What Causes Pain In The Chest And Shoulder Area With Severe Fatigue?

Posted on Tue, 27 Jun 2017

Question: Hello I went to the emergency room Wednesday with pain in my chest and shoulder area, I keep losing feeling in my left arm and I am fatigued. The emergency room ran some blood work, did chest x-rays and gave me a GI cocktail and ultrsound, then released me noting they thought my condition was GI related and to take prilosec. I am concerned something else is going on, I still feel lots of pain and I through up this morning.

Answered by Dr. Panagiotis Zografakis (1 hour later)

Brief Answer:
please upload the reports

Detailed Answer:
Hello,

it would be very helpful for me to know the results of the tests you've done. Please upload the reports either as scanned documents or as simple photos taken by a XXXXXXX phone. You can either upload them when asking a follow-up question or upload them elsewhere and give me the link.

Also please add more clinical details to your description. Important things when describing pain are the following:
- the exact location of the pain and its reflections
- associated symptoms
- duration of the symptoms and fluctuation of their intensity (if they were not constant that is)
- anything that made the symptoms better
- anything that made the symptoms worse
- the effect of treatment to the symptoms

I'll be glad to continue this discussion when you provide more information!

Kind Regards!

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

Follow up: Dr. Panagiotis Zografakis (2 days later)

they did not provide me with the results of the tests, they said that they all came back normal. The pain still persists as of today, it feels as if something is squeezing my heart from the inside and spreads to my neck and back side of my shoulder blades. every so often it has been causing my left arm to go numb and feel like a million small needles are poking it simultaneously for 3 or so hours at a time. i was instructed to take prilosec which i have done for the last 5 days now and it has made no difference. the pain varies from a 5 to an 8 on a 1-10 scale. nothing makes it better and nothing makes it worse.

Answered by Dr. Panagiotis Zografakis (10 minutes later)

Brief Answer:
there are some things to consider but...

Detailed Answer:
I see... If I knew what kind of tests they did, it would also help a lot. For example did they check for heart attack? A negative troponin assay 6 hours after the pain started is sufficient to exclude it. The chest X-ray, clinical examination and blood tests should have helped to diagnose events like pneumothorax, aortic dissection, pericarditis, etc; the most serious causes that is.

When all else seems to be negative, the upper gastrointestinal system or the musculoskeletal structures are usually blamed for the symptoms and that's why they suggested taking a proton pump inhibitor like prilosec.

Since this drug does not seem to help and the diagnosis is not certain, reassessment is recommended.

Kind regards!

Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

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