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What Causes Pleuritic Chest Pain?

Posted on Fri, 2 Jan 2015

Question: I have this left chest pain below collar bone above left breast it always seems to be there bit flares up relay painfull sometimes it hurts trough to my back and up my neck at times I'm 36 old male controlled high blood pressure I've had every heart test possible all clear a heart XXXXXXX a year ago all clear it's almost like a line of pain from below my ribs up my neck with most emphasis on upper left chest I am anxious and continuously worry it's my heart twist an sitting a certain way relieves it a little and lying down it goes away totally almost and I chew tobaco I don't know if it's in my head but seams worse chewing tobaco??? It's been going on over ten years now

Answered by Dr. Rakesh Madhyastha (6 hours later)

Brief Answer:
Pleuritic chest pain

Detailed Answer:
Hello

Thanks for the query

From the description you have given it looks like the pain you are suffering from is arising from the pleura. Pluera is nothing but lining of the lung.
Here is how you go about it

1. I would like you to get an x Ray done, if x Ray does not show any inflammation of the pleura get a ct chest done
2. approach a chest physician for a biopsy of the pleural lining
3. chronic inflammation of the pleura is known and it is known to cause pain in a similar fashion

The second close differential is fibromyalgia , but fibromyalgia is a diagnosis of exclusion. I would like you to go ahead with the steps given by me for diagnosis.
Since you have gone through all the tests for heart condition it is unlikely to be arising from it

I hope I was of help, if you have any further queries please get back to me

regards

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

Follow up: Dr. Rakesh Madhyastha (16 hours later)

How come it seems to hurt worse when i chew tobaco??

Answered by Dr. Rakesh Madhyastha (5 hours later)

Brief Answer:
vasoconstriction

Detailed Answer:
Hello

Thanks for getting back

Tobacco is known to cause severe vasoconstriction transiently. Vasoconstriction causes reduced blood supply to your pleura and the coronary arteries ( blood vessels to the heart) causing increase in pain. Vasoconstriction is also known to increase blood pressure.

( vasconstriction means that your blood vessels will become smaller in diameter )

I hope I was of help, if you have any further queries please get back to me

Regards

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

Follow up: Dr. Rakesh Madhyastha (1 hour later)

Thanks makes sense plus I've had extensive heart work ups so I should quit worrying about my heart which has caused major health anxiety that's overtaken me sometime now! I think allot is anxiety as well??

Answered by Dr. Rakesh Madhyastha (13 hours later)

Brief Answer:
Stop Tobacco

Detailed Answer:
Hello

Thanks for getting back

I am sorry for the short delay in my reply to you, it was a very busy day at the hospital.

I think you should stop worrying about the heart as it has been extensively studied by professionals, it will help if you stop chewing tobacco as well. Tobacco is known cause increased anxiety as well.

Do as I told in my previous post to you

Regards

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

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