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Intermittent pain in shoulder blades, under breasts, jaw. Diagnosed as esophageal spasm. Suggestions?

Hello, I am a 28 year old female. For approx. 9 years, I have been having pains on and off. The pains are not consistent at all and they come in waves when I do have them. The waves last for a couple minutes each time, and these episodes range from 10 minutes to an hour usually. The episodes sometimes happen once a month, sometimes every second day and can happen at any time of the day. The pains seem to radiate from between my should blades, around to the area under my breasts and up into my jaw (sometimes into my shoulders/upper arms). Nothing seems to help. My doctor has tried painkillers, but we aren t sure if anything works because the episodes are so inconsistent. The most recent diagnosis is esphophageal spasm , but it doesn t seem to matter if I ve eaten recently or not, or if I lay down after I eat or anything like that. The pain is so bad I have to stop what I m doing and just concentrate on breathing and getting through the wave . Sometimes I feel like it would feel better if could burp, or crack my back (I don t know if it would actually help, it s just how my body feels!). Have you ever heard of anything like this before? Help!
Asked On : Mon, 25 Mar 2013
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General Surgeon 's  Response

Thank you for the query.

Chest area is quite hard to diagnose as we have in this area nerves from abdomen, lungs, heart, esophagus and rib nerves and muscles. Esophageal spasm should not cause such pain. It should rather give occasional problems with swallowing.
Your symptoms can be caused by heart issues, gallstones or rib muscles and nerves issues.
Heart problem present at such young age are heart arrhythmia or mitral valve prolapse for example. It is quite characteristic for heart pain to radiate to the left arm or jaw. It can appear and disappear suddenly. To diagnose such issues, 24 hours Holters ECG and heart ultrasound should be done.

Gallstones pain is usually triggered by a meal and gives nausea as well.

Rib nerves pain is sharp, well localized. Gets stronger when breathing and can be unnoticeable when not moving the chest.

I suggest you to visit cardiologist for mentioned heart tests. You should also try Magnesium 400 mg a day supplementation and avoid coffee. Very often Magnesium can solve mild heart problems.

Hope this will help.
Answered: Wed, 24 Jul 2013
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