Brief Answer:
I recommend performing further tests to search for the possible cause

Detailed Answer:
Hello!

Thank you for asking on HCM!

Regarding your concern, I would like to explain that there are different disorders affecting all the mediastinal structures, which can cause your symptomatology:

- Costocondritis is an inflammation of the junctions where the upper ribs join the cartilage that holds them to the breastbone (sternum). It is a benign musculo-skeletal pain, which resolves spontaneously.

- Pancreatitis, which is an inflammation of the pancreas, can cause pain in this region

- Gastroesophageal reflux and esophageal stenosis ( based on your past medical history)

- A thoracic vertebral column disorder can cause irradiating pain in this region.

- A heart disorder. But in your case we can exclude this, as your cardiac tests are normal.

-An aortal dissection can not be excluded by your clinic, though it would be a rare disorder at your age.

I recommend consulting with your GP for a careful physical examination and performing a routine blood test, inflammation tests (fibrinogen, PCR, sedimentation), amylase blood levels, kidney and liver function tests, blood electrolytes, a chest x ray, a fibrogastroscopy and a thoracic spine x ray and an abdominal ultrasound to exclude the above mentioned causes.

If suspicions are raised a thoracic CT scan may be necessary to examine better the mediastinal structures.

Hope to have been helpful!

Feel free to ask any other questions, whenever you need!

Best wishes,
Dr. Iliri

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