Pain in the area near the sternum

[Ramesh G]

I am havingconsistent pain ( heaviness) in the area near the sternum. It started since a year back from now.
Initially it was just some heaviness and uncomfort feeling. I did not even know where the actual pain and unconfort feeling was.
I went to my family doctor who suggested to undergo upper gi series test. It was normal.
Then I went for chest x ray and chest scat scan. Everything was normal. Then I went for the
blood test which was also normal. After that for some time the the heaviness was reduced considerably.
I was feeling normal. That time I started doing some excercise with bit heavy dumbells and skipping rope.
Once again I got the problem. This time it was a severe pain in the area near the strnum.
I went to the cardiologist and did ECG also. According to Cardiologist there is no problem
related to the heart. Now the pain is becoming more n more severe. I once took a pain killer medicine
which relieved pain one hundred percenet for 7 to 8 hours.
I did visit to an ENT ( Ottoloringologist) in India
who confirmed that this pain has nothing to do with the throat. Another doctor in India told that the
pain is a muscular pain and prescribed some balm which did not help really.
Please advice as to what should I do.
thanks
Ramesh

[Debi]

I began to notice heaviness, pressure in my chest after having the flu in Jan.1999, by May like you the beginning of the day wasn't to bad but as the day wore on it got worst.  I became breathless with any activity.  They kept treating me for bronchitis. Want to start checking for Reflux or anything associated w/the stomach,but it had nothing to do w/eating. I went to a Cardio, EKG,Stress Thalium, blood work, xrays, 24 hr. monitoring in Cardio unit, all normal nothing showed. Then they did a catherization and found a major blockage in the left main artery to the heart. June I had double by pass surgery.  I recommend skip all until after they do a cartherization, then do everything else.  Good luck

[Jerry Basham]

Dear Ramesh,

       Please do not rule out two things:  1.  the
possibility of heart problems and 2.  the possibility
of spine and/or neck problems.

       Get the stress test (cardiolite) done if you
can, then if that's negative, go ahead and have your
spine and neck checked.

       Best to you,

        ----- Jerry

[John]

I haven't time to go into lots of detail but I can identify almost 100% with what you're saying here, particularly with the problem going away when you're asleep and worsening throughout the day. My take on this, from my personal experience, is that we're talking about the effects of sustained stress here ...
The point the other guy made about you feeling better after seeing the doctor is key IMO, I've had similar experiences ...

Again, IMO, you need to change your lifestyle to address whatever is causing these problems. I've almost totally changed mine over the past 6 months, encompassing everything from the way I work, how much I sleep, what and how much I eat and drink, posture and exercise etc and its working for me big time ...

As an aside, I also suffer from Psoriasis, caused by bad diet, no exercise and STRESS. The above measures have given me almost complete control over this horrible 'incurable' disease ...

Try to look at EVERYTHING in your life that makes you feel the least bit 'uncomfortable' and cut them out. It sounds easy and obvious but just how many of us actually try to take positive action about the negative things in our life? I've let my lifestyle slide in a big way since my teens and I started paying for it in my early 30's, the key is to get CONTROL back over YOUR life and start enjoying it again. Its your life so start doing what you want to do rather than what you feel you have to do ...

Good luck.

John.

[Ramesh G]

Thanks so much CCF CARDIO MD - CRC , Carrie , Dave  and John for your valuable advice.
Let me be more specific of my prob. Its not the pain that does not allow me do my job. Its a kind a heaviness that does not let me sit and type on pc properly. I cant turn my neck upwards back sitting straght. I cant turn left or right sitting very straight. Something in my chest is holding from inside which does not allow any movement. When I sleep there is absolutely no problem. First half of the day the problem is less sever but becomes worst in the later half of the day.  I dont have any other prob like no hunger etc.
Another imp thing is I have been under tremendous stress n tension for last two three years for some personal reason. That keeps bothering me all the time. And this pain has added to my worries.
Once again thanks for your suggestions.
Ramesh

[stevebu]

see a psychiatrist?  What kind of advice is that?  Maybe this guy has a medical problem, and a doctor needs to investigate his symptoms a little further.  Maybe you shouldn't judge people so quickly.

[John Mc]

I'm not a doctor but do have heart disease so I can relate to your anxiety. I only offer you this as a suggestion.

You have to methodically eliminate all possible reasons why you are feeling this and that starts with see a reputable doctor and being tested for various problems. You need to detemine when it comes on, what are you doing when it comes on, does it go away when you stop doing whatever brought it on, does it go away at rest etc? When you start to determine a pattern it makes it a lot easier for a Doctor to diagnose you.

From the sound of it I wouldn't be overly concerned but would try to establish a patern.  See your Doctor and ask for a strees test that will answere a lot of questions.

Good Luck

[Carrie]

See a psychiatrist. The reason you felt better at the docotors is because you felt safe. Anxiety disorder is what is sounds like especially if nothing is wrong.

[stevebu]

Ramesh

Have you ever had an echo or stress test done?  Those are two very useful tests for cardiac problems.  But then again, you night have some other type of problem.  Maybe the doctor here might have an idea or suggestion for you.  Good luck

[Cleveland Clinic, MD]

Dear Ramesh,

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.

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.

I hope you find this information useful.  Information provided in the heart forum is for general purposes only.  Only your physician can provide specific diagnoses and therapies.  Please feel free to write back with additional questions.

If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire online by using the Heart Center website at www.ccf.org/heartcenter.  The Heart Center website contains a directory of the cardiology staff that can be used to select the physician best suited to address your cardiac problem.