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Could Chest And Shoulder Pain, And Breathing Issues Be Pleurisy?

Posted on Sat, 18 Oct 2014

Question: About 5 months ago I woke up with chest pain went to urgent care the next day had an EKG and everything was fine the doctor said it could be asthma. He put me on albuterol and sent me on my way. Since then I have seen a pulmonary doctor and he has put me on many meds that do not help with the breathing issues or pain. Yesterday the nurse at my work said she heard rubbing and told me to ask if it could be pleurisy. I have a dull chest pain in the left side and sometimes in my back and pain in my left shoulder. I had bronchitis over the winter but I didn't know if that would have anything to do with it

Answered by Dr. Divakara (20 hours later)

Brief Answer:
Yes, it can be Pleurisy

Detailed Answer:
Hi

Greetings from Dr.Divakara.P

Thanks for posting your query.

Chest pain could be due to problems in heart, pleura ( a covering of lung ) , lungs, Stomach or esophagus or Nerve compression at your neck level.

A EKG even if it is normal it doesn't confirm that everything is fine with heart. If EKG is normal then a blood test called Troponin I should have been done. So possibility of a heart problem is still there.
All said as per your nurse comment that she can hear a rubbing sound , yes the possibility of Pleurisy is there. Pleurisy causes a sharp pain , very much localized to a small area of chest and increases in intensity on taking deep breath or cough. Is your pain like that ?
Kindly revert back with description of your pain , whether it is pricking or squeezing or burning?
Whether it is continuous or intermittent?
Whether any sweating is there associated with pain?
Whether the pain increases or decreases on taking food?

Looking forward for your reply.

Regards.

Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju

Follow up: Dr. Divakara (10 minutes later)

The pain is usually a dull pain in my upper left pectoral muscles sometimes closer to the sternum. Its continuous for the most part it seems to get a little better if i lay on my left side. Every now and then its a burning pain too which gets worse after eating

Answered by Dr. Divakara (19 minutes later)

Brief Answer:
Pain not due to Pleurisy

Detailed Answer:
Hi,

Pleurisy pain will be very sharp and localized, as if some one is pricking you with a needle. So either you don't have Pleurisy or it is not causing you the chest pain.

A burning pain is due to increased acidity in your stomach but it is just contributing to some extent for your pain. Ask your doctor to write a prescription of Rabeprezole and use it for 2 weeks.

Now we need to find out what is the cause of your dull aching pain in chest. It could be either due to some heart problem ( though you EKG is normal ) or some fluid or pus collection in your chest.

I advise you to get a Chest X ray and 2D Echo done. This will give us more information regarding the cause of your pain .

Any clarifications feel free to ask .
Happy to answer.

Regards.

Above answer was peer-reviewed by : Dr. Ashwin Bhandari

Follow up: Dr. Divakara (11 minutes later)

I dont know of its something with the muscle because when i touch it it seems to get worse

Answered by Dr. Divakara (4 minutes later)

Brief Answer:
It could be .

Detailed Answer:
Hi,

Tenderness to touch is not due to Heart problems but could be due to Muscle problem or Pus collection in the chest.

A chest X ray will tell if there is pus collection or not. Alternatively you can take NSAID's with Muscle relaxants combination and observe for response. If you feel better and pain disappears then it indirectly confirms Muscular pain .

Ask your local doctor for prescription.

Regards.

Above answer was peer-reviewed by : Dr. Ashwin Bhandari

Follow up: Dr. Divakara (7 minutes later)

Or could the pulmonologist be right and it could just be from asthma?

Answered by Dr. Divakara (1 hour later)

Brief Answer:
Unlikely to be Asthma

Detailed Answer:
Hi,

Asthma without Breathing difficulty or cough causing only chest pain is very unlikely . I doubt whether you have Asthma or not .

The very fact that you didn't respond to the medications given by the pulmonologist indicates that you don't have Asthma .

If you still feel that you have Asthma you can go for a test called Pulmonary Function Test .

Any other clarifications feel free to ask.
Happy to help .

Regards .

Above answer was peer-reviewed by : Dr. Ashwin Bhandari

Follow up: Dr. Divakara (13 minutes later)

I do have slight breathing difficulties and wheezing. I am on singulair and i can notice a difference if i forget to take it. Could the pain actually be caused by asthma if i do actually have it?

Answered by Dr. Divakara (1 hour later)

Brief Answer:
Still No

Detailed Answer:
HI

Ok you might be having Asthma but still Asthma causing chest pain is less likely.

I hope it is chest pain only and not chest tightness because Asthma can cause Chest Tightness.

I personally don't think Asthma can cause Chest Pain.

Regards

Above answer was peer-reviewed by : Dr. Vaishalee Punj