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Dull constant chest pain in the left side and Marfan's syndrome - Online Doctor Chats

Date : 13-Jan-2012
User rating for this question
Excellent Posted in: Hypertension and Heart Disease
Answered by

General & Family Physician
Practicing since : 2005
Answered : 2408 Questions
Doctor :   Hi
Doctor :  
How can I help you?
User :   Hi my question is related to chest pain, left side
Doctor :  
Please go ahead
Doctor :  
I can help you
Doctor :  
Are you with me?
Doctor :  
Please explain your problme in detail
User :   I have been having an almost constant dull chest pain in my left side chest, sometimes as high up as the nipple, but about 3 or 4 inches lower than that.
User :   usually
Doctor :   Do you have the pain now?
User :   yes its been worse last few days
User :   I should give you a bit of my history though
Doctor :  
Yeah please go ahead
User :   I'm 27 yr old male, with a very few signs of marfan syndrome. I've had two collapsed lungs in last 7 yrs.
Doctor :   Was it confirmed to be Marfan's syndrome by the Doctor?
Doctor :  
or you presume to be?
User :   no several doctors mentioned it
Doctor :  
Ok
User :   but not a for sure
Doctor :  
ok
Doctor :   Do you have shortness of breath / dizziness ?
User :   none whatsoever
User :   the pain sometimes gets sharp real close to heart and is scary
Doctor :  
Do you have cough ?
User :   yes i have a cough about half of the year
User :   pretty much every year
Doctor :  
Can you describe the episode of chest pain
Doctor :  
clearly
Doctor :  
How does it start and its increase, radiation, spread etc
Doctor :  
When does it relieve
User :   scariest episode, was a few days ago when i walked about 1/4 mile or so and it hurt sharp directly where my heart is piercing straight through my back
User :   it stopped when i stopped
User :   But i got "sexercise" the same night and there was no sharp pain at all
Doctor :  
Were any tests done by Doctors
User :   yes i've had x-rays, catscans within a month, echocardiograms a few years back, but was in for same pain
Doctor :  
No did they reveal anything significatant in the heart ?
Doctor :  
Now let us talk about your lung collapse
Doctor :  
did they reveal anything significatant in the heart ?
Doctor :  
with CT scan or ECHO
User :   no they said my heart was healthy, even a specialty heart doctor said i was ok
Doctor :  
Ok good to hear
User :   he did advise to get checked yearly bcuz of my posible marfans but i didnt follow up, too expensive with all the docs
Doctor :  
Ok
Doctor :  
But did they mention why is it important to get checked
User :   because of my possible marfans syndrome
User :   and my very tall, thin stature makes them think I may have it or something similar to it
Doctor :   What about lung collapse?
Doctor :  
How did it happen?
Doctor :  
When were the two lung collapse
Doctor :  
Were they partial ?
User :   first was 6 years ago about 20%, second was 1 year ago 50% but right side
User :   i never have right side pain, only the day it collapsed and it was extremely severe
User :   pain that is
Doctor :  
Did the doctor never said the reason?
User :   they said it was common in tall thin males at a young age
Doctor :  
Is it Pneumothorax?
User :   yes
Doctor :  
yes this is seen in young thin individuals
Doctor :  
This time too it can be that?
User :   well thats the thing I've been in for this pain and they check for that, and they never find a thing
User :   the pnuemothorax feels different to me
Doctor :   usuall thereotically speaking the dull pain is of lung cause
Doctor :  
Do you have pain when you increase the breathing
User :   not that i can notice
Doctor :  
Do you have pain both the times of breathing in and breathing out
Doctor :  
Are you an athelete
User :   no
User :   i dont get very much exercise anymore really, i know that is bad
Doctor :  
Ok I understand
Doctor :  
This is the time you just need an Xray and ECG atleast if not many tests
Doctor :  
They can almost differentiate the cause of the dull chest pain
User :   I am due for an Echo in a week, but i was fearful because, of this sharper pain i get rarely, I'm almost used to the dull pain
Doctor :  
If this is sharper pain then you have to get an immediate X ray in a ER
Doctor :  
You started with dull pain
Doctor :  
now you have sharp pain
User :   yes
Doctor :   What is the grade of the pain on a scale of 1 to 10
User :   but i've been through this cycle many times in my life and have went to ER for it multiple times
Doctor :  
and what is the result in most of the times
User :   they send me home and come up with something different everytime that their prescription does nothing for
Doctor :   I understand your thoughts here, but every episode should be carefully evaluated though they might turn to be benign.

Doctor :   What is the grade of the pain on a scale of 1 to 10 now?
User :   7 probably
Doctor :   Ok but I suggest you to go through the same process of seeing at ER
Doctor :   we cannot certainly evaluate the seriousness of it
Doctor :  
with more questions
User :   that is correct
User :   so you suggest i go to ER now while I'm having the pain?
Doctor :   Yes
Doctor :  
Your pain can be benign but everytime it needs to be the same process of evaluation
User :   ok, i have been there before for same pain, but i understand what ur saying
Doctor :  
Do you have to pay at ER
User :   I have insurance it pays 80%, but evry time I get bills of 600 to 1500 dollars after coverage, and I got kids to feed
Doctor :  
I think the insurance covers it, right ?
Doctor :  
Oh
User :   I have been through bankruptcy because of the bills once
Doctor :  
Can you take the 100% coverage as you have this risk?
Doctor :  
I guess the premium is high
User :   no my insurance does not offer 100%
User :   i dont think
Doctor :   I think you can make time one day to enquire about other insurances
Doctor :  
and more research about it
Doctor :  
and zero a better policy for you
Doctor :   Don't you think that a good idea?
User :   sorry to go off the subject but does the aorta go down the left side of your body or is it center?
User :   and yes i think that is a good idea
Doctor :  
It is in the centre
User :   so left side pains couldn't radiate from the aorta in your opinion
Doctor :   If you are talking about the aortic dissection kind of that happens in Marfan's
Doctor :  
it is a severe tearing kind of pain
Doctor :  
and person hardly gives any time to collapse
User :   yes but i know that ends in death usually
Doctor :  
Not all the time
User :   so a 7 year pain cant be that
Doctor :  
but most of the time
Doctor :   since the wall of aorta is thick and in Marfans the wall is torn because of its poor integrity
Doctor :  
it slowly gives way
Doctor :  
but they can be caught by Trans eosophageal ECHO
Doctor :  
I guess this is what is being done for you next week
User :   yes if i can make it that long in this pain, and a bit scared too
Doctor :  
My suggestion is the same
User :   thanks for your suggestions, talking to someone about it does help, doctors at practice are always in a rush
Doctor :  
I know that is the reason
Doctor :  
I started this
Doctor :  
I am here to help you in non emergencies
Doctor :  
You can clear many of your doubts
User :   If the pain worsens any whatsoever tonight or in next week i will go to ER
User :   otherwise i guess i will wait for my Echo
Doctor :  
The warning signs are these
Doctor :  
Dizziness
Doctor :  
Intense sweating
Doctor :  
Shortness of breath and not able to do your activities
User :   are those for a torn aorta?
Doctor :  
any emergency, cardiac origin
User :   ok
Doctor :  
I think it helps
User :   i never have any of those just bad pain
Doctor :   I mean along with chest pain above 6 on scale of 10
User :   oh ok
User :   sorry i just wanna live long and prosper, maybe i am trying to deny truth?
Doctor :  

Please fill the feedback form
Doctor :  
You will
User :   thank you
Doctor :  
Do not get disheartened
User :   literally, lol
Doctor :  
These symptoms are only to say that you need more evaluation
Doctor :  
and not death
User :   yes very true
Doctor :  
A timely intervention can prevent lot many deaths
Doctor :  
or complications
Doctor :  
One shoudl lead a good quality of life
User :   yes i should definitely exercise a little at least and eat a little better
Doctor :  
Makes sense
Doctor :   Thanks for consulting me.
Doctor :  
Bye for now.
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