Double vision chest pain

[bookgirl]

I'm a 37 year old female who was recently diagnosed with Asthma. Due to a small pulmonary embolism that occurred after the birth of my son 8 years ago the sudden onset chest pain was always checked first for a recurrence of that, but genetic testing showed no clotting factors and every sequential trip to the ER showed no blood clot. After the most recent bout of chest pain and pain under the sternum with a negative d-dimer and normal chest X-ray I was put on the prednisone due to asthma and what they thought was pleurisy and started on 40mcg Qvar and albuterol as needed . Chest and sternum pain (which was higher, right at the base of the throat and more like a sting or pinch) resolved after several days of prednisone but I started to get a worsening of my migraines (normal since age 10) and intermittent double vision with a slight drooping of the left eyelid. Doctors ordered a brain MRI which came back normal and double vision was thought to be due to worsening of migraine. However at the end of the prednisone course while the chest pain and tightness stayed away, the constant stinging pinching pressure right under the top of the sternum/center of my clavicle did return. The doctor was not concerned about this due to the normal chest X-ray and thought it could be anything from reflux (doesn't feel like that) or muscle/tendon strain due to the migraines. I already deal with a diagnosed generalized anxiety disorder which after several health scares has become more and more health related anxiety. So my anxiety can cause all sorts of symptoms, and I've definitely been under a lot of it. My question is about the chest X-ray and wondering if the return of the pain there could warrant something more than a chest X-ray. Do chest X-rays pick up most abnormalities if they are large enough to cause pain/symptoms in those areas?

[John Irlam, DO, FASCP]

Hi there,
Thanks for the post.  This is out of my realm of expertise unfortunately and should probably be moved to the radiology forum.  A normal chest Xray can't exclude an embolism although a negative d-dimer would make me think that an embolism is less likely.  I do agree that anxiety can induce a lot of symptoms and never discount the extent that stress can play in our lives.  Feeling better when on prednisone would fit with a diagnosis of asthma, I'm not sure what to make of the pinching sensation that you're feeling in your chest.  Chest x-rays will detect large abnormalities but are not nearly as sensitive as CT scans for lung disease.  Is there any additional information or test results available?
John

[wilsonmadison]

Generally x-rays catches the actual abnormality easily.But still if you have all these symptoms and your doctor is not concerned about it then see other doctor and clear you doubts.