Chest and Upper Left Back Pain

[Chrissy1189]

I am an 20 year old female in good shape. Recently I have been having pain in my upper left back and side, and just below my left breast. These pains are always sharp and stabbing. They can last anywhere between seconds and minutes. They leave me feeling exhausted, sometimes makes breathing difficult, and make me dizzy. I have visited a cardiologists who ran an EKG, a stress test and a halter and all results came back within normal limits. Despite this i still worry because the pain is persistent. He said Pots syndrome was unlikely. What could this be, if anything?

[Heiferly]

"Within normal limits" really doesn't say much about the holter results.  The sinus tachycardia episodes of POTS are sometimes not interpreted as clinically significant on 24 hour monitoring because healthy people will have episodes of sinus tachycardia corresponding to increased activity (i.e., physical exertion from running up a flight of steps, having sexual intercourse, straining during a bowel movement) that they might not note on their paper log of what they were doing throughout the time they were wearing the monitor.  You may want to ask for a copy of the holter results for yourself.  (You have a right to your own medical records, though there may be a small fee involved for making the copies.  See here:)

http://www.medhelp.org/posts/Dysautonomia-Autonomic-Dysfunction/Medical-Records--Test-Results--and-Charts/show/1044052

If indeed there weren't a bunch of episodes of sinus tachycardia (heart rate greater than 100 bpm) that wouldn't be accounted for by physical exertion on the holter monitoring, then I think you can rule out POTS definitively (unless your resting heart rate is less than 70 to begin with).  If your resting heart rate (awake, don't count your sleeping one) is under 70, that's a different can of worms, because that would lower the bar for a diagnosis of POTS for you to under the technical definition of "tachycardia."  

To learn more about POTS, you may want to read some of the basic articles about POTS here:

http://www.medhelp.org/health_pages/Neurological-Disorders/Further-Reading-on-Dysautonomia/show/696?cid=196

If it's not cardiovascular in nature, I would consider some of the things Surgimenopause suggested ... I would probably hedge my bets on seeing a Gastroenterologist next.

[AireScottie]

Here's the "Poor Man's Tilt" under "Introduction to Orthostatic Intolerance"
http://www.medhelp.org/health_pages/Neurological-Disorders/Further-Reading-on-Dysautonomia/show/696?cid=196

[AireScottie]

I get bad pain in my chest sometimes from dysautonomia.  Have you tried taking your heart rate and blood pressure while you have the pains?  Do you feel like you're getting any extra or skipped beats during this time?

There's also instructions in the Health Pages up above on how to do your own tilt test, preferably with a doctor nearby, like your primary care doctor.  My brain is blanking, though, and I can't find the link!

It would help to bring this info to your cardiologist if you do get unusual results.  Then he'll have something to follow up on.

[LivingInHope]

Have they checked your left kidney?  How about your stomach, which is in close proximity to your heart?  What about your esophagus, which potentially can go into painful spasms (had multiple chest pains recently and got my heart checked out & doc thought likely esophageal spasms)?  And your pancreas is behind your stomach- have they checked pancreatic function?