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What Causes Intermittent Chest Pain And Discomfort In Right Shoulder?
Question: am a 39 year old female with a history of hypertension and GERD, I do currently smoke and am overweight. I have been having severe intermitten pain in the chest with some discomfort in my right shoulder and arm, that also radiates to the lower part of my neck. When the pain in my chest hits, i get this pain all the way up the right side of my head also. I had some of the same symptoms back in November, except the shoulder and neck pain, underwent a nuclear stress test that came back negative. I am embarrassed to go to the ED, thought it might be related to GERD again, but haven't had anything today to eat but some water - due to lack of appetite.
Brief Answer:
GERD relation of symptoms possible, try PPI medication, rule out others
Detailed Answer:
Dear Patient,
the symptoms you are describing can be related to GERD, but i'd also like explain other possibilities that add to it:
If it is GERD, you can try acid blocking medication (PPI) and see if it gets better, like pantoprazole or omeprazole in the mornings. If this doesn't get better a gastroscopy is advisable (if you didn't have one lately). Also ruling out helicobacter pylori bacteria in your stomach through stool sample should be done. If you had that you'd need antibiotics. GERD gets worse from smoking so if you can it is advisable to quit. Also loosing weigt can help and avoiding spicy foods and hard liquors/alcoholic beaverages.
Other possible reasons that add to or can be a cause of your pain symptoms are:
1.) some tense muscles/ nerve affection coming from your cervical spine. X ray and/or mri of the cervical spine can be done possibly to check if any disc or vertebral lesion causes the pain radiating in shoulder and arm.
2.) coronary heart disease: the nuclear stress test you already took should be put in the picture together with an actual ekg, and actual ergometry (ekg on a bike) to rule out any heart condition. With smoking, hypertension and being overweight you do have 3 risk factors for heart condition, even though your young age and being female are known as protective factors.
In summary: try PPI medication like pantoprazole and try to reduce risk factors as described above, if it doesn't get better rule out heart condition and nerve affection of the cervical spine as advised.
Hope this is helping you , if you have any clarificatons you can get back to me, if this was helpful please kindly rate my answer. Best regards
GERD relation of symptoms possible, try PPI medication, rule out others
Detailed Answer:
Dear Patient,
the symptoms you are describing can be related to GERD, but i'd also like explain other possibilities that add to it:
If it is GERD, you can try acid blocking medication (PPI) and see if it gets better, like pantoprazole or omeprazole in the mornings. If this doesn't get better a gastroscopy is advisable (if you didn't have one lately). Also ruling out helicobacter pylori bacteria in your stomach through stool sample should be done. If you had that you'd need antibiotics. GERD gets worse from smoking so if you can it is advisable to quit. Also loosing weigt can help and avoiding spicy foods and hard liquors/alcoholic beaverages.
Other possible reasons that add to or can be a cause of your pain symptoms are:
1.) some tense muscles/ nerve affection coming from your cervical spine. X ray and/or mri of the cervical spine can be done possibly to check if any disc or vertebral lesion causes the pain radiating in shoulder and arm.
2.) coronary heart disease: the nuclear stress test you already took should be put in the picture together with an actual ekg, and actual ergometry (ekg on a bike) to rule out any heart condition. With smoking, hypertension and being overweight you do have 3 risk factors for heart condition, even though your young age and being female are known as protective factors.
In summary: try PPI medication like pantoprazole and try to reduce risk factors as described above, if it doesn't get better rule out heart condition and nerve affection of the cervical spine as advised.
Hope this is helping you , if you have any clarificatons you can get back to me, if this was helpful please kindly rate my answer. Best regards
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Above answer was peer-reviewed by :
Dr. Prasad
Answered by
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