chest pain

[Natali777]

Mother of my husbend is 71 years old. She quit smoking 7 years ago. She had hypertension. Three days ago she felt severe pain, irradiating in the left neck, shoulder region and left side of the body till the left kidney level. Also she had difficulty with breathing - it was painfull to her to inhail. We drive her to emergency, they excluded the problem with the hurt, performed different analises, the possible diagnozies is pneumonia with pleurities, but without incresed leukocytes count. The pain is still present. She was prescribed antibiotics. What else should she be examined for?

[Natali777]

Thank you for answering!

[Sandeep Bansal, MD, FCCP]

Chest pain can originate from chest wall (bone, muscle or skin), esophagus, heart, lungs, tissue linings surrounding the lungs (the inflammation of which is known as pleurisy or pleuritis). Sometimes problems with neck, spine, gall bladder, liver or stomach may also cause chest pain. Usually it is difficult to decide what to do when you have chest pain. The main concern is rule out life threatening conditions like heart attack, blood clots in the lungs (pulmonary embolism) and tear in the main artery (aortic dissection).
Besides a detailed history and physical examination, following are the usual investigations done to find out the cause of chest pain:
1. Electrocardiogram
2. Chest X-ray
3. Blood tests to look for infections, inflammation, blood clots and certain enzymes found in heart muscle.
4. Sputum examination to look for infections.
5. Based on above test results, further advanced diagnostic tests like stress test, CT scan, ultrasound and cardiac catheterization may be needed.

[Red2282]

Pleutal Effusion.  means there is fluid in the lung
Other wise could be heart related, fluid around the heart.  My husbands is a nurse and he thinks she may have fluid in/ around her heart or lungs.  
he says there is a special word but it could also be a friction rub in the myocardium.  hope all turns out well.