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Forum Name: Cardiology Diagnostics

Question: Odd and Unexplained Pains!


 MormonGurl37 - Wed Feb 09, 2005 9:59 pm

I am a 17 year old female who attends high school. I'm average height and weight and I do not engage in any type of drinking, drugs, smoking, etc. In fact, because of religious views I do not even drink any type of coffee, tea, or caffine. I feel that although I am not in the best physical shape, I do feel that I am fairly well in "shape." I do not feel that my pains have anything to do with stress as I do not lead a very stressful life.
About 2 1/2 years ago I started to experience chest pains. The pains are exceptionally random. The usually occur in my upper chest on both or either the left or the right. Sometimes the pain is very sharp, while other times the pain is a dull and extremely uncomfortable pressure. Sometimes the pain is very light and it does not really bother me, while other times the pain becomes so unbearable that I have had to leave school and come home. The pains come and go in a completely unpredictable fashion and remain for however long they feel like (or so it seems). Lately, I have noticed that with the chest pains I have been experiencing tiredness and strange pains in my right arm and/or leg. The pain in my limbs is usually very uncomfortable but not unbearable. It radiates down and encompasses the entire limb. In my hand I have noticed that my fingers feel weak and stiff when I experience this pain. The pain in my arm and leg never comes by itself, it only comes with the chest pains, so I feel certain that they are related.
I have been to the doctor numerous times because of my pains. I've been in ER as well as just normal doctor visits. I have had check-ups as well as EKGs done and blood samples taken. The doctors have been unable to find anything wrong. Because the doctors are unable to find anything wrong sometimes my parents express in "not so many words" that they think that I may be faking the illness. I can assure you that my pains are real and that I have no knowledge of their source. Because of the reactions that people have been showing I have lately (for the past several months) kept my pain and discomfort to myself. I have stopped telling anyone when they occur or how bad I sometimes suffer from them. I am finding all of this very frustrating and I do not know what to do.
 Dr. Yasser Mokhtar - Fri Feb 11, 2005 9:39 pm

User avatar Dear MormonGurl,

The pain that you are having is not secondary to coronary disease. First of all because you don't have any risk factors for coronary disease and the charateristics of the pain are atypical as compared to the pain of coronary disease.

Atypical chest pain in a young person usually rises the suspicion of mitral valve prolapse, a very common condition that needs to be watched. i would recommend that you have an echocardiogram (ultrasound of the heart) done to rule out this condition.

Regarding the pain that you are suffering from, in addition to possibly being due to mitral valve prolapse, it could be due to neck spine problems, chest wall problems such as costochondritis (inflammation of the cartilages of the ribs), acid reflux disease and anxiety attacks.

What kind of measures have been taken to take care of the pain? Have you had any pain relievers? Have you tried any antiacids? Have you tried any sedatives?

Sometimes, treatment is used as a diagnostic test, so if a patient comes in with a certain symptom and the doctor is not sure what is going on, treatment is given and if the treatment works then the suspicion was true.

So, i would recommend that you try any of the above mentioned treatment modalities after you discuss it with your doctor.

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

Yasser Mokhtar, M.D.
 MormonGurl37 - Thu Feb 17, 2005 8:40 am

I want to thank you for responding to my questions! I looked up some of the problems that you mentioned that could possibly be causing my pain and yes, they do look like they could be a possibility. As far as measures to take care of the pain, the only things that doctors have told me to try things such as an antacid and advil. They have never given or even mentioned any type of special medicine or prescribed medicine. I supposed that it was because they didn't find any definite thing wrong with me, so they just told me to take a simple pain reliever when I experience it.

One thing I failed to mention in my previous post was that I have seemed to lately be prone to hyperventilation. Well, it's only happened twice, but they were within a few months of each other, and fairly recently. The first time was at a dance where I believe that I merely became overheated and there was a trained nurse there who helped me calm down. However, the second time was a bit strange. I was at school, nothing unusual was happening and I just passed out. When I woke up a few moments later I knew what was going on around me but I felt as though I couldn't move my head, my arms or my legs and they had a severe "tingling" sensation like when a limb falls asleep. I was taken to the hospital, yet again, and had tests done. They said that it was probably just that I hyperventilated, even though they couldn't tell me why, and that I should be fine. I returned to school that afternoon and had no more problems with passing out or such since.

Even as I sit here now I am feeling these chest pains. Today they seem to be more of a burning and pressure sensation with pain extending down into both of my arms and causing my hands to feel weak (which is making my typing this a bit strange feeling). I often feel very tired while I experience these pains. I understand that these symptoms could possible be pretty serious but I still hesitate to go to a doctor again about them. As many times as I have been to a doctor and as I have described my pains to them not one of them have ever suggested what you have. They all seem to believe that it is nothing to really worry about and that advil will solve whatever it is. I've rather lost my faith in the doctors around here after seeing so many of them to only, time and time again, have them come up with nothing they believe it could be. Do you believe that there could be a reason that none of the doctors that I have seen have felt that it was serious enough to be concerned about?
 Dr. Yasser Mokhtar - Thu Feb 17, 2005 10:13 pm

User avatar Dear MormonGurl,

Thank you very much for the update.

i would recommend that you have an echocardiogram to rule out mitral valve prolpase. The main symptom of this condition is atypical chest pain and palpitations and It occurs mainly in young females. If you have an echocardiogram and it turns out that you have mitral valve prolpase, you will put your mind to rest and never worry about this chest pain again.

If this hyperventillation is part of the whole symptomatology, then most probably you are suffering from panic attacks.

About your last question, i think if you see the same doctor over and over again with the same symptoms and the doctor does all the tests that are supposed to be done in this situation and nothing comes up, then some doctors will sure think that you have nothing (tests negative over and over) serious to worry about and i think they might have a good excuse to think that way.

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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