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Doctors Lounge - Orthopedics Answers
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| ethansky
- Tue Nov 18, 2008 2:39 am |
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Hi, I am a 30 year old male relevatively active non smoker (phx smoking). 2 weeks ago i have started with intermitant sharp/ache pains central/right sided chest, base of left lung region and right axilla region. They come on at rest, no increased pain on inspiration, no productivity. The pains are intermitant. I went to my GP he listened to my chest and questioned me. I am doing a disertation at university and i am training as a podiatrist (so my back position is poor smetimes). He has claimed that these pains are postural related and prescribed nsaids. The pain will not go away after 2 weeks now and it is driving me mad. I am under a lot of pressure at the moment and do have issues with anxiety on occassions. Any advice?
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| Tom Plamondon PA-C
- Wed Nov 19, 2008 8:31 pm |
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 Right sided chest pain is reassuring in terms of cardiac etiology.
At this point I have more questions than answers:
Any hx of blood clots or clotting disorders in the family?
Any recent long travels or prolonged immobilization?
Chest xray and EKG are normal?
Any identifyable triggers to this chest pain or any patterns?
Duration of the pain?
Does it radiate or stay local?
Relieved or worsened with food intake?
Any gastric reflux symptoms?
Any tender areas on the thorax?
Any hazardous fumes/ dust exposure?
Any hx of asthma?
Probably these were reviewed with GP, but can only give an abbreviated differential dx for chest pain:
pleurisy
intercostal strain
pneumonia/bronchitis
pulmonary embolism
cardiomyopathy
costochondritis
mechanical thoracic pain - posture related
Granted that the serious etiologies have been ruled out by GP. It may be prudent to attend a spa for some R&R...or a theraputic massage may be in order.
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