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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Chest Discomfort?

I am having some discomfort in my chest, and goes into my back. Mostly in middle. I haven t every really had heartburn so I didn t know if that could be the cause. I had a chest xray about 3 wks ago checking for pneumonia or bronchitis. No other real symptoms other than feeling tired.
Tue, 18 Apr 2017
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General & Family Physician 's  Response
Hi, If I were your treating Doctor for this case of discomfort in chest, I would come up with three possibilities, these include:

The first possibility is Heartburn/acid reflux is a symptom of GERD(Gastroesophageal reflux disease). It could be due to irregular diet patterns. Some common foods that we eat and drink, stimulate increased stomach acid secretion setting the stage for heartburn. Over-the-counter medications also may precipitate heartburn. Examples of these irritants include: alcohol, caffeine,aspirin, ibuprofen (Motrin, Advil, Nuprin, etc.)
Naproxen (Naprosyn, Aleve), carbonated beverages,acidic juices (grapefruit, orange, pineapple)
acidic foods (tomatoes, grapefruit, and oranges), and chocolate. Even smoking Smoking and the consumption of high-fat content foods tend to affect function of the lower esophageal sphincter (LES), causing it to relax from the stomach and allow acid to reflux into the esophagus.

A hiatal hernia where a portion of the stomach lies within the chest instead of the in abdomen, can affect the way the LES works and is a risk factor for reflux. Hiatal hernias by themselves cause no symptoms. It is only when the LES fails that heartburn occurs.

Antacids may be taken after meals, at bedtime, or when needed, to bind excess acid in the stomach and to coat the esophagus.
Proton pump inhibitors (PPIs) are another class of drugs that block the production of acid by the stomach. PPIs include: omeprazole (Prilosec, Rapinex), rabeprazole (Aciphex)

The second possibility of your chest discomfort is Peptic ulcer disease. Diagnosis can be confirmed by upper GI endoscopy. Try raising the head of your bed about four inches with blocks. It also might help to avoid eating or drinking for two hours before you lie down. To help control the stomach acid, one should not drink alcohol or drinks with caffeine in them, or eat chocolate or spicy or greasy foods. Also take some antacid but if the symptoms are severe, then you may need drugs like proton pump inhibitors.

The Third possibility:
If the chest pain is related to exertion. Another important possibility would be Angina. Coronary heart disease blockage in the heart blood vessels that reduces blood flow and oxygen to the heart muscle itself. This can cause pain known as angina. It's a symptom of heart disease but typically does not cause permanent damage to the heart. It is, though, a sign that you are a candidate for a heart attack at some point in the future. The chest pain may spread to your arm, shoulder, jaw, or back. It may feel like a pressure or squeezing sensation. Angina can be triggered by exercise, excitement, or emotional distress and is relieved by rest. You may have to get EKG done and if any ECG changes are revealed. Echo and angiography are necessary to clear the blockage.

As you do not have any cough and shortness of breath and normal chest x-ray, The possiblity of respiratory infection is less.

I suggest you to consult a physician and get an EKG done.

Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions.

Wishing you good health.
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What Causes Chest Discomfort?

Hi, If I were your treating Doctor for this case of discomfort in chest, I would come up with three possibilities, these include: The first possibility is Heartburn/acid reflux is a symptom of GERD(Gastroesophageal reflux disease). It could be due to irregular diet patterns. Some common foods that we eat and drink, stimulate increased stomach acid secretion setting the stage for heartburn. Over-the-counter medications also may precipitate heartburn. Examples of these irritants include: alcohol, caffeine,aspirin, ibuprofen (Motrin, Advil, Nuprin, etc.) Naproxen (Naprosyn, Aleve), carbonated beverages,acidic juices (grapefruit, orange, pineapple) acidic foods (tomatoes, grapefruit, and oranges), and chocolate. Even smoking Smoking and the consumption of high-fat content foods tend to affect function of the lower esophageal sphincter (LES), causing it to relax from the stomach and allow acid to reflux into the esophagus. A hiatal hernia where a portion of the stomach lies within the chest instead of the in abdomen, can affect the way the LES works and is a risk factor for reflux. Hiatal hernias by themselves cause no symptoms. It is only when the LES fails that heartburn occurs. Antacids may be taken after meals, at bedtime, or when needed, to bind excess acid in the stomach and to coat the esophagus. Proton pump inhibitors (PPIs) are another class of drugs that block the production of acid by the stomach. PPIs include: omeprazole (Prilosec, Rapinex), rabeprazole (Aciphex) The second possibility of your chest discomfort is Peptic ulcer disease. Diagnosis can be confirmed by upper GI endoscopy. Try raising the head of your bed about four inches with blocks. It also might help to avoid eating or drinking for two hours before you lie down. To help control the stomach acid, one should not drink alcohol or drinks with caffeine in them, or eat chocolate or spicy or greasy foods. Also take some antacid but if the symptoms are severe, then you may need drugs like proton pump inhibitors. The Third possibility: If the chest pain is related to exertion. Another important possibility would be Angina. Coronary heart disease blockage in the heart blood vessels that reduces blood flow and oxygen to the heart muscle itself. This can cause pain known as angina. It s a symptom of heart disease but typically does not cause permanent damage to the heart. It is, though, a sign that you are a candidate for a heart attack at some point in the future. The chest pain may spread to your arm, shoulder, jaw, or back. It may feel like a pressure or squeezing sensation. Angina can be triggered by exercise, excitement, or emotional distress and is relieved by rest. You may have to get EKG done and if any ECG changes are revealed. Echo and angiography are necessary to clear the blockage. As you do not have any cough and shortness of breath and normal chest x-ray, The possiblity of respiratory infection is less. I suggest you to consult a physician and get an EKG done. Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing you good health.