Doctors Lounge - Chest Answers
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Forum Name: Chest symptoms
Question: Esophagus Spasms
|goofynewfie - Tue Mar 31, 2009 1:18 am|
Hi, I went to emergency yesterday as it was the second time in 3 days I had severe chest pain. It felt like a sharp rock was in the center of my upper chest and then like more and more sharp rocks up to my neck. Both incidences lasted about 15-20 minutes and have left me scared to death to have another. There was severe pain, I was vomiting and dizzy/faint and sweating profusely. I had not eaten anything in approximately 16 hours previous to both episodes and both times was washing my hair. I was told that I probably had esophagus spasms as my chest x-ray, EKG and bloodwork were all fine. I was born with restricted movement in my joints and intermittent severe pain in knees all my life, purple and white legs and feet and pins and needles from my toes to my hips lasting for 2-3 days at a time with no diagnosis. Since January 2007 I have been having recurring right side facial symptoms, eyelid drooping, tightness by nose and tongue pulls to right, drooling, affecting speech and seem fuzzy and unable to think clearly or find the correct words. Last week I had a new symptom with the right half of my mouth where it feels frozen like when a dentist gives you a needle which has not gone away. Since January 2007 I have repeatedly asked doctors if this could be a problem in my neck as I have severe pain in my neck, restricted movement is more severe in neck area but have been told it is all in my head. I do however have an appointment next July to see a movement specialist to be checked for dystonia. I really think something is getting pinched or perhaps circulation cut off due to my strange sleeping positions and think that because it is difficult for me to reach over my head that this esophagus problem could be caused by something in my neck also. I frequently wake up feeling disoriented and with one pupil larger than the other which then progresses to the facial spasms which last for days. My life is over as I know it, I have alot of pain in neck, back of head and left leg almost constantly. A neurologist said my problems could be genetic, molecular or TIA's but told me he did not know. He did an EMG on my right leg, normal. I later had an EMG on my face, normal. I have never had any doctor check my circulation. Are you aware of anything that could be causing all these strange symptoms especially this excruciating new chest pain? I would appreciate any help, thanks.
|John Kenyon, CNA - Sat Apr 18, 2009 8:32 pm|
My first thought, and this still stands, is that the chest pains you describe, especially with the corrolary symptoms, should make it a priority that any cardiac problem be ruled out first. While I clean EKG is a good thing, it's not usually a good final indice for this sort of thing. And while you do seem to have some severe central nervous issue going on, this doesn't mean you cannot also have some other issue as well. Too frequently the squeaky wheel gets all the attention, which is unfortunate. But assuming this is just one more part of the varied spectrum of neurological symptoms (and it certainly could be) then it's a puzzle to me why no concrete diagnosis, or even a solid guess, has been made. The EMGs would be only a part of a comprehensive neuro workup. Nerve conduction studies, ENG, brain MRI, etc., should all be done also. Further, this neurological problem could be secondary to a congenital vascular issue, and that needs to be considered also in the differential diagnosis. Not nearly enough has been done to narrow down the field of possibilities. Your suspicion of a cervical problem seems not unreasonable, with the exception of things affecting your eyes and face. The unequal pupils suggest something pressing on the brain, which of course needs far closer attention. The drooping and other facial paralysis suggests a brain lesion or pressure also.
The dystonia consult may well help you get pointed in the right direction. I certainly hope so. There are so many potential problems that could be causing this, and that may help by working backward from one of the symptoms to the central cause, and it is definitely a central nervous issue, with the possible exception of the chest pains, which fit classic cardiac presentation and this should be followed up first and foremost.
I hope this is helpful to you. Good luck and please follow up with us as needed.
|goofynewfie - Sun Apr 19, 2009 11:48 am|
Thank you so much for taking the time to respond. It is very reassuring to not hear you say that it's all in my head and leave it at that as was suggested in the University of Alberta emergency department. As this is now on my file, my family doctor can see no further and states to me that "all the tests have been done" even though he gave me a brief neurological examination which he stated was abnormal. I can only hope that nothing more serious happens before a knowledgable medical professional decides to take this seriously and take the time to thoroughly investigate what may be happening to me and help me so I can get my life back. This is my second family doctor since January 2007 and as of now, I am on my own, in pain, been denied disability benefits and have one appointment to see a movement disorder doctor in July. I would appreciate if you have any recommendations on how to handle a situation like this or how I go about getting my symptoms taken seriously? I really appreciate your help.
|John Kenyon, CNA - Tue Apr 28, 2009 12:07 am|
You're very welcome and I'm so sorry the system is being so unresponsive and reactionary. The "branding" of a patient as being somatasized (basically hypochondriacal) often short-circuits the process, and this is especially disturbing since you have had an abnormal neuro workup! This really makes no sense, to admit to you there's something not right, then dismiss the whole thing. I guess given the system you have to deal with the only constructive suggestion I can make is that you take a very aggressive, even militant approach to having this be followed appropriately, show up at the ED occasionally if symptoms remotely warrant it, and generally make yourself unavoidable so that eventually someone will have to take a further look. It's not the best way but it may well be the only way.
I'm so sorry this is working out this way for you. Please stay in touch and keep us updated. And do not allow them to ignore you. My best thought as one who has not had to live with this sort of system but has heard enough similar stories. Good luck with this. Please keep us updated.
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