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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Painful Rib Cage And Back, Affected Breathing, Tuberculosis History With Pleural Effusion. Quit Smoking. What Is The Diagnosis?

Almost a week back I was into my normal routine of cycling for 15mins and then weight training, by midway through the weight training routine, I suddenly felt a searing pain at the back of my rib cage. It was only on the left side. The back side of the chest felt tight and pain became worse with breathing and movement especially if I bent forward or twisted my body. It eased out if I breathed from my stomach.
The tightness and acute pain was there for a couple of days and then started easing out. The pain has been there for a week now but has reduced and I have not taken any pain killers. Breathing discomfort has reduced and I feel some pain only when I exert to breathe in deep or exhale completely.

I have a history of tuberculosis (about 10yrs back) with pleural effusion that was cleared using a needle & pipe and had continued medications for around 6 months.

I am a current smoker and smoke about 5-6 sticks a day usually, could be lesser on some days. I quit smoking 2 days back fearing the worst and since then have experienced tightness in my chest and breathlessness i.e. howsoever deep I breathe I feel lack of oxygen...however this comes and goes. Specifically this morning I was almost sure that the pain I had experienced was pleural pain and could be due to a cancerous condition and at that time I started feeling completely out of breath though I was just sitting, now it is gone and I am running around the office without feeling any breathlessness.

What is your diagnosis?
Mon, 4 Nov 2013
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General & Family Physician 's  Response
Hello,
Thanks for the query to H.C.M. Forum.
If I were your treating doctor for this case of severe case of chest pain on the left side rib cage , I would come up with these possibilities , these includes.
1 Pleural effusion , diagnosis can be confirmed by chest X ray . As recurrence of pleurisy is very common , if proper precaution is not taken as in your case ( you mentioned that still you are a smoker).
2 Next possibility may be due to peptic ulcer disease , as pain is centralized only one portion and this may be due to acute gastritis . As sometimes patient feels breathlessness in acute gastritis . Diagnosis can be confirmed by upper G I endoscopy . Avoid greasy , spicy foods , alcohol, drinks with caffeine in them , smoking. Also take some antacid ,but if symptoms are severe you may need drugs like proton pump inhibitors.
3 Consolidation of left lung , diagnosis can be confirmed by X ray chest.
In my opinion consult a physician and get his opinion.
Good luck. Dr.HET
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Painful Rib Cage And Back, Affected Breathing, Tuberculosis History With Pleural Effusion. Quit Smoking. What Is The Diagnosis?

Hello, Thanks for the query to H.C.M. Forum. If I were your treating doctor for this case of severe case of chest pain on the left side rib cage , I would come up with these possibilities , these includes. 1 Pleural effusion , diagnosis can be confirmed by chest X ray . As recurrence of pleurisy is very common , if proper precaution is not taken as in your case ( you mentioned that still you are a smoker). 2 Next possibility may be due to peptic ulcer disease , as pain is centralized only one portion and this may be due to acute gastritis . As sometimes patient feels breathlessness in acute gastritis . Diagnosis can be confirmed by upper G I endoscopy . Avoid greasy , spicy foods , alcohol, drinks with caffeine in them , smoking. Also take some antacid ,but if symptoms are severe you may need drugs like proton pump inhibitors. 3 Consolidation of left lung , diagnosis can be confirmed by X ray chest. In my opinion consult a physician and get his opinion. Good luck. Dr.HET