A 48-year-old female asked:
I am a 42 year old female, bmi of 20 - not overweight, with fairly low cholesterol. i have been having pain on the left side of my chest for several days. i had a normal ekg a month ago. my doctor says it's muscular, but i can't seem to get relief from st
3 doctor answers • 4 doctors weighed in
Family Medicine 19 years experience
It : It sounds like you may be dealing with costochondritis (inflammation between the ribs). This can cause recurrent chest pain. Have you tried an inti-inflammatory medications like advil (ibuprofen) or motrin? Also a short course of steroids may help alleviate your symptoms.
Lastly are you stressed or have anxiety? If so, often times it can present as physical symptoms.
If you had a normal ekg and negative stress test two years ago it is unlikely that your issue is cardiac.
Please continue to see your doctor until you have symptom relief.
5.3k viewsAnswered >2 years ago
Family Medicine 35 years experience
I'm : I'm sorry to hear about your ongoing chest pain. It sounds like your main concern is heart disease, which was essentially ruled out two years ago with your thallium stress test. (since your pain seems to have remained the same for at least two years, since it is intermittent in character, and since it isn't exertional in nature, it's unlikely that you have heart disease.) the only way to ensure that your coronary arteries are clear is through coronary angiography -- or ct angiography -- which really doesn't sound like it's necessary.
When a patient has persistent pain that defies diagnosis, it's always worthwhile to revisit the history: when does the pain occur? What makes it better or worse? What are the associated symptoms? Is the pain related to stress? Is it related to a specific activity, etc? In the case of chest pain, what are the patient's cardiac risk factors (e.g., cholesterol, hdl, ldl, and triglyceride levels; smoking; family history; diabetes; hypertension; obesity; sedentary lifestyle, etc.)?
Physical examination also plays a key role in diagnosing chest pain: are the lung fields clear? Is there a murmur or valvular click (some individuals with mitral valve prolapse experience recurrent chest pain)? Can the pain be provoked by chest wall compression, specific maneuvers, or changes in position? If a chest x-ray has been done, were there any unusual findings? Is the abdominal examination normal? (and so on)
if a thorough evaluation rules out any serious underlying conditions, we are often left with non-specific diagnoses, such as "chest wall pain" or "muscular pain, " and the best we can do is reassure patients that 1) there doesn't seem to be anything serious going on, and 2) we'll be there to start the process anew should their symptoms change in any way.
Discuss your concerns with your doctor. Ask if there are any additional avenues that need to be pursued. Only you will know when you're comfortable that all such avenues have been exhausted.
5.5k viewsAnswered >2 years ago
Internal Medicine 18 years experience
Chest pain: It sounds like it may be musculoskeletal but always good to ensure. Ice packs and moist heat will definitely help me move in the right direction with gentle stretching and massaging. This type of pain can be very painful so an Ibuprofen may help to. Make sure you take deep breaths or else you may be at risk for a lung infection from taking shallow breaths.
5.4k viewsReviewed >2 years ago
Last updated Oct 4, 2016
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