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Hello, I am trying to decide if I should go

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Cardiologist
Practicing since : 2001
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Hello, I am trying to decide if I should go to ER :: for the last 2 days I have been experiencing a pain on my left side of my abdomen, it woke me up tonight around 4 AM :: I am 73 male, have had bleeding ulcers before and have 3 stents in my heart. The pain is level 4-6 in a 10 worst pain I have felt [kidney stone] :: Trying to rule out a stomach ulcer or any other issues causing pain in that area [liver / pancreas / ?] :: Have had same pain before when I wear pants/belt that causes my belly to push up against my chest but goes away after I release the tight belt pressure :: Does not feel like a heart failure or have the symptoms I have felt before for that [no burning/strong pain in center of my chest projecting unto my arms/throat and jaws] :: I do have some mild extra salivation :: I have taken Ranitidine [two 150 mg every 12 hours in last 24 hours :: no dark stool as of last movement some 28 hr ago
Fri, 2 Feb 2018 in Heart Attack
 
 
Answered by Dr. Ilir Sharka 59 minutes later
Brief Answer:
I would explain as follows:

Detailed Answer:
Hello!

Welcome on HCM!

I passed carefully through your recent medical history and would explain that your actual pain is more likely of extra-cardiac origin (relieved by pressure - as when releasing the tight belt pressure).

Nevertheless, as your has a previous history of coronary artery disease with three implanted stents it is necessary to perform a careful differential diagnosis between a gastrointestinal disorder (such as gastritis or relapsing ulcer, spastic colitis (IBS), chronic constipation, kidney stone, hiatal hernia, etc.) and a nonspecific symptomatology of a cardiac issue.

Coming to this point, if the pain is not relieved by any anti-inflammatory and anti-spasmodic drugs (ibuprofen, buscopan, etc.) you should ask medical assistance to the nearest ER service at your living area for performing a careful physical exam and several lab tests as follows:

- resting ECG,
- cardiac enzymes (CK-MB, Troponin),
- complete blood count,
- PCR & ESR,
- complete urine test,
- liver and renal function tests,
- abdominal ultrasound,
- fasting blood glucose level,
- fibrogastroscopy (if suspicions about gastritis or ulcer are raised)

Hope you will find this answer helpful!

In case you have any further questions, feel free to ask me again.

Kind regards,

Dr. Iliri
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