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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Left Sided Chest Pain With Pleural Effusion?

My daughter is 23 and generally healthy. This week she came to visit. It is a 6 hr. drive. One day after arriving she had chest pain on the left side from shoulder to under her breast. She went to the ER and had lots of tests, nothing wrong other than a bladder infection. The next night the pain doubled in intensity, she said 10 on a scale of 1 to 10. I took her back to the ER, and they again did blood work, X-ray and CAT scan. All testing was normal, there was a left small pleural effusion. The doctor said she couldn't find anything really wrong, suggested more testing with her PCP. The pain was intense and a similar situation has happened before after traveling. She also gets migraines and is on LoEstrin birth control. I am worried that there may be something serious wrong. She has had pleurisy in the past as well.
Fri, 3 Mar 2017
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Pulmonologist,  's  Response
Hello and thank you for asking in HCM.

I can understand your concern.
I will try to give you some other information.

I all the inflammatory tests are negative we exclude the acute factors causing pleural liquid i mean the inflammatory process of the pleural space which is very painful.
According to the history it would be better to test for for autoimmune disorders and i would reccommend as follows:
ANA
pANCA,cANCA
Rheumatoid Factor
Anti phospholipid anticorps
PPD

I am sure her doctor knows well these tests and will advice her further.

I they are negative too the other cause to be excluded is LoEstrin she is using already.
But for this better to consult with her gynecologist.
I wish a good health for you and your daughter

Dr.Jolanda
Pulmonologist
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What Causes Left Sided Chest Pain With Pleural Effusion?

Hello and thank you for asking in HCM. I can understand your concern. I will try to give you some other information. I all the inflammatory tests are negative we exclude the acute factors causing pleural liquid i mean the inflammatory process of the pleural space which is very painful. According to the history it would be better to test for for autoimmune disorders and i would reccommend as follows: ANA pANCA,cANCA Rheumatoid Factor Anti phospholipid anticorps PPD I am sure her doctor knows well these tests and will advice her further. I they are negative too the other cause to be excluded is LoEstrin she is using already. But for this better to consult with her gynecologist. I wish a good health for you and your daughter Dr.Jolanda Pulmonologist