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Forum Name: Miscellaneous Chest Diseases

Question: Symptoms of Costochronditis


 scbaman - Thu Dec 15, 2005 9:12 pm

Please explain the overall symptoms of Costochronsitis. My physician has put me through many tests-blood work, ECG, X Rays and all negative. No organic problems-liver, pancreas, gallbladder.ECG shows no cardiac problem. Overall cholesterol is 187. Had a cardiac stress test 11/03 and am scheduled for another in 2 weeks.
Pain is sub sternal and sometimes radiates along left side of sternum and into back and rib cage, usually on left upper quandrant. Sometimes pain is on right side. Occasionally seems to cause being short of breath. Sometimes really hard pain in sternum area, but is relieved by pain medication ( Lortab 7.5 or 50 mg Demerol). Also am subjected to rapid pulse and anxiety.
Had GERD and esophgeal dysphagia, with 3 trips to ER in the past for emergency endoscopies to relieve food stuck in spasming esophagus. Gastroenterologist has me on continuing OTC Prilosec, but that doesn't relieve the chest pain. Any ideas I can share with my doctor?
Thank you.
 Dr. Anthony Solomon - Fri Dec 16, 2005 12:21 pm

Tietze's syndrome is a possibility. This is an inflammation of the cartilage end of the rib which connects to the breastbone.

Unfortunately, there are no laboratory tests to diagnose this syndrome, but exclusion of ischaemic heart disease, peptic ulcer disease and GERD are important. Your post suggests that all these were negative.

Ask your doctor about it and see if it relates to your symptoms.


Dr Anthony Solomon
Consultant Physician, Tropical & Genitourinary Medicine
 scbaman - Fri Dec 16, 2005 6:07 pm

Thanks for your reply. I will add this to the possibilities to discuss with my doctor.
 scbaman - Fri Dec 16, 2005 7:49 pm

Tietze's syndrome is also known as Costochronditis, which is what my personal physician feels I might have.
However, it has been going on a long time, and the pain episodes seem to be somewhat related to the GERD I had s few years ago.But no medications prescribed for the GERD symptoms relieve the pain.
Using pain meds such as Demerol and Lortab relieve the pain and additional medications such as Valium and sleep medication Ambien make it possible to sleep without the pain.
Any additional ideas would be appreciated. Thanks....
 Dr. Anthony Solomon - Fri Dec 16, 2005 8:03 pm

Please indicate if you have been tested for Helicobacter pylori antigen / antibodies and if so, results obtained.
 scbaman - Fri Dec 16, 2005 9:18 pm

Yes have been tested and with negative results.

History of ulcers/GERD started about 1995/96 due to high use of ibuprofen prescribed for severe tendonitis. From the ulcers, which were treated and healed successfully, esophageal problems developed, mostly esophageal dysphagia.

Endoscopies were done, very small and of no consequence hiatal hernia. GERD was diagnosed, but has been treated with success by Nexium and Prilosec.

Swallowing difficulties continue, but have tapered off over the past year. 3 times have had to go to emergency room for emergency endoscopies to alleviate food stuck in severely spasming esophagus. Nitroglycerin was prescribed to stop the smooth muscle spasms if and when they occur.

I have been treated consistently by my Osteopathic Physician with osteopathic manipulation therapy to relieve pinched nerves in thoracic spine area. I apparently have a chronic condition where three or 4 vertabrae slip out of alignment and create severe upper back, shoulder, neck and rib pain. This might be contributing to this chest/sternal area pain.
 Dukert - Tue Jan 24, 2006 2:25 pm

Would you be kind enough to look at my posts under chest pain in pulmonary section. My mother who is 88 had bouts of this Titeze's syndrome you refer to...does it run in families? And, do my symptoms sound like this syndrome? Also, I have IBS, and pssorasis...both auto-immune I believe...does this have any possible relationship?

Thank you.

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