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What Causes Pain Under The Left Rib Cage?

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Posted on Mon, 15 May 2017
Question: Hello,
i have chest discomfort in left side under the chest and i already did stress test, ECHO, x ray, CT chest two times. the doctor want do Ct coronary angiogram . i am concern about this test because i already exposed to radiation from previous tests from few month. and for this test i will exposed to more radiation to 45 mSv . another doctor here said "I would not recommend performing a coronary angio CT scan, because of radiation and because your symptoms are not suggestive of a cardiac ischemia. "
do you recommend me to do this test and is the radiation safe ?
thank you

I would like to mention that i could do sport but the discomfort come in rest all the time
doctor
Answered by Dr. Indu Kumar (3 hours later)
Brief Answer:
It is far below the maximum allowable safe dose.

Detailed Answer:
Hello,
Thanks for writing to HealthcareMagic,
I've gone through your query and understand your concern,

I advise for angiography as you have symptoms in resting stage.
Though your age doesn't support possibility of cardiac problem but is important to rule out any coronary ischemia due to your symptoms.

Don't worry about CT radiation,it is far below the maximum allowable safe dose.
Spiral technique causes very less exposure and it can be recommended due to its highly accurate diagnostic ability.

Get well soon.

Hope I have answered your query.
Further queries are most welcome.

Take Care
Dr. Indu XXXXXXX
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Indu Kumar (22 minutes later)
Thank you
But another doctor didn't recommend me to do this test as he mentioned "In such case coronary angio CT is not considered a firm indication.

It may add beneficial information in regard of other potential structures involved in the pathophysiology of pain (chest CT may reveal other extracardiac disorders responsible for your current complaints (such as a backbone disorder, a hiatal hernia, a chronic pleural inflammation, an articular disorder,etc.).

But, it is not justified for concluding a coronary artery disease, as long as you don’t have other medical evidence (the performed cardiac tests has resulted normal) and coronary risk factors that raise sufficient suspicions about any cardiac issues.

So, my personal opinion would not go in favor of a coronary angio CT.

Regarding the differential diagnosis of several extra-cardiac causes that may be involved in your recent chest discomfort, I would recommend discussing with your doctor on the possibility of performing a chest MRI, which doesn’t utilize X ray imagine, so it does not produce harmful radiation."
What do you think


and also he mentioned "oming to this point, as all your previous cardiac tests have resulted normal and your symptoms are not typical of a cardiac disorder, I would not recommend performing coronary angio CT scan, because it would be just another dose of unnecessary radiation.

As your chest CT scan has resulted normal, other extra-cardiac causes have been excluded too.

So, in my opinion it is just anxiety or a musculo-skeletal pain. In my opinion your symptoms are not related to any cardiac disorders.

I would not recommend performing a coronary angio CT scan, because I find it unnecessary in your clinical situation.

Just try to relax and do not worry about !"

that's why i am not sure if i do CT coronary angio or not
doctor
Answered by Dr. Indu Kumar (18 hours later)
Brief Answer:
You may need proper and complete investigations.

Detailed Answer:
Hello,
Thanks for writing to HealthcareMagic,
I've gone through your query and understand your concern,
Sorry for replying late

It is right that there may be many causes related to your symptoms and therefore choice of investigations may vary with physician.
It is very important to examine clinically and history taking for proper choice of investigation.

You may need detail history taking to exclude some causes.

As we discussed earlier, though your age and investigation like(ECG and ECHO)doesn't support heart disease but we can't ignore symptoms in resting stage.

You may need proper and complete investigations.
I advise both MRI thorax and CT angiography. You may also need upper GI endoscopy.
We can't take chance and in such conditions and all related investigations are advised.

We are mainly concerned about radiation exposure.
CT angiography causes far less exposure than maximum allowable safe dose.So,it may be advised for diagnostic purpose.

Get well soon.

Hope I have answered your query.
Further queries are most welcome.

Take Care
Dr. Indu XXXXXXX
Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Indu Kumar (2 days later)
Thank you
but ECG , ECHO and stress test all for the heart determine blood vessels are working, why you mentioned they don't support heart disease.

and also can i take this supplement in the link with blood pressure medicine amlodipine 5mg, propranolol 20 mg and baby aspirin 81 mg .

XXXX
Asked by Me , 14 hours ago
The general doctor said i can't take it because will raise my blood pressure and because has stimulant but the cardiology said i can take and won't hurt me but i am not sure because not regulated from FDA
doctor
Answered by Dr. Indu Kumar (7 hours later)
Brief Answer:
ECG,ECHO and stress tests are normal,so it is doesn't indicate heart proble

Detailed Answer:
Hello,
Thanks for writing to HealthcareMagic,
I've gone through your query and understand your concern,
Sorry for replying late

As ECG,ECHO and stress tests are normal,so it is doesn't indicate heart problem.
But angiography is gold standard and most accurate to assess coronary heart vessels.

I don't think there are any problem related to above mentioned mediciens. These medicines are widely used and approved by FDA.

Get well soon.

Hope I have answered your query.
Further queries are most welcome.

Take Care
Dr. Indu XXXXXXX
Above answer was peer-reviewed by : Dr. Remy Koshy
doctor
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Follow up: Dr. Indu Kumar (1 hour later)
thanks
i will try do CT ango to make sure everything is fine. and do you think the chest discomfort from blood pressure medicine
but i mean can i use this supplement in the link
https://www XXXXXXX com/Brain-Juice%C2%AE-Herbal-Energizer-Nootropic/dp/B01I6ACGRU

with amlodipine 5mg, propranolol 20 mg and baby aspirin 81 mg because the supplement not regulated from FDA, please check the link and let me know
doctor
Answered by Dr. Indu Kumar (17 hours later)
Brief Answer:
Aspirin may cause acidity to some patients.

Detailed Answer:
Hello,
Thanks for writing back,
I've gone through your query and understand your concern,

Aspirin may cause acidity to some patients and it may cause epigastric and chest discomfort.
You may take proton pump inhibitors like Omeprazole/Pantoprazole once daily for prevention.

Sorry, I mean to say that main medicines (amlodipine, propranolol, and aspirin) are FDA approved, not supplement mentioned in your query.

Get well soon.

Hope I have answered your query.
Further queries are most welcome.

Take Care
Dr. Indu XXXXXXX


Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Indu Kumar (3 hours later)
Hi
the doctor gave me Omeprazole 20 mg and aspirin but i stopped taking them because another doctor online recommend me to stop them because he said aspirin will make internal bleeding and he recommended me to stopped it so i stopped it. he said i don't need it because i don't have heart problem . what do you think
and is it safe to take these supplement with these medication

XXXX
thanks you
doctor
Answered by Dr. Indu Kumar (20 hours later)
Brief Answer:
You may start medicines after investigations.

Detailed Answer:
Hello,
Thanks for writing back,
I've gone through your query and understand your concern,

It is o.k if you have stopped taking medicines.
You may start medicines after investigations.

You can take supplement ,I don't think it is harmful.

Get well soon.

Hope I have answered your query.
Further queries are most welcome.

Take Care
Dr. Indu XXXXXXX

Above answer was peer-reviewed by : Dr. Raju A.T
doctor
Answered by
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Dr. Indu Kumar

Radiologist

Practicing since :2004

Answered : 6729 Questions

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What Causes Pain Under The Left Rib Cage?

Brief Answer: It is far below the maximum allowable safe dose. Detailed Answer: Hello, Thanks for writing to HealthcareMagic, I've gone through your query and understand your concern, I advise for angiography as you have symptoms in resting stage. Though your age doesn't support possibility of cardiac problem but is important to rule out any coronary ischemia due to your symptoms. Don't worry about CT radiation,it is far below the maximum allowable safe dose. Spiral technique causes very less exposure and it can be recommended due to its highly accurate diagnostic ability. Get well soon. Hope I have answered your query. Further queries are most welcome. Take Care Dr. Indu XXXXXXX