Dr. Hive--Are you better Drs at diagnosing than the hospital? Here's a challenge

[Chris in VA]

Ds has had chest pain, right by his heart, for over a month now. Sometimes it's dull, sometimes sharp and stabbing. The Drs have done a stress test with an echocardiogram, a "plain" echocardiogram, several EKGs, and a chest xray.

 

They have found NOTHING. Big fat zero. There has been no injury, it's not heartburn, it does sometimes feel worse when he is on his back laying down or somewhat reclining.

 

Sometimes it really hurts, most of the time just a dull pain.

 

Doesn't seem to be spinal or a pulled muscle.

 

Nothing in the breast ultrasound (like a cyst, which he thought might be pressing on his heart, as that is what it feels like--a poking or pressing sometimes). Ribs are ok.

 

Sigh. This is so hard!

[MariannNOVA]

Have they done a thallium stress test? I'm asking because Angina does not always show up on a regular stress test OR on an EKG.

 

My guess is going to be angina pectoris.

 

 

:grouphug:

Edited April 19, 2012 by MariannNOVA

[Chris in VA]

Is that the radioactive one? Nope, not yet.

Off to google AP. Thanks!

[Jean in Newcastle]

Could be a mild form of pericarditis - inflammation of the sac that surrounds the heart. It isn't always picked up by echocardiograms etc. My doctor had me take high doses of anti-inflammatories to treat it. (I wouldn't try to treat it based on what I said, but ask the doctor if he thinks that it could be pericarditis.)

[Hope in God]

Is this a definite heart thing or could it be digestive? Something like H. Pylori?

[MariannNOVA]

Is that the radioactive one? Nope, not yet.

Off to google AP. Thanks!

 

Yes, thallium is the radioactive one. It tends to be definitive as long as the patient is on the treadmill long enough and gets his/her heart rate up high enough.

[kalanamak]

Has he perchance, while intoxicated, aspirated a non-radio opaque foreign body into a bronchi?

 

Costochondritis is VERY common and may take some careful palpating to detect.

[ChristusG]

My uncle had chest discomfort for a little while. He kept telling the doctor and they did every test they could do....nothing showed up. Finally they told him that the only ing left to do was a heart cath, but they really didn't think it was necessary. However, my uncle wanted it done just for reassurance. Turns out, his valve was 99% blocked and he could have had a massive heart attack at any moment that the doctors said would have left him dead. He's only 48. He had to have a stent put in.

 

Goes to show that the noninvasive tests do not always pick everything up.

[Jean in Newcastle]

Costochondritis is VERY common and may take some careful palpating to detect.

 

That was my other guess. I've had this too and the doctor had a hard time deciding if it was costochondritis or pericarditis.

[datgh]

Stress? Many years ago when I was majorly stressed I didn't understand how it could effect the body. I had a lot of chest pains which of course made me more stressed because I thought I was having heart trouble which caused worse pain and it would be as you described it - painful at times and a dull ache at other times. I still suffer from it when my stress levels are up but I now recognize it for what it is and know how to put the pain to rest. I hope you get some answers because I know how scary it can be.

[Holly IN]

Not a dr but I do have question. Is his pain constant? or coming and going?

 

I am thinking pluersy. 3 of us have it sometimes it comes in droves then quits.

 

Holly

[Little Nyssa]

No answers but :grouphug: I hope you find out soon.

[maddykate]

What about acid reflux? It sounds like something my dd did around age 5. After about a month of meds, she was good to go. No more problems.

[mommymilkies]

I had the same thing as a child. Killer chest pain. It's very rare for me now. Other than one documented case (wearing a halter monitor) of tachycardia and some palpitations a few years ago, they've never figured it out. I think, looking back it was Precordial catch syndrome. http://www.cincinnatichildrens.org/health/c/chest/ It's benign as far as they can tell, but not well studied. I used to pass out from the pain as a child.

 

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1627421/pdf/archdisch00769-0087.pdf

[UmMusa]

I went in for odd chest pain. Doctor though possibly arthritis of the joints that meet under the breast area where the ribs wrap around from the back. Reading other replies, though, it might have been stress because I don't have it anymore.

[Amy in KS]

When my iron levels tanked last time, it presented as persistent and scary chest pain. After getting my levels up, the problem resolved. I've had weird anemia issues all my life, but i never realized that it could cause chest pain.

 

Another thought-- asthma can feel like several bricks sitting on your chest. You can develop asthma as an adult.

[Kathleen in VA]

Has his doctor had him wear a Holter monitor? I had chest pain a long time ago and when all the usual non-invasive stuff came back normal, my doctor had me wear one for a week.

[Dolphin]

By all means make sure his heart is checked throughly.

 

but

 

it could be as simple as upper chest wall pain.

 

It is not a pulled muscle or anything like that, it is just pain that sometimes comes above the heart. I was a little older (15) when I developed it. It tended to act up when I was not sleeping well. I found cuddling with a heat pad for 20 minutes would make it better (and that would not make a heart problem any better)

 

Here is an article about non cardiac chest wall pain. Things to look into like having his gall bladder looked at.

http://www.medhelp.org/posts/Family---Internal-Medicine/non-cardiac-chest-wall-pain/show/227527

 

:grouphug::grouphug:

[mamakelly]

I had crazy chest pain and shortness of breath a few years back. Turned out to be panic attacks. :001_huh: Stress can bring them on. Since then, when things get super stressful it occasionally happens again.