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Forum Name: Miscellaneous Chest Diseases

Question: Chest Pain - centre/right-of-centre - Help !


 walrus52 - Fri Nov 11, 2005 11:07 pm

OK, if anyone recognises these symptoms I'd appreciate any help identifying what's wrong with me:

I'm male 53, overweight, been intermittently a heavy smoker but quit for good 7 months ago. I've suffered severe acid reflux for some years which I control with over-the-counter antacids. The acid problem is a lot less since I quit smoking but I still get it sometimes when I turn over in bed. Around the time I quit the ciggies I tried to diet to prevent massive weight-gain. My idea of a workable diet tends to be mainly grilled fish, huge salads, fresh fruit and probably a little too much dry white wine. It kinda worked as my weight rose a little but slowly came back down again. But, I began getting a regular chest pain which has not gone away all these months.

The chest pain is focussed to the centre, radiating just right of centre, of my upper chest. If I draw a line between my nipples, I'd say the pain is centred about an inch above that line. It typically strikes every other day and usually in the late afternoon or evening. It's triggered by my walking even a short distance, not necessarily uphill or relating to any kind of real exertion. It also comes on sometimes when I lie down in bed. To get rid of the pain I have to either sit down and lean forward, or if I'm outside walking I must stop and lean on a wall or whatever. The pain goes away in less than a minute. There is no shortage of breath, no sweating or dizziness and no palpitation. There is no sensitivity on the surface although the pain doesn't seem to be very deep. Describing the pain is difficult. I'd say it is a 'hard ache' and feels as if I've swallowed a chunk of rock and it's lodged in my chest. It doesn't seem to matter if I've eaten or not, or what I've eaten, but it does seem to occur at times of day when I'd normally be eating. I have a history of hypertension but my blood pressure has been under reasonably good control for many years by taking a daily cocktail of Atenolol, Nifedipine, Losartan and Aspirin and getting regular check-ups. I was told I had a 'slight systolic murmur in the aorta area' about 18 months ago but I was smoking heavily at that time. If I go see my doc about this problem I know he will give me his usual lecture about my being overweight/obese as he has done for every complaint I've consulted him about for the last 20 years. I've read about Barretts and hiatal hernias, GERD and gallstones ... what's happening doesn't really seem to fit any of those exactly. Anyone have any ideas? It's almost disabling me and scaring the hell out of me to be truthful.
 Xtrasystolic - Wed Nov 23, 2005 8:17 pm

User avatar Dear sir,
first of all, good job on kicking the smoking habit. About your weight loss, its best you take a lot of salads and fruits (as you do), but try to avoid fructose rich fruits. Not only do they help loose weight, they are also good for preventing complications from hypertension.
About your pain, it definitely is atypical for being cardiac in origin. More likely GERD, seeing how it appears at mealtimes, and antacids help relieve it (have you tried nitroglycerine for the pain ?). Anyways, I'd say you best go see a gastroenterologist if possible, and a simple check up would help diagnose it for sure.
P.S. Don't overdo on the white wine please, keep it to a mid-sized glass per day, regards. :)
 John Kenyon, CNA - Fri Jul 18, 2008 11:37 pm

User avatar Hello walrus52 -

Despite your concerns about what lecture your doctor may fire your way (and of course you're going to hear the weight one), and the possibility of GERD or some related problem which certainly could be aggravated by your interesting diet (not necessarily a bad one, but perhaps portion control could be a starting point), the pain you describe does sound as though it could possibly be heart-related. I realize most people believe all cardiac pain occurs beneath the sternum and radiates to one or both shoulders, arms, etc., but what you describe follows more the pattern of exercise-induced mild to moderate angina. It may well not be, but the description regarding your walking is classic for stable angina. If you have this problem you hopefully have long-since had it ruled in or out, as it can get suddenly a lot worse. If it is not the problem, with your chronic weight issues and history of smoking you could be looking at a coronary event down the road anyway, and so should definitely have gotten a thorough workup to rule out coronary artery disease. "Atypical" chest pain is much more common than people realize.

I hope by now you've found out what the problem was and done something about it and that this finds you in good health.

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