Idiopathic Pericarditis Diagnosis - but I'm not fully confident

Hello -

It has been awhile since I have posted in MedHelp, but it really helped me over in the anxiety forums! This is the first time I have posted in this section and hopefully I will garner some good responses!

Anyhow, quick bg on me - 31 year old male 6' 175 lbs., I do smoke about a pack a day or less, do not get too much exercise (however, I am not a couch potato and play soccer with my kids 3 or 4 times a week but am certainly out of shape). Overall, as far as illness is concerned, I am as healthy as an average person is. I do not get sick that often and when I do, I usually get over it quite well.

As mentioned above, my biggest "issue" is anxiety. I was diagnosed in 2001 with generalized anxiety disorder with panic attacks. The first 3 or so years after that time were the worst in my life - anxiety is absolutely horrible and very hard to deal with. I chose to forgo meds after about a year when they were not really working. I have since made extremely good progress and while I deal with some symptoms of anxiety on a weekly basis - they always pass and no longer rule my life. The biggest lingering issue related to anxiety is health anxiety related to (I think) being mis-diagnosed with lymphoma when I was 19 (it was just an infection) and heart problems (which turned out to be my anxiety only). I also passed out one time when I was in a store when I was 19 and never went to the hospital and that has haunted me ever since. I was fine right after that and could have been related to being extremely hungry and sleep deprived. That was 12 years ago and it has never happened since. I am assuming that if it was a major issue then it would have happened again.

ANYWAY, the issue at hand.Wednesday during the day was like any other day. I felt fine. However, on the way home, I started feeling like I was getting gas high up around my ribs - this is not uncommon with me. I am generally a very gassy person and get gas pains in the strangest of places. There was a time when I was younger when I got horrible chest pains in my right side just below my armpit and gas was determined to be the cause. Anyhow, this feeling (on Wed) was more ticklish and just like regular gas. I came home, used the weed eater on the grass on our hill, ate, and put our 3 year old to bed. No big deal. When I was sitting on the couch, I still felt this (what I thought was) trapped gas feeling in my ribs on the left side of my chest. However, it was not up near the breast - it was down much lower and closer to my side. Still, no other symptoms and while it was annoying, it wasn't really painful. Went to sleep and slept well.

The next day I got up and noticed that the pain was there still, but not really severe and only if I breathed in deeply. Again, I still thought it could be gas, but thought it weird that it wasn't gone yet. I thought that it could have possibly been a pulled muscle because I had been playing soccer the day before AND was using the weedeater and starting it could have pulled a muscle.

During the day, I felt fine still - the pain wasn't really getting that much worse, but it wasn't going away. I was trying very hard to not let my health anxiety gears get to working and cause more symptoms that were only related to my anxiety. I did a fairly good job; however, I was feeling some feeling of the anxiety but am fairly positive that is all that it was. I did go to the restroom and (sorry for being somewhat candid here) it was fairly gassy and it seemed like the pain moved a little to the right side of my body and was relieved a little bit. Again - told myself it was gas and just went on throughout the day.

I coached a soccer game that evening and started to notice that when I breathed in is only when it hurt. I would get to a certain point and it would feel like a stabbing pain and would have to stop my breath at that point. I had a cracked rib on the same side a year ago (but it was up very near my armpit) and it felt exactly the same as that. The pain I was having was not under my sternum nor near my left breast area (where you would put your hand when saying the pledge). It was still near the side of my body and about 3 inches below my left nipple and around the side. And, it did hurt when I pressed on the ribs on the outside - the pain did not seem to be "under" my ribs.

However, since I was feeling like it was not going away, I thought maybe I should go to the ER, even though I was not having any other symptoms.

When I went to the ER, they hooked me up to the heart monitor, took my blood, vitals, ECG, and chest xray. My vitals were perfect, everyone said my heart rhythm was fine and nothing was shown in any of the tests. I had no symptoms of a cold or virus and felt fine.

The doctor came in and listened to my chest for quite a while and then basically told me the following paraphrased of course:

He said "if you lay down it hurts worse than when you are sitting up". I said I was not sure, but had been laying down and it was essentially the same - it only hurt when I breathed in to a certain point. It was not just hurting in general.

"First, let me say that it is a lot harder than one would think to listen like this and determine anything definitively" (I said I understood how it could be). Then he stated "I think I hear a little bit of a pericardial rub". Then he proceeded to give me the diagnosis of idiopathic pericarditis and explain what it is, etc.

He said that there was no cause that he could see bc everything else was perfectly fine. He sent me on my way with a  prescription for indomethcin (which I did not take because he said it wasn't necessary and I do not take medicine unless it was absolutely necessary) and just took one 200mg ibuprofen every 8 or so hours which really didn't make a difference. I was told that if it got worse or had difficulty breathing to come back to the ER. I was told it should heal up fairly quickly and was told that I didn't need to see my PCP unless it did not go away after about a week. This was on Thursday and it is already much better.

That's all well and good and throughout it all my health anxiety was surprisingly absent and I did all that I could to not search the internet for pericarditis. However, my concern is that I am not certain this is an accurate diagnosis based on my complete lack of any other symptoms and the doctor's less-than-confident statements.

Everything that I have read states that pericarditis causes chest pain, but does not ever reference it hurting where mine hurt and in the same manner. Bear in mind, it did not hurt at all unless I breathed in AND it hurt when I pressed on my ribs where the pain was located - not extremely bad, but it did hurt. If the percardium was causing the pain, why would either of these facts be the case? I did not have any weakness or shortness of breath/difficulty breathing, other than a shortness of breath when climbing stairs or walking up a hill simply because I couldn't breathe in all the way due to this pain - which is similar to when I had cracked ribs.

Am I completely wrong in questioning this? Am I wishful thinking? To me, it seems as though it could be some sort of pulled muscle. OR, if it is pericarditis, is it possible for this to be caused by a pulled-muscle type injury except instead of an intercostal, it is the pericardium?

Thanks in advance for patience in actually reading this entire post as well as any comments that you may have.

Mike M.