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Forum Name: Cardiology Symptoms

Question: Constant chest pains


 haphelthheart2 - Thu May 06, 2004 4:11 pm

I am a 24/f, and I don't smoke. I have been having chest pains for the last three months now. I went to the doctor and had an EKG, and it was normal. He thought that it could be my gallbladder or gallstones, so I had an abdominal ultrasound done, and it also came back normal. So, the doctor finally diagnosed costochondritis, which is the inflammation of the chest wall, and he put me on steroids. The chest pain went away for awhile, but it has come back. I have this contstant dull ache in my chest and it spreads to my armpits. I am scared that it might really be a heart problem. There is no history in my family of heart problems at such an early age. But, I am considering further tests. I just wanted to get your opinion on what you think my problem is.

Thanks so much!
 Dr. Yasser Mokhtar - Thu May 06, 2004 5:42 pm

User avatar Dear Haphelthheart2,

Thank you very much for using our website.

Chest pain is usually worrisome for coronary disease. Coronary disease has risk factors the presence/absence of which can usually predict fairly well the probability of the person complaining of chest pain having or not having coronary disease.

These risk factors include family history of premature coronary disease, smoking, hypertension, diabetes, high cholesterol, sedentary life style and obesity.

You did not mention who on your mother's side of the family has heart disease and what kind of heart disease they had but you mentioned that no one had a heart problem when still young. You do not smoke. You have not mentioned anything about whether you excercise regularly and how much do you weigh.

Chest pain caused by heart disease usually has certain characteritics. The coronary pain is usually a sharp pain, but can be perceived by patients as pressure, burning or stabbing sensation. It usually occurs on exertion, lasts for a few minutes and is relieved by rest. Its location is usually behind the breast bone and can move to other places like the left arm, the back or the neck. If severe enough it can be associated with nausea, vomiting and sweating, but these symptoms are so non-specific and they are not an indication that the pain is of coronary disease but just the pain might be severe.

The answer to all these questions makes it most of the time easy on the physician to decide the origin of the chest pain and whether it is cardiac in origin or not (from the heart).

You being a female, at your age, a non-smoker, no heart disease history in the family at a young age and not having high blood pressure nor diabetes in addition to your chest pain characteristics not sounding typical of coronary disease and a normal ekg make it very highly unlikely that your chest pain is of heart origin.

Having pain under the arm pits at the same time makes it a possibility that you might be suffering from a nerve problem like shingles which is a nerve infection that is manifested by a rash and pain (have you ever had a skin rash at this area before), sometimes even, there is no rash. After the rash is gone (or if there was no rash), sometimes this is followed by chronic pain in the area where there was a rach, a condition known as postherpetic neuralgia and the treatment is medications that affect the nerves. Also, this could be a problem with the nerves of the spinal cord especially the neck and upper spine. So, i would suggest to have an x-ray of the neck and thorax spine.

Costchondritis can be a cause of this ongoing chest pain.

Once more, thank you very much for using our website http://doctorslounge.com and i hope that this information helped.

Yasser Mokhtar, M.D.

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