chest pain

[lburke]

I have been having chest pain since tuesday and i have been to the hospital 4 times with in this week. each doctor say something different. one said  gastroesphageal reflux , another said costochonritis , another said carpal tunnel and a pinch nerve in the neck ,and then one said it have something to do with my mucsles and reflux . so my question is what is really going on with me .To me it sound like a stroke , heart attack , or angina . All the doctors say my heart is ok ,my lungs are ok and im not having a stroke or heart attack. Just need to know what is going on because i have to kids to take care of.

[Tuckamore]

Hello Iburke,

Welcome to the Pain Mangement Forum. I am glad that you found us and took the time to post. But sorry to hear about the various diagnosis you have had for your pain.

Thank goodness it is not a heart attack...or a CVA (cerebral vascular accident). I do understand how frightening your symptoms my be. Rest assured that had you had either the tests would have revealed them. Both events are rare at your age.

Please try not to stress as it will only make your symptoms increase. I know that is easier said then done.  

I do not suggest any medications other than what the physicians have prescribed for you.  Proton pump inhibitor (PPI) medications are contraindicated in some ppl and with other medications.

I agree that your symptoms could be any of the diagnosis you received at the various ER Departments. Indeed you could have all of the diagnosis. Remember that an ER is not a good diagnostic department for routine conditions. They are the best at treating and dealing with life threatening events which they have ruled out in your case.

GERD or gastrointestinal issues can be extremely painful. They can mimic a cardiac episode but are very distinguishable from one another as your ERs were able to do.  

I cannot tell you what is going on...but I can encourage you to see your PCP for a complete clinical examination. He/she can diagnosis your symptoms and not just guess. If your PCP feels your condition warrants a consult with a gastroenterologist most will refer you to one.

The symptoms of a CVA (stroke) and a MI (heart attack) present very differently. It's not if you don't have one that you must have the other. Angina is actually more of a symptom than a specific disease. It usually presents differently in woman than it does men. But again your PCP the ER Department is usually very good at ruling out or in angina. After visiting several ERs I would be fairly certain that you do not have angina.

It's apparent to me that you need to see your PCP.  I sincerely hope that you will do so. There is no need to live in fear. We are a chronic pain (cp) forum. Our members suffer with cp. You might want to post on other forums within MedHelp. You can locate them by clicking on the blue word Forum on the top left hand side of this page.

I wish you the very best. Please feel free to keep us posted.

Take Care,
~Tuck

[Jaybay]

The good news is that the hospital ruled out a heart problem, and as mindlink described it's not a stroke either.  

I also agree that acid reflux is the likely culprit.  The symptoms are very often so painful that they're mistaken for a heart attack.  My husband had horrible chest pain that finally got him off his rear into the doctor's office.  He had ignored it for so many years that it turns out he has completely fried his esophogus.  That condition is called Barrett's Esophogus, which is a precancerous condition that must be monitored for the rest of his life.  The doc thinks he's had reflux his entire life - it's just the way he's built - and it finally got bad enough to mimic a heart attack.  It pays to be proactive with your health!

Your primary doc might start you on a proton pump inhibitor (PPI) medication like protonix, nexium, or aciphex.  Prilosec is an over-the-counter PPI medication.  It's meant for only a 14 day course.  If the pain persists you MUST see your doctor! PPI's stop much of the production of stomach acid rather than neutralizing it like a typical antacid products.  It wouldn't hurt to ask for a referral to a gastroenterologist if your problem has been of longstanding duration.  A GI doc can perform an EGD - that's the procedure where the look at your esophogus, stomach and duodenum with a flexible tube and camera.  The reflux may be caused by something like a hiatal hernia or a problem with the sphincter between the stomach and esophogus and be entirely curable.

The hospital has determined you aren't an emergent case, so it's time to deal with it at a clinical level.  Make that appointment with your primary doc or a GI doc and see what they can do to help you feel better.  Hope it's soon!

[mindlink]

I am not a doctor, but one thing I can tell you is that it's not a stroke.  A stroke happens in the brain when a vessel breaks or leaks, or a blood clot finds its way to your head, and you will feel it there.  The guy who said it was a pinched nerve sounds like a dope.  Sounds much like intense acid reflux to me, which can be very painful, but I would go to your primary physician and insist that he/she pursue this ... send you to a specialist, do tests ... whatever it takes to get to the bottom of it.  I had a severe pain in my chest two years ago which eventually radiated all the way around to the middle of my back and, at the same time, experienced urgent diarrhea, loss of and vomiting.  That was a heart attack.  There are many other symptoms of a mild heart attack which doctors should know about but discount in women.  You have to be insistent and real crabby if necessary.  Hope you get the care you need, and fast!