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Forum Name: Chest symptoms

Question: Female, 24, All sorts of Chest Pains


 Pammy03 - Thu Nov 05, 2009 3:23 am

I'm a 24 year old female. I'm 5'9 and I currently weigh 265 pounds. Ive had weight problems most of my life, but I was not this overweight most of my life since I was very active from 5 years old to 19 years old, participating in sports most of my life. I was 215 pounds 2 years ago so I have let myself go and gained quite a bit. For the past month, I have started Weightwatchers and working out slowly to get back to how I used to be.

About a month ago, after I had woken up, I was laying in bed and out of nowhere from when I was leaning over the bed to grab something, I had strange chest pains. It occurred right in the center of my chest but very high up, on top of my breasts. It felt like something was really stretched so there was tightening and pressure in the center, I had my fist over it for 2 minutes while the pain occured and then it just went away. It felt sore for about 10 minutes but that had not happened for a while. A week later, the exact same thing occurred to me while I was driving for 2 minutes..I almost felt like I had to pull over but it went away. It had not happened to me again for a while. One day, when I went to the gym, I was stretching for warm ups, and I felt a little pain during one exertion and it was sore in the specific area on my left side right on top of my breast. I did not feel it again but since then, very randomly and for little periods of time, I would feel that specific spot on my left side on top of breast feel sore, or ache or even have a sharp pain for a minute. I ignored it because it did not feel serious since it was random and for little periods of time.

This past friday, while I was sleeping, I had the attack again come to me and it woke me up. It was in center of my chest and it felt like it lasted a little longer...about a few minutes and it stopped again. However, since that day, I have felt more pains all through out my chest. That specific spot on my left side as I mentioned above still occurred more frequently and it still does. Saturday night, I am embaressed to say this, but I had went out for Halloween and had way too much to drink. I was extremely car sick on the way home and wanted to puke a little bit to get the alcohol out. When I had gagged myself, I spit up blood but I didn't vomit. After that, I did not do anything. I did not want to irritate it or anything but seeing blood worried me alot. However, the pain started radiating through my right side, and after a few days it radiated through my back. Now there is pains all over my back...many times it feels like theres a sharp poke in random areas on my back and it'll feel like that for an hour or more. It is very uncomfortable and scary. Only at night between 1-3 am I feel shallow breathing for 30 minutes or so. It might be because I am worried. I went to the doctor 2 days ago, and she said she did not think it was my heart and thought it was anxiety attacks but we decided it could not be that because I am not that type of person to have something like that. She then gave me Nexium ( strong acidic meds ) to take for few weeks and see if it helps with the pain since it may be Acid Reflux. It helps a little but the pain is still there and it pokes me in such random spots that it is starting to drive me crazy.

I do not have insurance so we did not schedule for an X-Ray ( the doc said she'd do it if it made me feel better, not because she felt it was emergency) but I am in the middle of getting insurance from the state so it would take 2 weeks for me to finally get covered. I really wanted more doctor's opinions because I feel like something's wrong.
 Pammy03 - Thu Nov 12, 2009 4:44 pm

Update: So far Nexium has gotten rid of the pain BUT I still get the aches and random sharp pains on left side of my chest above my breast as I've mentioned. The pains happen less frequently. Ive been working out with my trainer and I've noticed, I can't bend over too much or lay down face down because it hurts my chest, as if it feels like the chest wall is moving down with me and it aches and tightens kind of.

Another thing is - I have a big history of thyroids and Ive gotten tested for it in the winter but nothing. I had a period for a month during august-sept. and since then I havent gotten any periods. I took a pregnancy test today, and Im not pregnant. I've noticed this past week, I'm sooooo tired. Im experiencing alot of fatique, shallow breathing when working out, and I just want to sleep all the time.
 John Kenyon, CNA - Fri Nov 20, 2009 12:14 am

User avatar Hi there -- The initial presentation with sudden, sharp pains that were superficial and left you with soreness/tenderness in the area sound like they may be a totally different thing from what's been happening more recently (the Unfortunate Coincidence phenomenon). Those first episodes sound a lot like Tietz's syndrome, or costochondritis, an inflammation of the connetive tissue between the ribs where they connect to the sternum. This often can be aggravated by certain postures or positions, and the tenderness upon manual pressure strongly suggests this. It is usually a transient condition although it sometimes can be chronic. It responds to over-the-counter anti-inflammatories such as Aleve and Advil. The later pain, however, sounds more visceral, and could well be due to acid reflux or some other non heart-related issue. The trial of Nexium should help prove or disprove that idea in fairly short order. The fact you wound up vomiting some blood also could go along with reflux disease or even just plain gastritis (often the two are similar or may go hand-in-hand). There are other possibilities, but this seems like a reasonable approach your doctor is taking, given all you've described. Anxiety certainly could become a component as well, and always helps cloud the picture somewhat.

I'd definitely try consistent use of the Nexium for at least a month. If, of course, anything significantly different or worse shows up you should get yourself to an emergency facility right away, but I feel it's fairly safe betting on gastroesophageal reflux disease (GERD) possibly co-existing with Tietz's syndrome. Treating for GERD would make the most sense, especially if you find this causes an improvement in the symptoms.

Hope this is helpful to you. Please follow up with us here as needed, and update us as to how this all unfolds. Good luck to you.
 John Kenyon, CNA - Fri Nov 20, 2009 4:16 pm

User avatar Hi there -- Your second post wasn't put up til after my response to the first one had posted, so I apologize for any seeming inconsistency. I'm glad to hear the pain is better, and with the additional information I still feel the first answer was probably the right one, but given your current weight this also could be an even more simple matter of excess fatty tissue in the abdomen having no place to go and so pressing against the diaphragm and phrenic nerve when you attempt to bend at the waist. First, obviously, don't do that if it hurts. Second, it may be useful to have an upper GI study done, as people with your degree of obesity are more prone to develop hiatal hernia, which also can produce these symptoms. While hiatal hernia is most often treated with the same meds as GERD (ie: Nexium) there are sometimes additional things that can be done to minimize the discomfort.

Hypothyroidism could certainly help explain the weight problem, and this needs to be explored further to determine if it is a factor. Meanwhile I'm glad the Nexium seems to have helped some, and this is strongly suggestive of either GERD, hiatal hernia or a combination of the two. This is hardly surprising given the weight you've put on. If thyroid is a factor, this should be encouraging, as proper treatment of that should help the weight loss program that is going to be necessary in any case.

Please keep in touch.
 Pammy03 - Fri Nov 20, 2009 7:27 pm

Thanks for your responses...I was doing a lot of research this week because the pains came back. I haven't had attacks at all since Ive taken the pills but my chest has gotten a lot more sore and tender and I can't even lay down facing downwards or bend over deep because it feels like my chest wall is falling off. My upper back is starting to be sore and hurt as well...it gets to the point now where it hurts to turn as well sometimes. Ive been more tired as well and sleep seems to help along with a lot of water. I realized the diet green tea I was drinking had citric acid which could explain for the pain coming back, and the nexium does help...should I keep taking this for a longer periods of time because my doctor gave me two weeks worth? the only thing that has not gone away or help is the chest muscles and soreness...I work out with a trainer 2 times a week, and some exercises involving my chest wall, I can't do because it hurts...it feels like it's weak. What is that feeling where if im laying down face downwards, it feels like it falls off?? Also, the past two days, I have felt like a inflammation feeling on my back, like a burning/small vibration feeling going all around which makes it sore.

Also still no period as well...it's almost 2 months and a half now, and I'm not pregnant. My doctor didn't think I needed a thyroids test because I took one last winter since I noticed a lot of symptoms of thyroids occuring but there was no sign of thyroids in my blood tests.
 John Kenyon, CNA - Wed Nov 25, 2009 1:18 pm

User avatar You're very welcome. You definitely seem to have two different things going on at once. The GERD seems to have responded well to the Nexium, so it would be wise to continue that for a while, since there is often healing that needs to take place in the upper GI tract, and the medication will allow that.

The thoracic soreness is definitely musculoskeletal, probably inflammatory in nature, and may be widespread in the ribcage. Could also be due to thoracic outlet syndrome (TOS), which can be posturally caused or due to overweight, heavy lifting, any number of external things, and also can be congenital. It's not serious except for the discomfort and mild disability it can cause, and for this reason is also worth exploring.

Please keep us updated. Thyroid testing would seem to be indicated, especially with the missing period. Let us know how things unfold. Good luck!

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