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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Pressure Under Collarbone. Have Acid Reflux. Earlier Chest X-ray And Stress Test Normal. Hiatal Hernia?

Having pressure under my left collarbone. It seems to move around the genral area. I had a chest x-ray about 5 years ago(was ok) and also had a heart stress test (which was ok except I found out i have a prolapse mitriel valve). I also have accid reflux. I have smokde in the past. I'm wondering if I have a hieatal hernia or gas in that area. I also sleep on my left arm so maybe this is the casue. Any thoughts on what might be going on.
Tue, 25 Jun 2013
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General & Family Physician 's  Response
Hi Thanks for using HCM,

Since you have mitral valve prolapse diagnosed 5 year back I suggest you to get one echocardiograph and ECG done to rule out any cardiac problem. With that take daily evening Tab Pantoprazole with domperidone to prevent acid secretion and reflux and also sleep in right lateral position atleast 30 min to 1 hour after dinner and tab Aceclofenac after food for pain. Take plenty of fluids. Hope this will cure you. Take care.

Regards
Dr.Lohit
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General & Family Physician Dr. S. Jegadeesan's  Response
Hello,
You have acid reflux, pressure under your left collar bone which moves around.
X-ray Chest and Treadmill test done 5 years back were OK except mitral valve prolapse. Your suspicion of Hiatus Hernia can be easily ruled out by doing a Barium meal study or endoscopy.
The pressure under your collar bone may due to a condition called Thoracic outlet syndrome, even though congenital need not produce symptoms for several decades. The symptoms are due to the blood vessels and nerves under the collarbone supplying the arm are compressed between the collarbone and the first rib. Causes may be 1) an extra first Rib - Visible in X-ray 2) Trauma to the shoulder or collarbone area 3) Abnormally tight fibrous band (ligament) connecting the spinal vertebra with the ribs. There may be other symptoms like pain, tingling in your left shoulder down to your left hand
The thoracic outlet syndrome has to be ruled out by consulting a Thoracic Surgeon.
Consult, Investigate and get treatment
Best wishes

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Pressure Under Collarbone. Have Acid Reflux. Earlier Chest X-ray And Stress Test Normal. Hiatal Hernia?

Hi Thanks for using HCM, Since you have mitral valve prolapse diagnosed 5 year back I suggest you to get one echocardiograph and ECG done to rule out any cardiac problem. With that take daily evening Tab Pantoprazole with domperidone to prevent acid secretion and reflux and also sleep in right lateral position atleast 30 min to 1 hour after dinner and tab Aceclofenac after food for pain. Take plenty of fluids. Hope this will cure you. Take care. Regards Dr.Lohit