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Extreme chest pain that feels like gas. EKG, blood work normal, no heart issues. Any suggestions ?

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General & Family Physician
Practicing since : 2004
Answered : 1722 Questions
Periodically, I get extreme chest pain that feels like gas build up. It feels like a ballon is inflating in my chest. The onset is rapid and it can last anywhere from 5 minutes to about 90 minutes. The pain is dull and can range from mild discomfort to severe, usually severe. It does not effect my breathing, but the pain can sometimes take my breath away. I've seen a doctor, a GP, and my EKG was normal and my blood work showed no sign of heart muscle damage. He ruled out heart issues and said it's probably nothing. I'm sure that's true but I'd still like to know what the problem is so I can prevent it and/or get relief when it happnes. I can't have this happening to me at work, it's fairly debilitationg. Any suggestions?
Posted Tue, 22 May 2012 in Lung and Chest disorders
Answered by Dr. Chakravarthy Mazumdar 11 hours later

Thank you for the query.

From the complaints, it was essential to have a cardiac check up and it turned out to be the normal. That is a good news as the most important organ is preserved.

Such debilitating chest pain can be from acute peptic ulcer disease, Acid reflux disease, gall bladder diseases like gall stones with biliary colic and oesophageal disorders.

The best next step would be an Upper GI endoscopy and Ultrasound abdomen.

If you do not want to be investigated now. You should try a course with proton pump inhibitors (PPI) like Omeprazole or Pantaprazole. Omeprazole is available over the counter ( PRILOSEC OTC 20mg )for 2 to 4 weeks, once a day before breakfast. A 40mg dose is better which you can get it with a local doctor. The pain can be eased with Syrup PEPTOBISMOL or any over the counter anti ulcer medicines within minutes. Did you try it? You can get an Ultrasound scan abdomen during this period to look for large gall stones.

If the PPI course is not effective the next step would be an upper Gut endoscopy and CT (computed tomography) scan abdomen.

You can prevent further episodes or less debilitating episodes by:
1) Avoid coffee, peppermint and lying on the bed immediately after meal
2) Raise the head end of the bed
3) Avoid tight clothing
4) Smaller and frequent meals
5) Bland diet which needs more chewing helps in release of alkaline enzymes.

Let me know if this fits your description.
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