What Causes Chest Pain And Heart Burn?
Question: Hi I have chest pain (daytime 4 \ 10 when lying down 6\10) and possible heartburn, but I have not had heartburn before or acid issues? I have had an ECG by paramedics and a doctor and they report no heart or lung issues, the pain is 24\7 though and I am one day into Omeprazole medication, but the extent of the pain is worrying me. My blood pressure check was ok for my age. I am 52 Male and athletic fit at + 180lbs?
Brief Answer:
Unlikely cardiac,but needs more evaluation.
Detailed Answer:
Hello dear,welcome to healthcare magic forum.
I am Dr Aslam here to help you.
As you describe,you are having round the clock pain,and you have no history of diabetes/hypertension/hyperlipidemia.Such a pain is unlikely to be cardiac.Anyhow,as pain is significant,and not coming down with omeprazole,we need more evaluation.
To guide you better,can you please give me the following details?
1)Are you a smoker?
2)Is the pain is exacerbated by walking/exercise?
3)What happens to pain during coughing/deep breathing?
4)Is the pain associated with excessive sweating/nausea/vomiting?
5)Have you taken a chest x-ray for this?
Thank you.
Unlikely cardiac,but needs more evaluation.
Detailed Answer:
Hello dear,welcome to healthcare magic forum.
I am Dr Aslam here to help you.
As you describe,you are having round the clock pain,and you have no history of diabetes/hypertension/hyperlipidemia.Such a pain is unlikely to be cardiac.Anyhow,as pain is significant,and not coming down with omeprazole,we need more evaluation.
To guide you better,can you please give me the following details?
1)Are you a smoker?
2)Is the pain is exacerbated by walking/exercise?
3)What happens to pain during coughing/deep breathing?
4)Is the pain associated with excessive sweating/nausea/vomiting?
5)Have you taken a chest x-ray for this?
Thank you.
Above answer was peer-reviewed by :
Dr. Shanthi.E
Thank you Dr...
I am a Non Smoker have never smoked
No - excercise is fine I walked pretty far this morning
Pain remains constant not really affected by Coughing \ or deep breathing
No sweating or vomiting at all
No x ray was suggested by my GP or the medics - so no
Please remember I am only one day into the omeprazole treatment, the Dr has given me four weeks, but I do not want many weeks of this pain as it is worse when I lie down so sleep is impossible, normal pain relief doesn't seem to work?
I am a Non Smoker have never smoked
No - excercise is fine I walked pretty far this morning
Pain remains constant not really affected by Coughing \ or deep breathing
No sweating or vomiting at all
No x ray was suggested by my GP or the medics - so no
Please remember I am only one day into the omeprazole treatment, the Dr has given me four weeks, but I do not want many weeks of this pain as it is worse when I lie down so sleep is impossible, normal pain relief doesn't seem to work?
Brief Answer:
You can modify the treatment with your doctor.
Detailed Answer:
Hello dear,
So the pain is very unlikely to be cardiac.
Now,If I were your treating doctor,I will order a chest x-ray and repeat ECG .If that is normal,I will add an anlgesic and an antacid(preferably with a local anaesthetic) to omeprazole,and re-assess the condition on 3rd day.
If the pain is not coming down,I will escalate analgesia and make arrangements for exercise testing(TMT) to be sure not having marginal cardiac ischemia(though it is unlikely).
Most probably,we can sort out the issue by this step.If not, we may need further evaluation like CT/MRI scanning,and thinking of any abdominal conditions causing secondary chest pain.
You can discuss this with your treating doctor.
Meanwhile,just note the following tips:
1)avoid spicy/fried/oily food items
2)avoid tea/coffee/chocolates
3)reduce non veg,especially beef/pork,and fried items
4)Take enough green leafy veges,fruits and water.
Wishing you a faster and complete recovery.
With prayers,Thank you.
You can modify the treatment with your doctor.
Detailed Answer:
Hello dear,
So the pain is very unlikely to be cardiac.
Now,If I were your treating doctor,I will order a chest x-ray and repeat ECG .If that is normal,I will add an anlgesic and an antacid(preferably with a local anaesthetic) to omeprazole,and re-assess the condition on 3rd day.
If the pain is not coming down,I will escalate analgesia and make arrangements for exercise testing(TMT) to be sure not having marginal cardiac ischemia(though it is unlikely).
Most probably,we can sort out the issue by this step.If not, we may need further evaluation like CT/MRI scanning,and thinking of any abdominal conditions causing secondary chest pain.
You can discuss this with your treating doctor.
Meanwhile,just note the following tips:
1)avoid spicy/fried/oily food items
2)avoid tea/coffee/chocolates
3)reduce non veg,especially beef/pork,and fried items
4)Take enough green leafy veges,fruits and water.
Wishing you a faster and complete recovery.
With prayers,Thank you.
Above answer was peer-reviewed by :
Dr. Shanthi.E
thank you
I had another ECG with the GP. The anti acid treatment I am taking will take how long to take effect please? What painkillers can I take meanwhile that actually work please? Is there an analgesic I can buy off the shelf in the UK as you recommend please?
Another thought is that was doing chest weights in the gym 24hrs prior to symptoms, but this does not feel muscular and the pain changed with body position.
I had another ECG with the GP. The anti acid treatment I am taking will take how long to take effect please? What painkillers can I take meanwhile that actually work please? Is there an analgesic I can buy off the shelf in the UK as you recommend please?
Another thought is that was doing chest weights in the gym 24hrs prior to symptoms, but this does not feel muscular and the pain changed with body position.
Brief Answer:
see the answer below please
Detailed Answer:
Hello dear,
Depending on the severity,it will take about 5-7 days for anti acid drugs to control the pain completely.Mean while,paracetamol and antacid syrups with local anaesthetics like oxethazaine will take care.But pain usually comes down in first two days itself.If not,we have to look for any complications or diagnosis other than acid peptic disease.
Before acid peptic disease is ruled out,it is better not to use strong analgesics like NSAIDs,as this will aggravate symptoms.You can use paracetamol and tramadol(I am not sure whether tramadol is available off the shelf in UK).
In my opinion,if the given drugs does not bring down pain in first two days,it is much better to go back to your GP and discuss the issue,rather than going for over-the-counter medication.
And,as the pain changes with position,a chest x-ray is strongly recommended.
Regarding relation with chest weights,I am not able to commend with certainty without a physical examination.Usually,there will be some focal tenderness to touch,if this was the trigger.
Hope you got some idea regarding the situation.If you have no further questions,you can close the discussion and rate the answer.
Again,wishing a faster cure,Thank you.
see the answer below please
Detailed Answer:
Hello dear,
Depending on the severity,it will take about 5-7 days for anti acid drugs to control the pain completely.Mean while,paracetamol and antacid syrups with local anaesthetics like oxethazaine will take care.But pain usually comes down in first two days itself.If not,we have to look for any complications or diagnosis other than acid peptic disease.
Before acid peptic disease is ruled out,it is better not to use strong analgesics like NSAIDs,as this will aggravate symptoms.You can use paracetamol and tramadol(I am not sure whether tramadol is available off the shelf in UK).
In my opinion,if the given drugs does not bring down pain in first two days,it is much better to go back to your GP and discuss the issue,rather than going for over-the-counter medication.
And,as the pain changes with position,a chest x-ray is strongly recommended.
Regarding relation with chest weights,I am not able to commend with certainty without a physical examination.Usually,there will be some focal tenderness to touch,if this was the trigger.
Hope you got some idea regarding the situation.If you have no further questions,you can close the discussion and rate the answer.
Again,wishing a faster cure,Thank you.
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj