Doctors' Answers to "Frequently Asked Questions" - Chest Pain

These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An individual patient is always advised to consult their own physician.

Chest Pain [posted 1/14/99]
Question: For the past few days I've been getting an intermittent pain in the middle of my chest, sometimes sharp, sometimes dull, and lasting no more than a second or two. It comes without warning, can occur when I'm just sitting (I have a very sedentary lifestyle), and seem to have no bearing on my meal patterns. It's like a spasm of some sort and the pain can radiate across my chest and down my left arm. These spasms can come a few minutes apart or I could go several hours between them. They do not occur when I'm asleep at night. I am prone to anxiety-related symptoms and wonder if this is anything to be worried about?

Answer: You won't be able to tell without a physical. Could be your heart, stomach, anxiety, gall bladder or esophagus. You need to see a doctor.

Chest Pains [posted 1/7/99]
Question: The other night I woke up with severe pains in the right side of my chest. It depended on which way I moved, but it came in waves. Could this have been something serious, or a muscle pain or something less serious? I do workout, and thought it could be a muscle pain.

Answer: Pain with movement could be several things and muscle painis clearly one of them.

Non-Cardiac Chest Pain [posted 7/23/98]
Question: I'm 25, have been cleared of heart problems, and suffer from chronic chest pain. Acid-blockers don't work. Anti-spasmodics don't work. I even got talked into having my gallbladder taken out, which only made things worse. What's left for me, as far as treatment is concerned?

Answer: To be able to decrease the pain, you will need to know the cause. Tests which you might need include the Bernstein Test (intraesophogeal acid monitoring) and esophogeal monitoring to look for spasm. If you have already had these tests, symptomatic relief with calcium channel blockers for esophogeal spasm (or common duct spasm), propulsid (for reflux since acid blockers were insufficient) or nitroglycerin (usually a long lasting form like Isordil or Imdur) one at a time until symptom relief can be achieved. If it has been determined that nothing life threatening is going on, so focus on other medications for symptom relief.

Chest Pain [posted 7/17/98]
Question: I'm in good health though about 30 pounds over weight. Recently I've been experiencing pains in my chest, under my right breast they come and go either when I'm active or not. I have no lumps, and no other symptoms. Should I be worried?

Answer: Pain in the right side of the chest is never heart disease. However, there are a few possibilities which might warrant follow up. First, pain from your gall bladder can be felt here. Second, liver inflammation is sometimes felt here. Thirdly, lung tumors/masses will occasionally present with pain (serious but uncommon usually painless). Lastly, and most likely is a pull in the muscles/ligaments of you ribs.

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