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Forum Name: Chest symptoms

Question: Upper right chest pain when moving right arm


 arowland25 - Sat Feb 17, 2007 12:34 pm

Hello. I am a 28 year old female. I posted the other day about shortness of breath. I've had shortness of breath for 2 weeks, just problems catching my breath. Went to the dr., chest x-ray & blood work came back fine. Was prescribed albuterol & prednisone to help clear w/the breathing. The shortness of breath has gotten better, but not perfect. Last night I ate dinner and came home and sat on my couch and started having the shortness of breath, upper right chest pain that radiated to my shoulder blade/back area. The pain was worse when moving my right arm. After 1 1/2 hrs I went to the Emergency Room. They did blood work, chest x-rays, EKG, & APG. All came back fine. I arrived at the ER around 11 p.m. and by 2 a.m. I was very nauseated and started vomitting. The dr. there came to no conclusion as to what was wrong with me, and sent me home.

The pain is still there today, more when I move or take a deep breath.

Any ideas on what this could be? I had my gallbladder removed last October, so that can be ruled out.

Thanks,
Mandy
 Dr. Yasser Mokhtar - Wed Mar 07, 2007 4:20 pm

User avatar Dear Mandy,

What you described in your first post might be some kind of allergic rhinitis (nose inflammation because of allergies) but the ent physician ruled that possibility out i think. This being said, however, feeling of stuffy nose and not being able to breath because of this problem could be because of allergic rhinitis especially if you have environmental allergies. What you describe sounded to me more like an upper respiratory infection with ears being affected (with the dizziness that you were having).

The chest pain that you have might be related if it was caused by the same process (an infection that reached your lungs) especially that the pain increases by taking a deep breath which is very suggestive of pleurisy (inflammation of the membrane surrounding the lungs).

The chest pain could also not be related to the arm pain that you have and they could be related to a neck problem.

i am not an advocate of prednisone use unless there is an indication like asthma or other ailments that require steroids for their treatment.

If there is a suspicion that this might be asthma, a test called methacholine challenge test should be done.

Shortness of breath and chest pain can also be caused by a condition called pulmonary embolism (blood clot to the lungs) but if you went to the er, this was most probably thought of and was ruled out.

Silent reflux can cause some of the original symptoms especially if it was severe. If you don't want to take medications for long periods of time without a good reason, you can have a test done called 24 hours ph monitoring and this should tell whether or not you have reflux.

Obviously, tests and medications cause money, time, effort and stress. i think you should wait for a while and see. If you improve, then no need for further testing. If you don't, then you might make the case of going back to your primary care physician for more testing.

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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