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What Causes Chest Pain?

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Posted on Thu, 30 Oct 2014
Question: I had an upper endoscopy today to hopefully determine the cause of chest pain I've been having. The doctor said everything looked normal. He rushed out of the room so I was unable to ask him a question. My question is this: I have very brief (seconds) pangs of pain in my chest (mostly center but also left and right of each breast) that are sometimes accompanied by pain or a hit-your-funny-bone feeling in my elbows and/or wrist. These pains lasts just 15-45 seconds and seem to be relieved by burping. What could be the cause of these pains if I had a normal upper endoscopy? I have had a stress test and my doctor said it's not my heart - would chest wall pain cause the pains throughout my chest and even into my elbow/wrist? Or would GI pain be felt in those joints? Thank you.
doctor
Answered by Dr. Enrique Molina (1 hour later)
Brief Answer:
unlikely GI related

Detailed Answer:
the fact that your upper endoscopy was unremarkable, and you remain in pain makes it highly unlikely that your pain is from the GI tract in origin. Even less likely if it radiates to your arm. I see you had a normal cardiac evaluation. My impression is that your pain is musculoskeletal, a condition called costochondritis, particularly if it is short lasting. it is usually associated with movement, and pain respond to anti-inflammatories. Another consideration is fibromyalgia, in which certain areas are more sensitive, and pain is worsened by pressing in certain trigger points of the body. Ask your doctor to check for it during your next physical exam.
If the pain worsens when you swallow or eat, then another test that can be considered is an esophageal manometry, which serves to measure the pressures of the muscles of the esophagus (which can't be assessed during a regular endoscopy). But based on the information you provided i wouldn't consider it now.
Hope that helps, let me know if you have further questions
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Enrique Molina (11 minutes later)
Could the costochondritis be differing pain to the arms as I've mentioned above? I did have a stress test show normal bit I'm not sure that would even be an adequate test to rule out cardiac pain? Are my symptoms common of a cardiac condition? Like I said the pain happens at completely random times and happens about 15-30 times per day. It is often accompanied by the twinge of pain in my arms. It is very brief but it does concern me. I think it has caused anxiety because I am now experiencing dizziness throughout the day (also at random times) and my doctor says that is anxiety.
doctor
Answered by Dr. Enrique Molina (1 hour later)
Brief Answer:
it does not seems to be the heart

Detailed Answer:
based on your description it does not seem to be the heart. The fact that it occurs so many times a day, and lasts for so little time goes against a heart condition. A stress test is a good test; another option which you may have had already is an EKG (electrocardiogram).
Costochondritis may occur in multiple joints and therefore the arm pain and chest pain are likely related (but not necessarily).
The dizziness should not be related to the pains you are having, but i agree that if you become anxious when the pain starts, you may become dizzy.
You are very young to have any cardiac condition, therefore if a stress test and an EKG are normal, i would forget about the heart at this time.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Enrique Molina (6 minutes later)
One last question: I had a massage the other day and it left me VERY dizzy afterwards for about 15-20 minutes. I was VERY, very dizzy for 5 minutes then was able to walk but still felt off for the remaining 10-15 minutes. I know that's a little off subject but that dizziness does seem like it could have been anxiety and I'm wondering if that could be a clue to the rest of the story. Does that burst of dizziness have any plausible connection to any of the ailments (chest pain, random dizziness, etc.) I've previously stated? I apologize for having so many Q's - I have been very concerned about the cheat pain and this has all left me so confused and I am really at a loss for an explanation after my endoscopy came back normal today.
doctor
Answered by Dr. Enrique Molina (22 minutes later)
Brief Answer:
yes

Detailed Answer:
anxiety can manifest in multiple ways. dizziness is definitely a common one, but pain is also manifestation, and all your symptoms could be secondary to anxiety. In your case i would suggest getting treated for the anxiety and see if pain goes away.
Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Enrique Molina

Internal Medicine Specialist

Practicing since :2004

Answered : 364 Questions

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What Causes Chest Pain?

Brief Answer: unlikely GI related Detailed Answer: the fact that your upper endoscopy was unremarkable, and you remain in pain makes it highly unlikely that your pain is from the GI tract in origin. Even less likely if it radiates to your arm. I see you had a normal cardiac evaluation. My impression is that your pain is musculoskeletal, a condition called costochondritis, particularly if it is short lasting. it is usually associated with movement, and pain respond to anti-inflammatories. Another consideration is fibromyalgia, in which certain areas are more sensitive, and pain is worsened by pressing in certain trigger points of the body. Ask your doctor to check for it during your next physical exam. If the pain worsens when you swallow or eat, then another test that can be considered is an esophageal manometry, which serves to measure the pressures of the muscles of the esophagus (which can't be assessed during a regular endoscopy). But based on the information you provided i wouldn't consider it now. Hope that helps, let me know if you have further questions