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Have chest pain. Chest x-ray normal. Chest Woke up feeling squeezing and intense pain. Suggest?

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Practicing since : 1998
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I have had alot of chest pain but at the er I had ecg which came back normal but with a unspecific twave abnormality. I also had blood and a chest xray which came back fine. i also had a stress test done which showed the same twave thing but it got better once exercising. and the cardiologist said it was normal. but I have been having a pain under my left breast on and off as well as a swelling as seen in the picture I can feel something swollen going from my side to the middle of my chest is this anything major?(artery, blood vessel) my doctor didnt seem to think so. but the other night I woke up with that section feeling like it was getting squeezed it was intense and relaxed for a few and it went away I have also been having severe acid reflux I just dont know if I should go to the er again I think they think im nuts I have been there at least 4 times in the past 2 months or wait til I get my endosvopy done. I just dont know how to pursue this do u think everything is fine and/or do u reccomend any tests I could suggest to my dr or the er staff? I can also upload a copy of my ecg so u can see
the twave issue
Posted Fri, 18 Oct 2013 in Hypertension and Heart Disease
Answered by Dr. Sukhvinder Singh 1 hour later
Brief Answer:
please see below

Detailed Answer:
Dear Sir
1. A pain chest associated with local swelling is atypical for cardiac or heart related pain. It is more likely to be a local pain.
2. If you could perform the stress with good exercise capacity and there was no repetition of pain during exercise phase of stress test, then likelihood of pain to be anginal is low. Once a stress test comes normal, non-specific T waves does not carry any significance.
3. The pain of angina comes with exertion/ exercise and goes away with rest. It is usually behind breast bone. It may radiate to arms , jaw or upper abdomen. The pain which can be localized, elicitable by touch or pressure, not related to exertion is less likely to be anginal.
4. If you have severe pain you must go to the ER. You have to go their till they resolve the issue. If there is a swelling also, the you should get yourself examined by a surgeon also.
5. Reflux disease can be a possibility for pain and endoscopy is likely to be helpful.
Hope this helps. Feel free to discuss further.
Above answer was peer-reviewed by
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