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Forum Name: Cardiology Symptoms

Question: Chronic Pain that moves around!


 mjb - Sat Mar 28, 2009 2:50 pm

For the past five years I have had chronic pain in my mid back, across the bra line area along with pain that varies depending on the day. It is very frustrating. Mostly on the left side. Left shoulder and in the left shoulder blade. Lately the pain has been also located in my left rib area. It is very uncomfortable. Also in the middle, front area, under my rib cage. I had a thallium stress test 5 years ago that came back; false positive. I do see a cardiologist who believes my heart is fine. I just need to control the BP; which I am on meds for. Do you have any ideas of what this might be? I know it sounds crazy, but the pain does move around, but is always in the mid-back area as well as the pick of the day.
 John Kenyon, CNA - Sun Mar 29, 2009 11:19 am

User avatar Hello --

While women do tend to present most often with atypical symptoms when they have heart disease, what you describe, because of its "wandering" nature, its general location, and the fact that it seems to have remained stable (except for its focus) is probably not cardiac in origin. However...

You did have a false positive nuc scan back around the time of the start of this pain. I'm curious as to how your doctor determined the test to be false positive. This has to have been determined by some further testing. Did you subsequently have a followup nuc scan/stress test or perhaps an angiogram? False positives are more common in women than men, usually due to breast tissue (when there is a good deal of it present). However, a positive test with no symptoms doesn't automatically rule out heart disease. I don't think your current symptoms are cardiac related, but I'd be remiss if I didn't suggest that this be ruled out with some degree of certainty, along with trying to determine the cause of your discomfort.

Possible causes of your wandering pain: postural problems of which you would likely be unaware (and can be fairly subtle), cervical or thoracic spine problems, lower GI irritation (often just gas collected in the splenic flexure of the colon on the left side can cause pain that's referred up against the diaphragm, which then distributes it randomly in the general area you describe), Tietz' syndrome (costochondritis), an inflammation of the cartilage between the ribs, and even thoracic outlet syndrome, an abnormality of the brachial plexus which can cause wandering pain in the back, neck, chest, arm and hand and even numbness and tingling in the pinkie finger and side of the hand on the affected side). All these things could be explored and ruled in or out.

I'd be very interested to learn how your doctor determined your stress test to be false positive. Other than that, I think you might look at the rather long list of potential non-cardiac causes of your pain and perhaps start ruling these out, one or more at a time, via an orthopedist or neurologist.

I hope this is helpful to you. Good luck with this, and please follow up with us as needed.
 mjb - Sun Mar 29, 2009 7:20 pm

Thank you so much for your input. I will definitely follow up and find out that information for you on the false positive results. I did have some other testing, however, I am not sure what they were it was so long ago. I will certainly find out though. I have had blood work and EKG's and x-rays. Once I receive the information you requested, I will be in touch. Thank you again.

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