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Forum Name: Cardiology Symptoms

Question: Stabbing chest pain...so confused...


 bluestreak - Tue Mar 01, 2005 11:22 am

Hello,
First let me give you a summary of what has been going on with my health the last month & a half/two months. I'm a 33 year old female. I don't smoke & am not over weight. On January 4 I went to the ER for what I was afraid was a heart attach...chest pain, arm, neck jaw pain. They dismissed this as heart burn. I have since went through wearing a Holter Monitor, upper endoscope, colonoscopy, barium enema, Hida scan, abdominal ultrasound, pelvic/abdominal cat-scan, & am scheduled for another cat scan Friday. All test have come back normal, except they found a small polyp in the gallbladder... Also a simple cyst & also what they think is a proteinaceous cyst on my right kidney (which is what the second cat scan is for). They are also sending me to a rehumatologist, because they can't figure out anything & think maybe it's fibromyalgia. My lower ribs started hurting after the attack that sent me to the ER first & also in the same area under my left rib. Also pain behind right & left shoulder blade. All intermittent. They do think my gallbladder is still a possible culprit for some of the pain, & I can't really disagree--if I eat something greasy it's a bad thing. They want it removed.

Okay--now getting to my current concern. Two weeks ago about 2 Am in the morning I was awaken by a sharp stabbing pain in the center of my chest, just off to the left side. It went away after a minute, but was severe enough to bolt me upright in bed & wake my husband. I did not feel anything till I rolled over the next morning. Felt an aching in my chest & reproduced the pain by pushing on the area that hurt the previous night. I realize that would not point to cardiac pain, but I have aching that comes on every day for the past two weeks. I get it about once or twice a day...it can happen no matter what I'm doing...setting walking etc.... Sometimes it's to the left center of my chest where the sharp pain was, sometimes it's on the right. It's not the sharp stabbing pain that brought this all on, but enough that I'm wondering if it could be heart related.

Any help is GREATLY appreciated!

Heather
 Dr. Yasser Mokhtar - Tue Mar 01, 2005 12:11 pm

User avatar Dear Bluestreak,

For one to decide whether or not chest pain is due to coronary disease, major risk factors for coronary disease and characteristics of pain are looked at and then the probability of this pain being due to coronary disease is determined.

Females of the child bearing age are naturally protected against coronary disease (unless they have had many major risk factors for coronary disease for many years). You have one major risk factors for coronary disease (positive family history) and the characteristics of the pain are not typical as compared to those of pain caused by coronary disease. So, the probability of this pain being due to coronary disease is low.

Of all the investigations that you were subjected to, you did not have an x-ray or a ct scan of the neck to check for neck problems which is a common cause of chest pain.

If the chest pain is reproduced on pressure, this points to non-coronary pain and usually points to muskuloskeletal causes such as muscle inflammation or inflammation of the cartilages of the ribs, a condition known as costochondritis. You might want to try over the counter pain medications and anti-inflammatories such as advil, etc...

Other cardiac causes of chest pain include a condition called mitral valve prolapse. Just needs to be watched and needs an echocardiogram to be diagnosed which i recommend you have as well.

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

Yasser Mokhtar, M.D.
 bluestreak - Tue Mar 01, 2005 12:17 pm

Dr Mokhtar,
Thanks for your reply. I did want to mention I had a x-ray of my heart when I was in the ER. They saw nothing. Also the pain I have is not always reproduced with pressure. That only happened after the first sharp stabbing pain & then one other time. Typically it just aches & pushing on my chest does not reproduce anything. Aching typically only last 30 seconds & then disappears. It's strange...

Thanks again,
Heather
 Dr. Yasser Mokhtar - Tue Mar 01, 2005 12:38 pm

User avatar Dear Bluestreak,

Thank you very much for the update.

An echocardiogram is an ultrasound of the heart not an x-ray. It visualizes the heart in real time and provides the health care provider with lots of information and is non-invasive.

Not being able to reproduce the pain every time does not mean that it is not related to musculoskeletal causes.

i would recommend you having a neck x-ray/ct scan of the neck (to rule out neck spine problems), an ultrasound of the heart (echocardiogram to rule out mitral valve prolapse) and trying an over the counter pain reliever to see whether it is going to help with the pain.

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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