Hi,
Noted your history about pain in back at bottom of left rib area, that comes and goes, normal echocardiaography, known
pleurisy.
As per the history you have provided, it may be pleurisy that gives such pains.
Since the pain is at hte lowest ribs,
costochondritis also needs to be considered.
I would advise you the following in such a situation:
Consult your Doctor and get a referral for a Pulmonologist.
Clinical evaluation can help the nest to find the cause by local palpation, auscultation and investigations like
CT scan of chest and as needed or advised.
All these will give the most proper diagnosis and thus help to get an appropriate management.
Hope I have answered your query. Let me know if I can assist you further.
Regards,
Dr. T Chandrakant, ENT & General Surgeon