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What Causes Left Rib Pain With PVCs?

Posted on Thu, 22 May 2014

Question: I have left rib pain and PVCs following a pulmonary function test 4/24/14. I went to emergency room and was worked up for the heart and it was normal other than pvcs. My personal doctor thinks kidney stone, which a small one was noted on a PET scan. My cardiologist thinks a floating rib got injured from the pulmonary function test is the culprit. Many opinions, no results. Now, pain is spreading to right side. ER just makes sure you are not dying on their watch and internal medicine and cardiologist do nothing.

Answered by Dr. T Shobha Deepak (4 hours later)

Brief Answer:
Possibility of Costochondritis to be considered

Detailed Answer:
Hi
Welcome to Healthcare-Magic
Greetings of the day

Dear Ms XXXXX
The cause of pain is unlikely to be due to serious life threatening condition.
if the pain is situated in the front of chest and especially localized and with pain on pressure, it is most likely from the ribs (possibility of costochondritis). It would be very helpful if you could provide me with the exact location of pain as it becomes very important for arriving at conclusive diagnosis.
I would suggest you something which is very simple and will definitely provide you the much needed relief
1. Hot water fomentation : local application of warm fomentation using hot water bag will be helpful
2. Analgesic like Ibuprofen will be helpful

I don't think that coincidental detected stones unless obstructing the Ureter could be the cause of pain .

Do get back to me

Take care

Best Regards
Dr T Shobha Deepak
MBBS, MD

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. T Shobha Deepak (35 hours later)

The pain is the anterior left 10-12th ribs and goes straight through to the back. The pain started 2-3 hours after pulmonary function test along with tachycardia and PVCs. I still have the pain although pain killers help. It did get worse and started migrating to center of chest and right anterior ribs. It feels like a constriction band around lower ribs making it hard to take a deep fulfilling breath. The PVCs are pretty regular, so much so that my EKGs are abnormal and you can manually feel the heart skipping when you take my pulse. Thus far, my primary and the ER docs don't seem concerned but to me this problem is quite bothersome.

Answered by Dr. T Shobha Deepak (2 hours later)

Brief Answer:
Possibly due to oesophageal spasm

Detailed Answer:
Hi
Greetings
Dear Ms

The constricting pain in the anterior chest could likely be due to oesophageal spasm and gastric acid reflux.
I would also suggest you addition of antacid like Pantoprozole 40 once a day early morning with a glass of water.
The pain radiating to back is likely muscle spasm. Continue taking analgesic and start with hot water fomentation.
Do get back to me if you need any further assistance, will be glad to assist you.

Take care

Best Regards
Dr T Shobha Deepak

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. T Shobha Deepak (1 hour later)

I was fine until PFT! I personally think I sprained my diaphragm. Doesn't feel like acid reflux or GERD and why would I have sudden onset of that. What about PVC. You haven't addressed that at all

Answered by Dr. T Shobha Deepak (6 minutes later)

Brief Answer:
2d Echocardiography is normal there is no concern

Detailed Answer:
Hi
Even if the EKG is showing PVC, if the Echocardiogram has demonstrated normal ejection fraction and no wall abnormality then there is no cause for concern.

Any irritation or injury to diaphragm can cause increased relaxation of lower oesophageal sphincter which promotes reflux.

as your physician who has personally attended to you and examined you has ruled out any significant abnormality, there appears to be no cause for concern.

Take Care

Regards
Dr T Shobha

Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar