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Chest, arm and shoulder pain. Worse with exertion. Diagnosed with costochondritis. Help

Just went to the er with worsening chest, lt arm, shoulder pain, sob with exertion. My d dimer was 664, cpk 42, bnp 23, ct shows sm hiatal hernia and 2x3mm lung nodule. I was diagnosed with costochondritis , but am concerned about the relentless pains, abnormal labs, and lung nodule. She I pursue a second opinion on diagnosis?
Asked On : Tue, 28 Aug 2012
Answers:  1 Views:  377
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Internal Medicine Specialist 's  Response
Dear friend, welcome to HCM.
was an EKG not done?
pain of costochondritis would go away with NSAIDs (anti inflammatory pain killers).

an EKG is must to rule out cardiac ischaemia.
the tiny lung nodule does not look significant.
what is the normal range for d-dimer for your reporting lab?
if it is significantly high as per reference range, you need to rule out pulmonary embolism by CT pulmonary angio.
was the CT scan plain or a pulmonary angio?

however, costochondritis would not cause shortness of breath on exertion generally.
please feel free to seek opinion if you feel things are not improving.

take care and keep me posted .
pl. rate the answer before you close.

Answered: Tue, 28 Aug 2012
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