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Forum Name: Valvular Heart Diseases

Question: chest pain moving to the lower lung


 worried86 - Fri Oct 30, 2009 6:45 pm

I am a twenty three (23) year old female. For the past 4 months I have been experiencing chest pain. It starts in my heart and quickly moves to my lower left lung. It lasts for about 20 mins once I have taken pain killers. It was originally diagnosed as a cracked rib. It only happen when I've been asleep for a few hours at night. The pain is so severe I can hardly stand. I am a smoker and have had 2 children my youngest being 6 months. I came off oral contraception pill just weeks before it fist happened. It is starting to worry me as the is a history of angina in my family. Please help
 John Kenyon, CNA - Tue Nov 10, 2009 10:41 pm

User avatar Hi there -- You describe your symptoms by identifying internal organs, but these are almost certainly not involved in what's happening. Your problem was originally diagnosed as a cracked rib and this is still possible. It almost certainly involves a rib or the cartilege between the ribs. Heart pain isn't sharp or stabbing in nature and angina is aggravated by exertion, not sleep nor lying down. Rib pain is often aggravated by lying down and frequently occurs during sleep because of pressure on an inflamed area of the rib cage. This is most likely what's going on, although there is no way to prove this at a distance. It would be wise, because of pain in the chest, to have a comprehensive workup including an EKG to rule out any sort of heart involvement (for your own reassurance) and a chest x-ray to rule out possibility of pulmonary embolism, which also seems highly unlikely. I do believe in ruling out the worst-case scenarios first, and since you're not in a doctor's office there's no concrete way to eliminate these concerns on line. Once the serious problems are removed and you're not worried about them, you can find out what's actually causing this, which very likely is orthopedic (involving bone and/or muscle and connective tissue). The fact that this responds to pain killers (and I assume you mean over-the-counter pain medications like Advil or Aleve) in an appropriate time period suggests very strongly it is neither heart nor gastrointestinal, which of course leaves chest wall structures, again muscle, bone and connective tissue. Even if this is proven to be the case there's usually not too much to be done other than treat the symptoms. If it turns out to be muscular only, sometimes a muscle relaxant along with non-steroidal anti-inflammatories such as ibuprofin (Advil, Motrin) or naproxyn (Aleve) can be helpful, especially in avoiding sleep disturbance. Hopefully this is helpful. Good luck to you and please follow up with us as necessary.

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