15 y/o with chronic mild chest pain, please help!

[ERgrl4eva]

I'm a 15 y/o girl that has been having chronic mild chest pain. I do have moderately severe asthma that has been controlled, and I had a spontaneous pneumothorax four years ago. About two years ago I began having chest pain...a sharp stinging pain that would worsen when I breathed in. It became increasingly frequent, occuring nearly every five or ten minutes. The doctor said I had pleurodynia and that it would go away. It did get better, but every once in a while I would experience the same pain. A few months ago I began having similar pain again. Both my chest x-ray and EKG were fine, and the doctor suggested it was from reflux. For one week it got pretty bad. The pain changed to more of a crampy pain, or a another type of pain that was kind of dull, but I could pinpoint it's location. I also got headaches everyday. Once I was shopping and got a bad headache, crampy chest pain, broke out in a clammy sweat and felt very lightheaded/dizzy...something that's never happened before. I had some bloodwork done that showed nothing was wrong. The pain got better after that week but since then for the past two months I've still been having pain. I can pinpoint where it is, normally on the left under the breast, but sometimes on the right or in the middle. It will last anywhere from a few minutes to a few hours and has no correlation to eating,exercising,or anxiety. Antacids don't help. It doesn't interfere with my daily life. Often times I feel like it's in my head cuz I can't find an explanation, but it's definitely there, and it's definitely pain. Please Help!

[National Jewish]

The diagnosis of pleurodynia was probably correct.  Pleurodynia is an infection of the chest caused by a Coxsackie virus.  Other names for this problem are Bornholm's disease and the devil’s grip.  The virus causes inflammation of the sac that holds the heart.  Although this would cause chest pain usually there is also fever.  Since this is a viral infection, antibiotics would not help.  Your current pain is probably not pleurodynia.

You should have your heart checked by a cardiologist to see if this could be the cause of your pain.

Gastroesophageal reflux disease (GERD) is the back flow of stomach contents, including digestive juices, into the esophagus or food tube.  This is most commonly called reflux or heartburn.  Your pain could be caused by reflux.  However having a headache, crampy chest pain, breaking out in a clammy sweat, and feeling very lightheaded and dizzy are not typical symptoms of reflux.  Reflux can cause the following symptoms:
· Heartburn or a sour taste in the mouth;
· Pain occurring in the middle of the chest;
· Coughing and/or choking while lying down;
· Increased trouble breathing while asleep; and
· Even no symptoms at all.  This is called “silent reflux” and it is common.
Please check with your doctor about this possibility.  Even though you have taken an antacid, it is possible that it has not helped your symptoms because it is not controlling the reflux.  A pH probe is the best test to find out if you truly have reflux and/or if the medicine is controlling it.  This test measures the acid in your esophagus to see if digestive juices are coming up from your stomach.  Please read our Gastroesophageal Reflux Disease MedFact at http://www.nationaljewish.org/medfacts/reflux.html for more information about things to do to lessen reflux.  A gastroenterologist is the type of specialist to let you know if further testing is needed to identify reflux and the best treatment.

[ERgrl4eva]

I forgot to add that I have been burping a lot as well. When the chest pain is localized on one side (like when I normally have left sided pain) I don't get the burping...it only occurs when I get pain in the center of my chest. The pain builds and feels kind of crampy and then I'll burp...this has been happening pretty frequently. I know that's a sign of indegestion, but why don't antacids help, why doesn't it correlate to when I eat, and why doesn't the pain subside? I know this sounds like I'm overreacting, but could it be cancer related? or some sort of disorder of the oesophogus?

[Ellis7]

For info see link:
http://www.emedicine.com/MED/topic1845.htm
Pleurodynia
========================

Regarding antacids for GE reflux; that's not the best drug. Try Prilosec, now OTC. See:
http://asthma.nationaljewish.org/about/relationships/gerd.php
Gastroesophageal Reflux Disease

"Medications that may be prescribed to help this condition:

Antacids after meals and at bedtime.
Tagamet® (cimetadine), Zantac® (ranitidine), Pepcid® (famotidine), Axid® (nizatidine)
Prilosec® (omeprazole), Prevacid® (lansoprazole)
Reglan® (metoclopramide) "
============================

[Ellis7]

More from the njc website on GE reflux:

"Physical measures:

Elevate the head of the bed 6-8 inches, by placing blocks under the legs of the head of the bed.
Avoid lifting heavy objects.
Avoid bending forward at the waist.
Avoid wearing tight fitting clothing."
-----------------------------------

Rather than elevating the head of bed, you can use a slanted foam wedge pillow. One I like is available at www.medslant.com
"Acid Reflux Wedge Pillow by MedSlant™"

[flacke]

I have the same thing happening to me.  All Test are normal.  I've been having them for almost three weeks.  My pain isn't too bad unless I rub the area on my chest the pain is coming from.  It's the 30 minute to two hour "panic" attacks I'm having almost every evening.  My BP goes from 100/70 to 140/90+.  And I'm afraid I'm having heart problems.  I had a stress teat 3 days ago and have heard nothing back.  I'm a 31 year old man.  Are you still having problems?  I'll be bring the info from this forum up with my doctor.  Thank you so much.  We're not alone in this after all.

[apmatt]

I'm not a forum type person, but your symptoms are too similar for me to ignore.  I'm a 33 y/o male that wound up in the ER 6 months ago with chest pain, dizziness (lightheadedness) and some apparently unrelated intestinal problems, primarily belching (a lot).  EKG, MRI, x-ray and blood work are all normal.  I now have frequent chest pain (more of a pressure) in random areas, left, right or middle, but very localized.  I can also pinpoint exactly where it hurts.  Belching usually relieves the chest pain/pressure.  The occassional lightheadedness bothers me since it doens't possibly seem related, but yet is almost always accompanied by the chest pain.  And it scares the hell out of me.

I've taken Nexium and Prilosec which both got rid of the symptoms, whereas antacids do not.  Symptoms come back when I stop the medication.  I don't have asthma.

A lot of people have guessed anxiety, but it doesn't seem to fit.  Let me know if you get any more information.