Pleurisy or something else?

[mhardy24]

Hello,
I'm a 29year old healthy male in good shape.  I have asthma and take singulair every night and I have my albuterol on stand by at all times.

About two weeks ago I went to urgent care because I had some very sharp chest pain (in the center of my chest) and it was made worse when I would lie down or suddenly change positions, i.e. sitting to standing.  I would often feel the stabbing sensation with each heartbeat.  I really have any other symptoms of an MI which is why I waited until the morning to see the urgent care doc.  

He quickly diagnosed me with pleurisy, gave me a z-pack and some low dose prednisone and i refused an rx for hydrocodone since i said I'd rather take nsaid's if possible.

Well, the pain is starting to come back and I'm concerned that it may not be pleurisy.  I understand that pleurisy can be a chronic condition, and I do have a pretty bad history of asthma, but the location (directly over my heart) has me concerned since it seems most cases of pleurisy are concentrated to one side and more in the lower rib cage area...at least from what I have read.

Should I be concerned that it is something else?  Also, are there any other remedies to consider before going to see my pcp?  thanks!

**forgot to mention, I had bilaterial laproscopic hernia surgery about 6 weeks ago.  wanted to mention that b/c my mom is concerned about pulmonary embolism, but the urgent care doc quickly dismissed that notion.

[kmar123]

In my opinion you may need a work up with a cardiologist and rheumatologist. Singulair has a new potential problem that the FDA has recently released and is putting out as a warning. My son has developed the same problem and I am suggesting he have a ANA ANAC lab test to test for the problem. Go to the FDA site and look up Singulair. That's what I did. My sons diagnosis was coronary vasospasm which mimics a heart attack. He was admitted to a heart hospital and all indicators were that he suffered a heart attack angiogram was negative for damage and labs went to normal levels before discharge. He is a chronic asthmatic with Samters Triad (look this up as well) which is nasal polyposis, allergy to NSAIDs, and asthma. He was controlled until age 19 when it all broke lose. He went thru aspirin desensitization and has done well up until last 4 months when he started developing these symptoms in the early morning hours after rest.

[Paderla Anitha, DNB]

Hello and hope you are doing well.

Cardiac pain or chest pain can be felt as a tightness and worsens with activity or exercise. It does not change with position. But when in doubt always best to have it checked. So please discuss this with your primary care physician who may ask for an EKG or a treadmill test to rule out a cardiac cause for the pain.

Hope this helped and do keep us posted.