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Question: Worrying Chest Pain, Any advice greatly recieved.

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 jinkus - Tue Mar 22, 2005 4:07 pm


I have been having chest pains in the left side of my chest for the last two months, after numorous visits to my GP and the hospital, my problem is still prominent and un-diagnosed. I have been told that it is most probably Musclo-sketol pain, or an inflamation of the cartlidge between my ribs. I am still very worried about the pain and sensations I am going through and appriciate an independent experts advice.

The symptoms I have been having are, sharp pain under my rib on the left side of my chest, sensation of shortness of breathe even though I am breathing normally, palpitations, sensation of my heart skipping a beat, awarnes of my heart beating harder than normal. The pain is not constent, it comes and goes, sometimes it is sharp, sometimes it is dull, I am very concerned about this pain and it is effecting my general enjoyment of life, I am having troble sleeping and this is always on my mind in case it is something serious that has beem overlooked.

I have had ECG,s X-Rays and a Barium meal so far, I am on a pre-scription of - Voltrol Diclofenac, Aupam, Rantiadine.

I would appriciate any advice or suggestions as to if the orginal Approximate diagnosis i have recieved sounds feasable or any suggestions as to what the problem might be.


 Dr. Yasser Mokhtar - Tue Mar 22, 2005 5:45 pm

User avatar Dear Sean,

i am no expert by any means but here are my thoughts.

You don't have any major risk factors for coronary disease (or at least you never mentioned any). Your chest pain is atypical as compared to that of coronary disease. So, the probability that your chest pain be due to coronary disease is very low.

The causes of chest pain are various and in addition to coronary disease, there is another heart condition called mitral valve prolapse which is known to cause atypical chest pain and palpitations. This condition is quite common in the younger population. It is diagnosed by an ultrasound of the heart (echocardiography) and needs to be followed-up. If you have an echocardiogram and it proves you have this condition, there are medications that can be used in this case to help you with the chest pain and the palpitations.

Your chest pain could just be a way of expression for the palpitations that you have been having.

Neck spine problems can cause chest pain. So, i suggest that you have a neck x-ray or ct scan to exclude neck spine problems.

In addition to acid reflux disease for which you are taking ranitidine (and by the way this is not the strongest medication for acid reflux disease) and inflammation in the chest wall or musculoskeletal causes (for which you are taking pain relievers and anti-inflammatory medications), another cause is panic attacks.

You could also try a small dose of a tranquilizer unless aupam is a tranquilizer that i am not familiar with.

So, i recommend that you have:
1. An echocardiogram to rule out mitral valve prolapse.
2. A 24 hours heart monitor and blood tests for thyroid functions and electrolytes if chest pain is the way your palpitations are being expressed.
3. A neck x-ray or ct scan to rule out neck problems.
4. May be starting a small dose tranquilizer if you are not already on one (aupam).
5. May be switch to an acid inhibitor stronger than ranitidine.

Thank you very much for using our website and i hope that this information helped.

Yasser Mokhtar, M.D.
 jinkus - Sat Mar 26, 2005 5:28 am

Thank you for your reply, the information i was provided with was very informative.

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