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What Causes Severe Chest Pain Located Below Th Ight Collar Bone?

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Posted on Mon, 30 Jun 2014
Question: Hi,
I am currently working offshore on my privately owned boat. I am aged 27, active and healthy. I am currently suffering severe deep upper right chest pain located almost on or just below my right collar bone. Laughing or taking deep breaths increases pain severely. Two days ago it started as mild chest pain in that area and has progressed. Three days ago I also suffered flue type symptoms on which a treated with rest and Codral cold and flu tablets. The Flue symptom's cleared up and these new symptom's started around 24 hrs later.
I will be seeking medical advise as soon as convenient but would like to hear your take on this could possibly be.

Kind Regards XXXXXXX
doctor
Answered by Dr. Hardik Thakker (44 minutes later)
Brief Answer:
please read detailed response

Detailed Answer:
Dear XXXXXXX

I have read your clinical case scenario. I would put forth the following differential diagnosis for the chest pain:

1) Pleuritic chest pain: this can be due to inflammation of the lung pleura due to bacterial or viral infection.

2) Musculo-skeletal pain: this can be due to injury to the medial clavicle or the joint causing pain.

3) Tietz's syndrome of the first or second rib: this can sometimes present as pain.

4) Costochondritis.

I would recommend you to have an X-ray of your chest to help us narrow down the diagnosis. I am not sure if it is possible at your work place. Therefore until you get to see the doctor, you can continue using pain reliever such as ibuprofen 400mg twice a day and muscle relaxant.

Since you had this pain following flu like symptoms and the flu symptoms went away, you most likely will improve in a few days. But seek immediate help if pain worsens.

I hope this helps you out. If you have any more questions, please do not hesitate to write back to me.

Yours sincerely,
Dr Thakker.
Note: For further follow-up it is advisable to consult an emergency medicine specialist. Click here.

Above answer was peer-reviewed by : Dr. Prasad
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Answered by
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Dr. Hardik Thakker

Internal Medicine Specialist

Practicing since :2006

Answered : 161 Questions

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What Causes Severe Chest Pain Located Below Th Ight Collar Bone?

Brief Answer: please read detailed response Detailed Answer: Dear XXXXXXX I have read your clinical case scenario. I would put forth the following differential diagnosis for the chest pain: 1) Pleuritic chest pain: this can be due to inflammation of the lung pleura due to bacterial or viral infection. 2) Musculo-skeletal pain: this can be due to injury to the medial clavicle or the joint causing pain. 3) Tietz's syndrome of the first or second rib: this can sometimes present as pain. 4) Costochondritis. I would recommend you to have an X-ray of your chest to help us narrow down the diagnosis. I am not sure if it is possible at your work place. Therefore until you get to see the doctor, you can continue using pain reliever such as ibuprofen 400mg twice a day and muscle relaxant. Since you had this pain following flu like symptoms and the flu symptoms went away, you most likely will improve in a few days. But seek immediate help if pain worsens. I hope this helps you out. If you have any more questions, please do not hesitate to write back to me. Yours sincerely, Dr Thakker.