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Having pain in chest, back, neck and shoulders. Done with ECG and experiencing ectopic beats. Suggest treatment?

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I often have pain in my chest, back, neck, jaw, shoulders (most often left shoulder radiating down the left arm and into the left hand) and back of head. I have been checked for heart problems and all results have come back clear. The tests I had included and amounted too: ECG, and a 24 Hour Heart Monitor (That I wore under my clothes for 24 Hours)
The results were that I was experiencing eptopic beats, and due to my having frequent heart palpitations, I was feeling them.
But this pain is something that I feel at great length and it is bothering me greatly.
I am in the UK, and the doctors I use here are on the NHS, and they don't offer much advice in way of these pains, I have put up with them with no answer for so long, that I have now signed up to private health insurance instead of the National Nealth Servoce (they are a great service, but sometimes one needs a little more than relaxed medical care)

It is often worse after I have eaten, and with physical exercise / exertion.
I don't smoke, but I do use an e cigarette (electronic cigarette).
Posted Wed, 11 Sep 2013 in Hypertension and Heart Disease
Answered by Dr. Anantharamakrishnan 2 days later
Brief Answer:
You need Endoscopy & TMT

Detailed Answer:
Hi friend,
Welcome to Health Care Magic

Relation to meals dictates the need for upper GI endoscopy to evaluate Oesophagus ans stomach

     Coronary Artery Disease needs to be excluded in view of relation to exercise... It is better to have a Treadmill Exercise Electrocardiogram (TMT). If it is normal, nothing to do...
     If TMT (Treadmill Exercise ECG) suggests ischemia, it is an indication for further work up – because at times, there may be false positive or false negatives. The next step is TMT with thallium isotope. It is the ideal non-invasive way to evaluate ischemia / to assess the PHYSIOLOGY (function) – to see whether the blood arriving at the heart muscle.
     If there is a suggestion, the next step is to see the ANATOMY (structure) – undergo catheterisation and coronary angiography with a view for possible intervention. It is the only way to directly ‘see’ the block, if any – and its location, extent, severity and so on. Coronary arteriography is invasive but it is the gold standard for this.
[CT angio is non-invasive study for the anatomy. If positive, she will need catheterisation, anyway.]
     The ectopic beats appear to be benign / and could also be from salbutamol...
The treating doctor alone can suggest further based on his assessment of the situation.

Take care     
Wishing speedy recovery
God bless
Good luck
Above answer was peer-reviewed by
Follow-up: Having pain in chest, back, neck and shoulders. Done with ECG and experiencing ectopic beats. Suggest treatment? 1 hour later
Hi there,

Thank you for your reply

I was wondering if perhaps an X XXXXXXX could show anything that would show anything as the mentioned.
I ask as I had an X XXXXXXX on my chest due to problems with taking a 'deep and satisfying' breath for a number of weeks (potentially a month or two) I have attached a picture of the X XXXXXXX (I was allowed to photograph the X XXXXXXX when I was able to view it at the hospital)

The X XXXXXXX result came with a partial diagnosis of COPD, I say partial as I have yet to see a chest specialist regarding further tests and a full diagnosis from the initial result.

I had an endoscapy arpund a year (maybe 12 to 18 months) ago and had a clear result, however I am diagnosed with GORD or something simular to do with gastric reflux. I have medication for this but often I find it less effective than I would like.

I quit smoking two weeks ago, and as per my previous message, started using E Cigaretts instead, in the last week, I have noticed significant improvement in my palpitations and in my asthma (as a smoker I would awake in a morning needing my inhalers instantly, whereas in as little as just two weeks as a non smoker, I no longer need a hit from my inhalers as soon as I wake up, in fact, I have to remind myself to use them, which is wonderful)

The pain however is still quite bad, and I find that it hurts greatly when I press down or tap on the areas where I feel the pain.

Answered by Dr. Anantharamakrishnan 2 hours later
Brief Answer:
need more test / additional drugs...

Detailed Answer:

     This X-ray certainly corroborates the diagnosis. There is no doubt. CT chest and lung function tests (spirometry) are often necessary to evaluate COPD and form a baseline for future assessment and comparison. Pulmonologist (Chest specialist) is the appropriate specialist for further assessment and assistance

     Probably you are given Proton Pump Inhibitors for your reflux... Addition of and prokinetic agents like domperidone / antacids like magaldrate may help... I usually suggest such combinations to my patients for better results. Sleeping with head end elevated, not lying down for an hour or two after eating add to the benefit...

     It's good that you have stopped cigarettes.... Many electronic cigarettes may also contain nicotine... The benefits need proof still... The best solution is to stop smoking – immediately, completely and permanently... The smoking disease is an addiction like other substances and be helped by de-addiction specialists, for the long term. It is important to avoid the company of smokers....

     Pain on pressing usually means local cause – generally inflammation like costochondritis... / and is generally has no serious consequences.. It improves gradually with time and rest. Regular pain killers like advil can take care of severe pain.

     Anti-depressants (like SSRI, SNRI class) and anti-epileptics (like gabapentin) elevate the pain threshold and help – irrespective of the cause or nature of pain.. If pain bothers you every day, you can ask your doctor about this group of drugs.

Hope this helps. Let me know if you need clarifications.

Above answer was peer-reviewed by
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