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Forum Name: Chest symptoms

Question: 3 years undiagnosed - stabbing/clamping chest spasm


 brownd6 - Sat Apr 04, 2009 9:43 pm

I'm 39 years old, male, and for past 3 years been having chest pain, the cause of which goes undiagnosed. I'm 5'10", 187 lbs., active and otherwise healthy. Have been following SouthBeach diet for 3 months and have lost approx. 20 pounds. Strenuous manual labor for 25 years (forestry, landscaping). have used chewing tobacco for 20 years. Occasional drinker (beer).

Symptoms: Pain & severe stinging left ribs, tightness in left chest area. Feels like it "pulls down" heavily while tightening. Sometimes accompanied by sweats/hot flash. Feels like a "shock." Other times, stinging or "inflamed" sensation on left breast (under skin). Yet other times, it feels like the muscle squeezes, feels like heart. The whole muscle clamps up/moves (wave-like contraction) and it simply feels "weird." Heartbeat seems to stay regular before, during, after these episodes. Breathing is not painful or problematic. Other times, general pressure all over left side, may come and go for seconds at a time for hours, and some days nothing happens. Under left armpit, muscle tightens with "rolling" sensation - radiating right across chest then down around breast area. Sometimes initial pain begins in back and radiates around to front of chest. Usually sleep on left side; sometimes rib area feels "swollen." No significant sleep problems. I cannot determine pattern to when or why pain starts. Can be any time of day, active or inactive, seemingly not related to food. Is becoming extremely disruptive as I am often uncomfortable and worried about it.

Medical investigation to date: After consulting with GP was referred to Cardiologist; had 2 stress tests, echocardiogram, CT-angiogram, full cardio workup. He found nothing to be concerned with (passed stress test with flying colors). Referred to Gastroenterologist; he did EGD and other (?). Again, nothing unusual showed, except: mild GERD, and small hiatal hernia. Prescribed Nexium, which I take about 1x/day. Referred to Neurosurgeon; had full work up and he found nothing to explain symptoms.

Currently trying physical therapy: stretching, exercise, but have not been able to recreate pain/spasm while with therapist. Am awaiting an appt. with Rheumatologist in the next month.
 John Kenyon, CNA - Fri Apr 10, 2009 10:14 pm

User avatar Hello --

Having had all the really serious problems ruled out is helpful. Now, however, you still have the odd symptoms and it will become more of a challenge to diagnose them. I'm thinking you may be having an atypical presentation of some sort of viral inflammation similar to shingles, but without the skin eruption. Since neurology found nothing, I'm surprised there wasn't at least a trial of pain blocking medication (which is also usually effective against seizures, and this could be Jacksonion seizure of rare type as well, based on your description). Medications such as gabapentin or pregabalin may just help control the pain and spasms. It would be worth a trial, even if there's no concrete diagnosis as yet.

I hope this is helfpul to you. Good luck, and please follow up with us as needed.
 brownd6 - Sat Apr 11, 2009 4:53 pm

the shingles were a thought and briefly tried gabapentin and it did not help. thanks for your thoughts and time any other suggestions would be great.

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