Pulmonary Embolism or Anxiety?

[wyvernwriter]

I'm 20, and I've been to the ER 2 times in the last 5 or 6 days complaining of horrific chest pain. It's everywhere -- my left shoulder, armpit, and arm, my back under my shoulder blades and in the middle, my neck, my head, my pectorals, everywhere. I've had gas pains like that before and I've gotten them to pass, so I can tell that these aren't gas. At the ER both times, they ran some blood tests, an EKG, and a urine test and everything came back normal. The first ER doctor suggested gastritis and put me on Bactrim and Protonix, and the second suggested anxiety. I'm not consciously anxious about anything -- but I know that it can happen subconsciously. I'm a really chill person.

The pain ranges from stabbing to throbbing to suffocating to pressure to stretching to tightness to virtually anything you can imagine. In my shoulders and back, it feels as if I've been hunched over carrying something extremely heavy -- you know that pain mixed with exhaustion. So THAT sounds like stress. But how can I rule out more serious conditions like a pulmonary embolism or celiac disease? If it's stress, I have a hard time telling if gluten affects me because I feel like I'd be getting subconsciously stressed about whether or not it's affecting me. You know? And pulmonary embolisms are serious.

I'm sick of this already, and I know many people suffer much longer than a week. But worst of all is that I get constant adrenaline shots. That kind of fizzly feeling you get right at the V in your ribcage and into your chest? Yeah, every 20-25 seconds. It's hard to sleep -- it keeps waking me up. This whole thing totally came out of the blue. Literally. I was sitting, doing nothing, and it just WHAM started.

Do you think this is really stress/anxiety? I don't want to be trying to ignore it if it's something important.

[wyvernwriter]

Thanks so much! Sorry to post this in the wrong place -- I'm new around here. :) I'll make sure not to do it again!

The ER also did a chest X-ray, and while I know that those don't necessarily always find everything, that was something I'd forgotten to mention in my previous post. Right now, the pain seems a little better and is actually mostly concentrated around the top of my right lung when I breathe out deeply.

Thanks for the help. Hopefully I'm on the road back to normal health.

[Jonathan D. Rich, MD]

Hello and welcome to the forum.

This is a PH forum actually but I will still answer your question, albeit with brevity.

1. A lot of what you describe does indeed sound like anxiety/stress, etc.  I would aggressively pursue treatment for this because its incredible how much better you are likely to feel if it is indeed all stress related
2. Having said #1, I agree with you that you need to also be sure to exclude other problems as well.  Celiac disease sounds incredibly unlikely. And not sure what tests the ER ran, but it doesnt sound like PE all that much either.
3. You need to stop going to the ER for your care (except in emergencies of course) and find yourself a primary care doctor who you trust and can help you.

Hope you begin to feel better soon.

Best,

Dr.Rich