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Having pain in rib cage that runs till chest. Normal CAT and mammogram. What to do?

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General & Family Physician
Practicing since : 2009
Answered : 3094 Questions
I have been having pain in the right rib cage that runs from under my arm to the lower rib, across my chest/upper stomach, and cups around my right breast. I feel like that side of my body is swollen and my upper stomach appears slightly discolored. I have had a mammogram and a cat scan and nothing showed up. This has been going on off and on for over 7 months.

I cannot lay on my right side to sleep as I feel like I can't catch my breath.
Posted Tue, 23 Jul 2013 in Bones, Muscles and Joints
Answered by Dr. Luchuo Engelbert Bain 1 hour later
Hi and thanks for the query,

It s reassuring that the CT scan and Mammogram never revealed anything XXXXXXX It however important for a critical review of these complaints to be made. It might be necessary to know if you have any past history of heart disease or recorded manifestations apart from the hypotension. Any recorded history of gastritis or gastroesophagal reflux disease?

The pain and characteristic symptoms you present are very compatible with two pathologies. Its first important to exclude ischaemic heart disease. Anginas (stable, unstable, printzmetal) could present with such pains associating chest and arm symptoms. Measuring heart electric activity with an ECG and a cardiac ultrasound could be helpful . Blood markers for ischaemic heart disease especially during pain episodes could be useful ( Creatinine Kinase MB, TRoponine I).

The second is gastroesophagal reflux disease. History o gastritis or acid reflux could be useful. Signs might not be very characteristic as such in certain cases. Its important to do an upper endoscopic evaluations to access the integrity of the lower esophagus, stomach and check for ulcers or any reflux characteristics.

A clinical evaluation and examination, preferable by an internist is necessary in this case. I would strongly suggest you book an appointment with an internist for a complete clinical review and get these tests done. Based on findings of the examination, other blood or radiologic tests could be added.

Should you have specific concerns, feel very free to ask for I shall be honored making my little contribution to improve om your health. Thanks again and kind regards,

Bain LE, MD.

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