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I Have This Tight Feeling Underneath My Ribcage All Around What Could Be This ?

Posted on Fri, 9 Dec 2022

Question: Hello, I have been suffering from tightness underneath ribs and sternum pain for about 5 months now, I have had many test done and they all come back normal, I had an endoscopy last September and all that came back was GERD, I have also had chest x-rays, EKG, blood tests, CT scan of the chest, CT scan of the stomach as well as ultrasound of the stomach, all normal, I have this tight feeling underneath my ribcage all around, it is better when I get home and when I sleep, I don't feel anything pressure around my ribs or that tightness when I am laying down, I have been to various chiropractors with no relief. Help!

Answered by Dr. Ilir Sharka (36 minutes later)

Brief Answer:
I would explain as follows:

Detailed Answer:
Hello,

I passed carefully through your question and would like to know if you have performed an exercise cardiac stress test to investigate for possible coronary artery disease.

If you have not performed such test, I would recommend performing it.

As your symptoms are relieved by sleeping, it could be indicative of anxiety or a musculoskeletal pain.

I would exclude GERD as possibly related to this symptomatology because it is usually worsened by laying position.

I would recommend trying alprazolam 0.25mg. If it helps relieve the chest tightness, I would recommend considering anxiety as a possible cause of you complaints.

I would also recommend performing a cervical spine X-ray study to investigate for possible chronic degeneration or a bulging disc which could trigger this situation.

In such case a cervical spine MRI study may be needed.

I recommend discussing with your doctor on the above tests.

Hope you will find this answer helpful!

Kind regards,

Dr.Iliri

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Ilir Sharka (31 minutes later)

Thank you, I have had various cardiac studies, I am very active and have been for over 30 years, I run, lift weights and do aerobic exercises on a daily basis with no problem recovering and never out of breath.

Follow up: Dr. Ilir Sharka (1 minute later)

I have also had cardiac blood tests and a lipid profile which all come out normal, my HDL is 71, my total cholesterol is 195, my triglycerides are 69. ,my LDL is a bit elevated at 110

Follow up: Dr. Ilir Sharka (1 minute later)

Also not chest pain but rib pressure and sternum pressure

Answered by Dr. Ilir Sharka (2 hours later)

Brief Answer:
I would recommend as follows:

Detailed Answer:
Hello again!

Thank you for the additional information.

As a cardiologist, I would exclude any cardiac issues, considering your symptoms and your normal cardiac tests.

Your blood lipid profile is within the normal ranges, although your LDL is a little elevated, because the LDL/HDL ratio is within the normal ranges. This means that you are not at any increased cardio-vascular risk.

Regarding the chest tightness, it could be related to chostochondritis, which is musculo-skeletal pain due to local inflammation.

I would recommend trying ibuprofen for some days. If your symptoms are relieved by this drug, it would indicate chostochondritis.

Local hot packs can help too.

Hope to have been helpful!

Wishing good health,

Dr. Iliri

Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar