Re: chest pain

Posted By kel on April 19, 1999 at 20:54:28
About a week ago I had chest pain that lasted on and off for about eight hours.  It seemed worse when I laughed, moved or breathed deeply; it was just a little right of the center of my chest.  I have also had palpitations and pinching or little pains in my chest on and off; these didn't occur with excercise.  I had tests done for my palpitations: tredmill stress test, chest x-ray, ekg, and echo.  The doctor wasn't worried about anything (these tests were before the aforesaid chest pain.) My questions are these:
1.  Should I go back to the cardiologist for this mentioned chest pain?
2.  Can you develop heart problems quickly?  Were the tests enough assurance that there isn't a problem?
3.  Also, can palpitations occur or be felt in the lower rib cage?
I am 20, female, muscular, don't drink or smoke.  There are heart problems in my family.  Mostly my mom's mom. Thanks for your time.

[Cleveland Clinic, MD]

Posted By CCF CARDIO MD -CRC on April 20, 1999 at 17:09:56
Dear  Kel,
Q:  Should I go back to the cardiologist for this mentioned chest pain?
A: Your family practice doctor or internist should be able to help sort through things.
Q:  Can you develop heart problems quickly? Were the tests enough assurance that the heart probably isn't a problem?
A: No and Yes.
Q: Also, can palpitations occur or be felt in the lower rib cage?
A: Where exactly in the rib cage?

Here is some general info on chest pain.
There are many causes of chest and neck 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), 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.

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.











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