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What Causes Chest Pain Right Above Sternum?
Question: Hi
I am female, 69, generally healthy and moderately active. I am at the high end of "normal" for weight at 168 lbs. I eat healthy and take supplements. I recently was diagnosed with occipital neuralgia, and the neck pain is my most bothersome complaint for nearly one year now. I have been referred to a neurologist. This morning I awoke with chest pain, not crushing or burning, or radiating anywhere, but there, right above the sternum. It seemed almost positional and once I got up and started moving around it seemed to subside, and now is almost gone. I have had similar pain before but not as strong as today. My pulse is strong, regular and 80 beats per minute. Do I need to consider a cardiac work up, or could this pain perhaps be muscular in origin?
I am female, 69, generally healthy and moderately active. I am at the high end of "normal" for weight at 168 lbs. I eat healthy and take supplements. I recently was diagnosed with occipital neuralgia, and the neck pain is my most bothersome complaint for nearly one year now. I have been referred to a neurologist. This morning I awoke with chest pain, not crushing or burning, or radiating anywhere, but there, right above the sternum. It seemed almost positional and once I got up and started moving around it seemed to subside, and now is almost gone. I have had similar pain before but not as strong as today. My pulse is strong, regular and 80 beats per minute. Do I need to consider a cardiac work up, or could this pain perhaps be muscular in origin?
Brief Answer:
I suggest to do a cardiac work up.
Detailed Answer:
Hello!
I am Dr.Rovena
I had gone through your query and understand your concern.
In the way you describe your symptom I can think of two possibilities:
-The first possibility is gastro-esophageal reflux disease (GERD) which is a condition when the stomach acid moves up into the esophagus leading to esophagus damage and inflammation.This cause an upper abdominal pain (chest pain),worse when lying flat or banding over,particularly soon after meals relieved by antiacids or sitting upright.
-The second possibility is heart disease probably angina pectoris.
The typical angina pectoris pain ( crushing pain behind the breast bone that may radiate to the left arm) is more typical in men and in women it rarely appears in this form.
If it would have been a muscular pain it would be there all time,the chest wall would be tender,the pain would worsen with movement and deep breathing.In the way you describe your pain I don't think it is muscular pain.
If I were your treating doctor,considering the fact that heart disease can be life-threatening and considering your age I would prefer to exclude heart disease by doing some investigation such as ECG,Stress test,Heart Ultrasound.
Once excluded heart disease I would think that this chest pain is due to gastro-esophageal reflux.This diagnosis is confirmed with esophagoscopy or I would prescribe you PPI drugs(drugs that inhibit the acid production in stomach) such as Pantoprazole,Esomeprazol twice a day 30 min before meals and see the effect.
If the pain go away with this drug than the diagnosis is confirmed.
I suggest to consult your cardiologist and do a cardiac work up to exclude heart disease.
Hope I was able to help you.
If you have any other question please feel free to ask,I will be happy to help.
Take care.
Dr.Rovena
I suggest to do a cardiac work up.
Detailed Answer:
Hello!
I am Dr.Rovena
I had gone through your query and understand your concern.
In the way you describe your symptom I can think of two possibilities:
-The first possibility is gastro-esophageal reflux disease (GERD) which is a condition when the stomach acid moves up into the esophagus leading to esophagus damage and inflammation.This cause an upper abdominal pain (chest pain),worse when lying flat or banding over,particularly soon after meals relieved by antiacids or sitting upright.
-The second possibility is heart disease probably angina pectoris.
The typical angina pectoris pain ( crushing pain behind the breast bone that may radiate to the left arm) is more typical in men and in women it rarely appears in this form.
If it would have been a muscular pain it would be there all time,the chest wall would be tender,the pain would worsen with movement and deep breathing.In the way you describe your pain I don't think it is muscular pain.
If I were your treating doctor,considering the fact that heart disease can be life-threatening and considering your age I would prefer to exclude heart disease by doing some investigation such as ECG,Stress test,Heart Ultrasound.
Once excluded heart disease I would think that this chest pain is due to gastro-esophageal reflux.This diagnosis is confirmed with esophagoscopy or I would prescribe you PPI drugs(drugs that inhibit the acid production in stomach) such as Pantoprazole,Esomeprazol twice a day 30 min before meals and see the effect.
If the pain go away with this drug than the diagnosis is confirmed.
I suggest to consult your cardiologist and do a cardiac work up to exclude heart disease.
Hope I was able to help you.
If you have any other question please feel free to ask,I will be happy to help.
Take care.
Dr.Rovena
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Above answer was peer-reviewed by :
Dr. Raju A.T
Answered by
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