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Pain in the left side of the chest - Online Doctor Chats

Date : 13-Jan-2012
User rating for this question
Very Good Posted in: Hypertension and Heart Disease
Answered by

General & Family Physician
Practicing since : 2009
Answered : 681 Questions
Doctor :   Hi
Doctor :  
how can i help you?
User :   Hello. My wife is having some severe pain in her lower left chest. Trying to figure out what it could be.
Doctor :  
since when she is having this problem?
User :   Here are some long details....
Doctor :  
User :   My wife started having severe pain in her left chest last night. The pain is located on her left side, just inside the lower part of her left breast. Around where the bottom of your heart would be. It's a sharp stabbing pain, as she describes it. She says the pain is deep inside. Pressing on her stomach, abdomen, lower chest area could not make the pain worse. It is inside. Perhaps past the rib cage.
User :   We went to the emergency room last night and spent 4 hours there while the Doctors did tests. She is fairly young, 33 years old. No bad medical history. She doesn't have any medical conditions, diseases, or problems. Other than being fairly overweight, she has always been in good physical health and isn't one to ever complain or make stuff up.
User :   So the Dr. at the emergency room did a series of different tests. The EKG came out totally normal, and they were monitoring her heart rate, blood pressure, oxygen, etc. for hours. All that seemed totally healthy. Blood tests looked normal. They thought maybe it was just indigestion so they had her drink a mix of Malox and Lidocaine to rule out indigestion. And the pain persisted long after that and still persists now, 18 hours later too. Definitely not indigestion. They took X-rays and the lungs looked healthy. No lung collapse. Heart looked healthy, as per the X-ray. Ribs looked good. Nothing indicative on the X-ray.
User :   A nurse suggested maybe it was gallstones. But the Dr. didn't seem to want to pursue that very much. They did NOT do an ultrasound on the gallbladder. Only thing they did that might have checked for gallstones was a blood test. But from what I read online, the gallbladder is on the right side of your chest or abdomen anyway. So since her pain is precisely in the lower LEFT chest, maybe that's why the Dr. didn't seem to think it was a gallbladder thing.
User :   So after hours of testing different things and ruling out a heart attack, they finally sent us home with some Vicodin (pain killer) and said if it still hurts on Monday to to see a family doctor.
Doctor :   let me read

User :   So now it's Sunday and she is still in bed, writing in pain, unless she takes these Vicodin every 4-5 hours. She keels over in pain and the pain is pretty intense. From diagrams I can find online, it looks like the items in this area where she is having pain are the lower heart, the lower left lung, and the top of the stomach.
User :   She can't get up and walk without the pain getting worse so she's just been staying in bed on the painkillers. She says she has to take short breaths because big deep breaths make the pain worse.
User :   Done typing....
Doctor :  
Doctor :  
there are many causes for the pain in the left side of the chest
Doctor :  
and as you said rightly it is not gall bladder pain
User :   So can you give me some ideas?
Doctor :   any pain in the chest for that matter should be ruled out the heart cause and it is ruled out with the series of tests done in emergency
Doctor :   the pain is sharp, stabbing like, which increases on movements of chest like deep breathing is clinically musculoskeletal in origin
Doctor :   meaning the pain is coming from the deep part of the chest wall
Doctor :   is there any redness of the skin over there at the region of the chest where it hurts?
User :   Well, yes. There was last night at least. But that's normal. She has very large breasts and her bra is always fairly tight. And the pain is right under the part where the bottom of the bra hits her chest. So that area is usually red when she takes off her bra.
User :   I think she's had her bra off for most of the day today. I could check right now and see if there's any redness. Want me to go do that?
Doctor :  
yes and also see if it is there on both sides or is it only on the left side?
User :   Ok. back in a few minutes...
Doctor :  
User :   No. there is no redness anywhere.
Doctor :  
thats good
Doctor :  
does she have problem of belching developed in these days?
User :   Not really. Not more than normal anyway.
Doctor :  
from the history and with the lungs and the heart being clear with investigation it is the spasm of th breathing muscle in the chest wall
Doctor :  
so not much to worry
Doctor :   did you try applying any local pain remedy gel to the painful area?
User :   No. The pain is inside. Not local.
Doctor :   yes the spasm pain will be inside
Doctor :  
and the treatment option will be to act from inside as well as outside
Doctor :  
as only vicodin has just failed to resolve
Doctor :  
the pain issue
User :   Vicodin helps. It makes most of the pain go away. But just for 4-5 hours.
Doctor :  
yeah thats what
Doctor :  
the pain is relieved but it should not come back again
User :   So what kind of things could this be? What about a pulmonary embolism?
Doctor :   no its not pulmonary embolism
User :   Why do you say that?
Doctor :  
it is an emergency and is life threatening
Doctor :  
it presents has acute sever breathing difficulty with rash over the body and the patient will collapse in a span of few hours
Doctor :  
not to worry about the pulmomary embolism
Doctor :  
as i said the pain increases on deep breathing and it is like sharp stabbing kinds is classic of the pleura and the chest wall
Doctor :  
X-ray has showed that pleura is normal
Doctor :  
so it is chest wall muscle
Doctor :  
try this flector gel
Doctor :  
local application
Doctor :  
tab cataflam 50 mg twice a day for 3 days
User :   Is that a prescription? or OTC?
Doctor :   otc drugs
Doctor :  
also you need to take tab prilosec otc 10mg once in the morning for 3 days
Doctor :  
also regulate the breathing like
Doctor :  
increase the depth of breathing progressively till the pain disappears
Doctor :  
like she needs to take deep breath and hold it for a while and than to exhale slowly
Doctor :   progressively she can increase the depth of breathing depending on the reduction in pain
Doctor :  
are you there?
User :   Yes
User :   Just a minute. Sorry....
Doctor :   ok no problem

Doctor :  
did you follow
User :   Ok. So Cataflam. That's an OTC drug? And it's apparently an anti-inflamatory?
Doctor :   it is used here for its analgesic property

User :   So it's just a pain killer?
Doctor :   it is also a pain killer and it is a weak muscle relaxant also it relieves the mild congestion in the affected muscle group because of the spasm
User :   Ok. Got it.
User :   And the flector gel? What is that? And how often do we apply?
Doctor :   it is a pain killer in the local form the most advantage of the gel application is from the massage action during the process of application
Doctor :   it also improves the blood circulation by producing warmth in the region of the application
User :   Is it the same thing as Voltaren Gel?
Doctor :  
User :   How often?
Doctor :  
it needs to be applied two or three times a day
Doctor :   and latter it can be stopped once the pain disappears
User :   I just called my pharmacy. Those are both Prescription-Only medications here.
Doctor :   you are from which country
User :   United States. Oregon.
Doctor :   ibuprofen or naproxen

Doctor :   this is otc in US
Doctor :   these drugs also belongs to the same group, little less potency than the voveran

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