cause chest pain?  Could mild valvular regurgitation cause this?  Thank you.

[chiefr]

I'm a High BP and High Cholesterol patient.   Recently, I've been experiencing quite a bit of chest discomfort.   It's not a crushing pain experience like my dad had when he had a heart attack.  It's more like a 'pinching' about 2 inches below my left nipple.  My BP is generally around 140-82 or so while on my meds.    

I'm thinking it might be GI related, because sometimes I might belch or pass gas, and the feeling eases some.   It's more persistent when I'm lying in bed on my back watching TV or something.   Roll over and I get some relief.   But, at other times I also have some left tricep aching, and that concerns me.   One time I sneezed and my left arm hurt to my elbow and chest seemed to tighten some.  

Comments?

[sk113]

My wife is 40 yrs young and she has had high blood pressure for 5 yrs. now. She take her medication on time every day. Sometime, mostly at night after bedtime her blood pressure increase to 220 over 120 approx. Then at this time she will get the shakes very badly. After and hour or so the pressure will reduce and the shakes will stop. Is this common with high blood pressure?

She has had every test that can be done on the heart, but all test are negative. We do not know what to do for the spike of the blood pressure or the shakes that is associated with it.

[CCF-M.D.-CRC]

Dear rp,
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.  Mild valvular regurgitation does not generally cause chest pain.

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.