Chest Wall Pain

Posted By mommydee on December 17, 1998 at 23:06:52:







Thank you for your recent conversations with me via this forum regarding my 14 yr old daughter and her recurrent sometimes severe chest wall pain (possible lupus patient, and 6 yr Graves' Disease patient).  You suggested that despite having normal tests last April (EKG, Echo, Exercise Stress with PFT, Chest XRay, and 30 day loop event monitor) and a normal EKG and chest XRay in the emergency room while having the chest pain and shortness of breath...that I should not wait till summer for her next appointment, but just let her cardiologist know that she was having worsened pain.  I did that, expecting them to say that since all the tests were normal, and she was being evaluated by other doctors for the chest pain (pediatrician, gastroenterologist currently, will see neurologist in January), it would be fine to just wait for her next appointment.  I was very surprised when they said they needed to see her next week at the latest, and gave me an appointment for Tuesday...they want me to get an HMO authorization for repeat EKG, repeat Echo, Stress test, chest Xray, Holter monitor, and 30 day loop monitor...they told me to go ahead and get authorizations for all this although they may or may not do all these tests.  
The only abnormal cardiac test she has ever had was ONCE she had an abnormal EKG...the instant report said enlarged right atrium, the EKG was repeated at cardiologist and showed the short spike that follows the large spike was largely elevated in height...it was almost as tall as the first spike.  However, with normal echo, and no symptoms at the time (2 yrs ago), this abnormality was of unknown significance and I was told to just watch her, call them if she passed out or anything.  Since that time she developed the symptom of the chest pain and shortness of breath, but all followup EKGs have been normal, and the second echo last summer was normal. With the addition of the last EKG at the hospital ER last month while in the midst of a severe attack of pain being normal, how likely is it that there could still be something cardiac related.  I wasn't worried at all about the heart being involved until I saw how concerned they were...it normally is not that easy to get an appointment, you have to call weeks or months ahead, yet they are working her in almost immediately.  This has worried me.  I was hoping you could give me a better perspective of what they are doing and how much concern I should give this.  Thank you for ALL your help!  
Dee