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Forum Name: Chest symptoms

Question: Lump below sternum


 livnaboard - Sun May 06, 2007 7:18 pm

58/M w/no surgeries. Non-smoker (10 years quit) with no heart attack history. Two years ago admitted to hospital in middle of night with chest pain (non-radiating) and central pressure. Admitted as a precaution, BP normal-to-low, heart ultrasound revealed a slightly lower efficiency in one chamber of my heart --likely since childhood or adolescence (according to cardiologiist). Passed stress test without issue. Regardless, they perfomed a heart cath -- unremarkable and no blockages noted. A follow-on diagnosis of GERD was arrived at and I have been on Prilosec (omnaprozole?) and it seems to have kept most of the problem in check.

I am 5'10, 195, recently lost weight from 210# and have recently noticed a "half-walnut-sized" lump in the middle of my chest, just below the sternum. It is not painful, but most noticable when I am recumbent or when I arch my back. It does not seem "moveable".

Although I've been through tens of archives, I get more confused over time. I cannot discern difference between the symptoms of Barrett's, GERD, or hiatal hernia (or something more ominous). I do find that I feel a bit of "fullness" in that general vicinity, but am not sure how much of that is "contrived" and how much is real.

Current meds are few, and include Zocor (20mg/day), Prilosec, a baby aspirin, multi-vitamin, and extra vitamin E & C.

I drink less than one glass of wine per day (sometimes a beer), 2-3 cups of coffee/day, occasional decaf wine w/honey & apple cider vinegar, and my 15# weight loss has occurred over eight weeks or so.

Thoughts/suggestions?

Thanks
 Dr. Chan Lowe - Thu Jun 07, 2007 1:24 pm

User avatar It's possible that you may be feeling a hernia. There may be a weak spot in the abdominal muscles that is allowing the intestines to slip through. Usually, though, these are not totally hard (although they can be). It would not be a hiatal hernia. This hernia is when the intestines slip through the diaphragm into the chest. Similarly, GERD or Barrett's should not cause this.

Another possibility, given the location, is that your xiphoid process is more prominent than typical. The xiphoid process is the small bone at the bottom of the breast bone. In some people it can be pointed somewhat outward rather than straight down. Given your weight loss it may be more prominent now.

If you were not trying to loose the weight I would recommend that you see your doctor. That is fairly significant weight loss. If you were trying to loose weight it is a lot less concerning.

It is probably a good idea for you to have a general check up sometime in the near future to have all these things evaluated just to be safe.

Best wishes.
 livnaboard - Thu Jun 07, 2007 7:26 pm

I appreciate the input. I went to the doctor (general MD) who stated he thought I might have a ventral hernia which was explained as a weak point in the upper abdominal wall muscle where a small fatty deposit from around the internal organs(the lump is not hard nor painful to pressure) has essentially oozed (my words) through the muscle. Regardless, I have a CAT scan (barium intake prior to test) scheduled which hopefully will further define the problem. Part of my weight loss involved increased "crunches" repetitions, which likely further tightened the lower abdominal muscles and perhaps exerts more pressure on the internal organs (and the fat surrounding them?) (That is my totally amatuer thought process...not the physician's).

Input welcome...

bh
 Dr. Chan Lowe - Fri Jun 08, 2007 11:36 pm

User avatar A ventral hernia can explain your lump well. It is possible that the crunches helped contribute to this. Doing crunches increases the pressure in the abdomen. If there was a weak spot in the abdominal muscle, the increased pressure may have been enough to push the intestines through the weakened area causing the hernia.

The CT scan should be quite helpful.

Best wishes.
 kyle33 - Thu May 07, 2009 2:03 pm

I am having a similar problem. The little bone at the bottom of my breast bone I think you called the xiphoid bone is somewhat tender and is swollen or is a lump. I have not had this before. I also feel very full or bloated a lot. There is also a slight burn or ache on the internal side of the swollen area or lump. This started about 2.5 weeks ago and was not quite as bad as it is now. I am setting up a doctors appointment but wanted any info I could get prior. If it is a hernia, how is it fixed?

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