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Pinching pain under left breast. Done Ekg, Triponin, dimer test, chest X-ray

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Infectious Diseases Specialist
Practicing since : 2002
Answered : 871 Questions
I woke up a week ago with a strange pinching pain under my left breast into i guess felt like through the rib cage. Had gone to ER they ran Ekg and Triponin and dimer test. All normal including chest xray.

Now im getting loud gurgling and rumbling in my belly and upper abdominal pain that started off dull but now is radiating all over my stomach and into my back and chest.

I went to a walk in clinic and the dr gave me a requisit for ultrasound to do today.

Is this something i should goto er for to have them check? They only checked my heart. :-/

Im worried because now my toes are getring numbness and i have other health issues too.
Including a positive igenix lyme test (igm) but doctors here dont recognize that lab.
Posted Thu, 7 Nov 2013 in Abdominal Pain
Answered by Dr. Roopa Hiremath 3 days later
Brief Answer:
Gastritis and Lymes disease

Detailed Answer:
Thanks for choosing health care magic.
I have gone through your query and I want to discuss your symptoms and rule out disease conditions.

Pinching pain in the chest: This symptom gives rise to suspicion that it could be either angina (cardiac cause) or gastritis and acid reflux.

The doctors in the ER have ruled out angina by doing EKG and other tests.

The other most common reason for upper abdominal pain is acute gastritis.
This condition presents with dull abdominal pain which is usually diffuse all over the abdomen and may radiate to back and chest.

I suggest you get in touch with your GP for a prescription of antacids, and preferably a proton pump inhibitor (Pantoprazole) which has to be taken twice daily before food for a week. I also suggest a smooth muscle relaxant to relieve your pain.
Ultrasound of abdomen can be done to rule out other causes of abdominal pain as suggested by your doctor.

Lymes disease: This disease is caused by tick bite and presents as fever, rash with joint pains.
Diagnosis of this disease is tricky as the antibody response appears late in this infection.

The symptoms of this disease vary according to the stage of the disease.
I suggest a confirmatory test like ELISA for IgM and IgG antibodies.
I suggest a confirmation of the disease first and then appropriate therapy can be taken subsequently.

I hope I have answered your query satisfactorily.


Above answer was peer-reviewed by
Follow-up: Pinching pain under left breast. Done Ekg, Triponin, dimer test, chest X-ray 35 hours later
Do most doctors recognize the Igenix testing or do they only take a cdc titre test seriously. Ive had an XXXXXXX test done, it was neg and informed me to test again in 4 weeks. The igenex test was a strong positive. I have brain lesions. Over ten of them. I didnt have brain lesions 5 years ago.
How late in disease usually does it take to show positive. My igm was positive and igg neg.
Answered by Dr. Roopa Hiremath 17 hours later
Brief Answer:
diagnosis detailed below

Detailed Answer:
Apologies for the late reply.

Lymes disease occurs in 3 stages:
Stage 1 - Round rash around the tick bite which is spreading and itchy. This occurs after 3-30 days after tick bite.
Stage 2 - Occurs few weeks after stage 1. Here patient has fever, headache, body pain, joint pains and lymph node swelling. Some patients can develop brain lesions during this stage.
Stage 3 - Also called persistent infection. This sets in months to years after stage 2 and characterized by joint pains, skin rashes, neurological symptoms and brain lesions.

Diagnosis of Lymes disease:
There have been reports of discrepant results given by IGeneX Lymes test and hence is not considered reliable by many labs.

CDC recommends two step testing process for Lymes disease.

First test is usually an Enzyme Immunoassay.(ELISA)
If it is negative, no further testing required.
Other diagnosis should be considered.

If first test is positive or indeterminate (not clear) then a second test is done to confirm using western blot test for IgG or IgM depending on the number of days the patient has had symptoms.

If patient has had symptoms for less than 30 days, both IgM and IgG testing is done.

If patient has had symptoms for more than 30 days, only IgG testing is done.

As mentioned in my previous reply, Lymes disease diagnosis is tricky because antibody response appears late in this infection.

Normally in any bacterial infection, IgM antibody is produced within the first week of the infection and then later IgG antibodies appear in the blood.

But in Lymes disease, the antibody response of IgM appears at 20 to 30 days of infection followed by IgG.

Hence it is easily missed during early infection and the doctor diagnoses Lymes based on clinical signs and symptoms.

I would suggest confirmation of the Lymes disease and further therapy based on test results.

I hope I have cleared your doubts.


Above answer was peer-reviewed by
Follow-up: Pinching pain under left breast. Done Ekg, Triponin, dimer test, chest X-ray 44 minutes later
Thankyou yes you have. If i am positive will the igm or igg show positive via western blot? The test says igm/igg so i shod assume igs the western blot test? And are thoses frequently false negatives? I did tbe second half yesterday.
Sorry i will stop asking questions after this.
Answered by Dr. Roopa Hiremath 10 minutes later
Brief Answer:
Western Blot is confirmatory

Detailed Answer:
Western blot is a confirmatory test and as it has been more than 30 days since your symptoms, IgG will be detected rather than IgM.

False negative results in Western blot is rare. If it is negative I suggest you get in touch with your treating doctor and explore other causes for the present symptoms.


Wishing you a speedy recovery.
Above answer was peer-reviewed by
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