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Forum Name: Cardiology Symptoms

Question: 22 year old with dull chest pain and odd symptom


 bread123 - Thu Oct 30, 2008 10:00 pm

Hi,

I am a 22 year old student who has a history of chest pain for around 10months now. No history in our family, and I am 5"7 and 9 stone. Do not smoke, but do drink. The pain is dull in nature, slightly towards the left side of my chest and often radiates to the back and down my left arm.

The only thing that I know for sure brings it on is alcohol. But this only occurs the day after I have been drinking and not immediately after a few beers. I feel a 'dragging' sensation throughout the day, with occasional deep, dull aches. Exercise can bring it on, but not always. When I am lying down the pain seems worse. Noticed that along with chest pain, accompanies a scatter of petechiae. Around 10-20 on arms and abdomen. These always increase in number day after alcohol consumption.

I saw a cardiologist 3months ago, who did ECG, stress, echo and bloods. All normal, about from mild tachycardia during echo, probably due to excitement/nervousness. Doctor prescribed proton pump inhibitor and sent me on way. Said petechiae likely to be incidental finding as bloods were clear.

Have tried mixtures of different antacids and proton pump inhibitors with no avail. Spicy/big meals do not bring the pain on.

Cutting out all alcohol has improved the pain to a degree, but is still brought on at random intervals. Petechiae have however stayed.

Completely up the wall with this, is really having a massive effect on my life. Have researched hundreds of conditions on the internet. What would you advise doctor? I'm totally lost which path to go down, cardio, gastro or possibly even respiratory?

thanks in advance
 John Kenyon, CNA - Fri Nov 07, 2008 10:16 pm

User avatar Hi there -

OK, here's what we know so far: you suffer occasional dull left-sided chest pain, especially after drinking. The pain sometimes radiates to your arm or back. With the pain you've also noted some pettechiae on your arms and abdomen. This has been going on for 10 months. Now to deconstruct:

Ten months of chest pain would, were it heart-related, have progressed most likely to something that would have sent you to an emergency facility by now. Also, because of your age, you are far less likely to have developed vastly premature coronary artery disease. The pettechiae definitely sounds incidental, although it may be related to drinking.

It would help to know if there is any family history of heart disease.

The pain sounds, on balance, as though it is GI in origin, probably an alcohol-aggravated gastritis, and a prescription for a potent proton pump inhibiting drug is probably in order, as well as giving some consideration to removing the most obvious trigger for the discomfort, which is the drinking. It seems you may have a stomach condition which is irritated by alcohol, and cause-and-effect tells us you feel worse after you've been drinking. Even an experimental period of abstinence might be useful, at least to test the theory that this is the cause.

Oh, and spicy foods do not, necessarily, despite advertising and common beliefs, cause or worsen heartburn or gastritis.

You may need to have an endoscopic exam if this doesn't get better, but given your age, the circumstances described, etc., it really doesn't sound like a heart problem. That said, gastrtitis (which can become a frank gastric ulcer) can be every bit as serious as a heart problem over time, and is nothing to leave to resolve on its own. Please follow up with a gastroenterologist about this.

I hope this is helpful. Best of luck to you. Please stay in touch here.

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