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Forum Name: Cardiology Symptoms

Question: Light but persistent chest pain (left side)


 NotMyRealName12 - Wed Oct 28, 2009 1:23 pm

I am 27, male, and was previously a light smoker (0-5 cigarettes a day). I have had occasional bouts of left-side chest pain for a few years now. Previously, it never lasted more than a day or two, and the intervals between events were substantial, but I've now had it for a week and a half straight.

It is a fairly mild pain (maybe a 2 on a pain scale), but it is essentially 24/7. It seems to be inversely related to physical activity - I primarily experience it while sitting or lying down, but if I go for a walk, it largely goes away (I do not know whether it's actually going away, or if the pain is mild enough that the activity makes it less noticeable).

I visited my doctor a few days ago. He did an EKG (looked normal) and hypothesized that it's acid reflux, so he gave me some prilosec samples and ordered an upper GI. The upper GI came back entirely normal, no reflux was seen, but I was advised to continue taking the two week course of prilosec and wait-and-see. So far (3 days in now), the prilosec doesn't seem to be having an effect.

Additional information:

While I generally feel okay (other than the chest pain), I tend to feel generally unwell (slight nausea, dizziness, shortness of breath) in the evening.

I have also, just in the past few days, developed difficulty waking up in the morning. I do not mean that I just can't drag myself out of bed, I mean my alarm clock (which is EXTREMELY loud) just doesn't wake me up. My roommate has woken me up twice in the last three or four days after my alarm had already been going off for 5-10 minutes.

I previously suffered from constant-but-mild muscle pain and twitching. An MRI showed that I don't have MS, and a blood test showed that I had a B12 deficiency, so my doctor figured that was the cause. The twitching is not entirely gone, but has greatly diminished.

Ideas?
 John Kenyon, CNA - Mon Nov 02, 2009 10:33 pm

User avatar Hello -- The pain you describe really disqualifies itself as cardiac in several ways, the main one being that it goes away during exertion and is only felt at rest. This is precisely the obverse of what one would see with almost any sort of heart disease, even if of the structural type. On the other hand you do describe some things that suggest you may be of an axious disposition, and anxiety is, oddly enough, commonly associated with left-chest pain (left chest pain is also extremely rare in relation to cardiac problems, another disqualifier). Further, pain that would be constant as you've described would be progressive. The whole cardiac explanation falls apart at this point, and while it could be anxiety-related, it could also be due to some unrelated physical problem. It would seem GERD has been ruled out, and it really doesn't sound much like that either, anyway. I'd look at the possibility of costochondritis, especially if the pain can be duplicated or aggravated by manual pressure on the affected area. This would, in fact, pretty much nail chostochondritis, an inflammation of the connective tissue between the ribs. I'd also want to rule out anxiety and possible splenic flexure syndrome. In this latter situation gas becomes trapped in the 90 degree turn of the colon near the spleen, where the transverse colon makes the sharp downward turn. Often gas can become trapped here, and this can press upward against the diaphragm, which can, in turn, refer vague (or sometimes even sharp) pain up to the left chest area. There a many possibilities. Cardiac-related doesn't seem to be one of them.

I do hope this helps. Good luck to you and please follow up with us here as needed.

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