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Suggest Treatment For Severe Pain In The Chest Area
Question: string like pain near heart
Brief Answer:
I would recommend as follows:
Detailed Answer:
Hello!
Thank you for asking on HCM!
Regarding your concern, I would like to have some more information on the pain characteristics:
1- Is the pain modulated by respiration or body position change? This could indicate possible extra-cardiac cause (probably a musculoskeletal pain).
2- How long does it last? When did it start?
3- Is it triggered by physical exertion?
4- Is it associated to other symptoms like dizziness, lightheadedness, shortness of breath, etc?
If your pain persists and gets more disturbing and if it is not modulated by pody posture changes or respiration, especially if you have known coronary risk factors like (diabetes, close smoking contacts, hypertension, dyslipidemia, etc.), I would recommend going to the ER for a physical exam and some tests to investigate for the possible causes:
- a resting ECG and cardiac enzymes (to exclude possible myocardial ischemia)
- a chest X ray study
- some other blood lab tests (complete blood count, PCR, sedimentation rate for inflammation or an infection).
Meanwhile, I recommend avoid physical activity.
Hope to have been helpful!
I remain at your disposal if you have any other questions.
Kind regards,
Dr. Iliri
I would recommend as follows:
Detailed Answer:
Hello!
Thank you for asking on HCM!
Regarding your concern, I would like to have some more information on the pain characteristics:
1- Is the pain modulated by respiration or body position change? This could indicate possible extra-cardiac cause (probably a musculoskeletal pain).
2- How long does it last? When did it start?
3- Is it triggered by physical exertion?
4- Is it associated to other symptoms like dizziness, lightheadedness, shortness of breath, etc?
If your pain persists and gets more disturbing and if it is not modulated by pody posture changes or respiration, especially if you have known coronary risk factors like (diabetes, close smoking contacts, hypertension, dyslipidemia, etc.), I would recommend going to the ER for a physical exam and some tests to investigate for the possible causes:
- a resting ECG and cardiac enzymes (to exclude possible myocardial ischemia)
- a chest X ray study
- some other blood lab tests (complete blood count, PCR, sedimentation rate for inflammation or an infection).
Meanwhile, I recommend avoid physical activity.
Hope to have been helpful!
I remain at your disposal if you have any other questions.
Kind regards,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks Dr. Sharka.
1. No modulation of pain by resp or position change.
2. Started 40 minutes ago and lasted 2-3 minutes.
3. I was walking in a sales office that is fairly small.
4. No other symptoms. Reclined in my chair to monitor; made muscles in right arm to check for numbness; had about ten seconds of pain on front top of left shoulder.
I do have history of continuous AFIB since XXXXXXX 2014. I am obese (6 ft 2 in., 300 lbs). Drank two whiskey manhatten doubles last night. Take 81 mg aspirin daily. Do not exercise. Last spring and summer worked with personal trainer 2x a week on strengthing lower body. I have grade 4 hip arthritis, bulging discs lower back and neck causing sciatica in right leg, factor 10 blood deficiency diagnosed as born with it, taking Mobic for arthritis, Cardura for prostate enlarged, over the counter Cholest-off for high cholesterol (180-230 readings last few years).
1. No modulation of pain by resp or position change.
2. Started 40 minutes ago and lasted 2-3 minutes.
3. I was walking in a sales office that is fairly small.
4. No other symptoms. Reclined in my chair to monitor; made muscles in right arm to check for numbness; had about ten seconds of pain on front top of left shoulder.
I do have history of continuous AFIB since XXXXXXX 2014. I am obese (6 ft 2 in., 300 lbs). Drank two whiskey manhatten doubles last night. Take 81 mg aspirin daily. Do not exercise. Last spring and summer worked with personal trainer 2x a week on strengthing lower body. I have grade 4 hip arthritis, bulging discs lower back and neck causing sciatica in right leg, factor 10 blood deficiency diagnosed as born with it, taking Mobic for arthritis, Cardura for prostate enlarged, over the counter Cholest-off for high cholesterol (180-230 readings last few years).
Brief Answer:
I would explain as follows:
Detailed Answer:
Hello again!
Thank you for the additional information.
Based on your pain characteristics, I would explain that it is quite difficult to differentiate if the pain is related to your cervical disc bulging (possible radicular pain) or from myocardial ischemia (especially considering your atrial fibrillation and dyslipidemia, which are frequently coupled with coronary artery disease).
So, if this pain persists in the next hours, I would recommend going to the ER to perform the above mentioned tests.
Otherwise, I would recommend consulting with your attending physician on the possibility of performing some cardiac imaging tests as follows:
- a coronary angio CT scan
- dobutamine cardiac echo or
- a nuclear perfusional cardiac stress test
which could help to confirm any possible evidence of cardiac ischemia and differentiating that way the exact reason of your complaints.
If the above mentioned tests result normal, inflammation tests (PCR and sedimentation rate) would help exclude inflammation (or shoulder joint arthritis) as a possible cause of these complaints.
Hope you will find this answer helpful!
Wishing all the best,
Dr. Iliri
p.s.: Sorry for the delay, but this is because of my professional commitment.
I would explain as follows:
Detailed Answer:
Hello again!
Thank you for the additional information.
Based on your pain characteristics, I would explain that it is quite difficult to differentiate if the pain is related to your cervical disc bulging (possible radicular pain) or from myocardial ischemia (especially considering your atrial fibrillation and dyslipidemia, which are frequently coupled with coronary artery disease).
So, if this pain persists in the next hours, I would recommend going to the ER to perform the above mentioned tests.
Otherwise, I would recommend consulting with your attending physician on the possibility of performing some cardiac imaging tests as follows:
- a coronary angio CT scan
- dobutamine cardiac echo or
- a nuclear perfusional cardiac stress test
which could help to confirm any possible evidence of cardiac ischemia and differentiating that way the exact reason of your complaints.
If the above mentioned tests result normal, inflammation tests (PCR and sedimentation rate) would help exclude inflammation (or shoulder joint arthritis) as a possible cause of these complaints.
Hope you will find this answer helpful!
Wishing all the best,
Dr. Iliri
p.s.: Sorry for the delay, but this is because of my professional commitment.
Note: click here to Consult a cardiac surgeon online. to know the best treatment option for your heart-related issues
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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