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Hi. I’ve Had Some Chest Discomfort About 2 Times This

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Posted on Fri, 20 Mar 2020
Question: Hi. I’ve had some chest discomfort about 2 times this week. I’d like to add that I have had chest pains dating back to my childhood. No hx of cardiac issues. And no diagnosis. All around healthy. For the most part. My chest pains this weeks have been shifting towards the right side. With some arm discomfort. Lasting between ten minutes and today it’s been almost a dull light pain close to all day. No SOB, dizziness nor have I been diaphoretic. I may have some slight HTN due to my medication prescription. Overall I’m a healthy 27 y/o m with no significant PMH. I’ve been lacking on personal care. Otherwise I’m here to make sure I’m not suffering any sort of cardiac issue
doctor
Answered by Dr. Ilir Sharka (54 minutes later)
Brief Answer:
I would recommend as follows:

Detailed Answer:
Hello!
Welcome to Ask a Doctor service!

I passed carefully through your question and would explain that your symptoms are not typical of any cardiac disorders.

I would like to know more about your pain:

- Is it triggered by deep breathing or body movements? This could be indicative of a musculoskeletal pain.
- Is it triggered by eating spicy food or large meals? This could be indicative of acid reflux.

Coming to this point, I would recommend performing some tests to investigate for possible causes underlying your complaints:

- a chest X ray study and a cervical spine X ray study
- a resting ECG
- complete blood count, PCR, ESR for inflammation.

In the meantime, I would recommend trying taking ibuprofen. If this improves your situation, it would be another argument in favour of musculoskeletal pain.

Another tip is to try an antiacid or PPI (omeprazole, pantoprazole, etc.) . If this improves your situation, it would be indicative of acid reflux. In such case , a fibrogastroscopy may be needed .

Hope you will find this answer helpful!

I remain at your disposal for any further questions whenever you need!

Kind regards,

Dr.Ilir Sharka, Cardiologist


Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Ilir Sharka (2 hours later)
Thank you. As far as the food and timing of my meals, yes to both. Spicy food are usually a go to. Late night meals do happen. I work in a field where night shifts and my sleeping schedule clash.

I’d like to add I am prescribed Amphetamine/Dextroamphetamine with a dosage of 75mg daily, evenly spread. I’ve been prescribed this med dating back to my middle school days. This could be the cause of my slight HTN. No real sleep issues. 4-6 hours a night. The HTN is not significant, no where near Cva levels. But I always questioned if this could be a cause of my discomfort.

Taking deeps breaths do from time to time create some discomfort but that’s absolutely a musculoskeletal issue. Two different types of pains.

When I run into this specific chest discomfort I do regularly take an NSAID. Which does seem to help 90% of the time. This evening I did however take ASA at 324mg. Which did seem to work.

Ultimately, I’m contacting you before I rush to the local ED. And my overall questions are,
-Given the symptoms described a little deeper, what’s your opinion?
-Would stopping my Amph/Dextro prescription help with my discomforts, as well as my HTN?
-Changing my diet and some extra excerise, do you think this would help?

Again before I run through multiple tests, as a 27 Y/O male with no PMH, more or less on the healthier side, my chief complaint is almost out of the blue, or rather sudden onset’s without explanation. Would a daily regimen of ASA be a positive add to my daily routine as well? Or try a more natural approach and decide further down the road to contact my PCP?

Again thank you for your time.
doctor
Answered by Dr. Ilir Sharka (6 hours later)
Brief Answer:
I would recommend as follows:

Detailed Answer:
Hello again!

Thank you for the additional information.

In my opinion this is a musculo-skeletal pain. Chostochondritis can not be excluded either.

But, I would not recommend using ASA, because it is an acid which can trigger stomach pain and worsen the situation.

Instead, I would recommend taking acetaminophen or ibuprofen, which are better treatment choices.

Regarding Amph/Dextro, I think that it has a lot of influence in your arterial hypertension and insomnia. So, I think that stopping it may definitely help improve your situation.

I would also recommend avoiding spicy of junk food. I would recommend trying to eat a more balanced food and eat more frequently and in small portions. An antiacid can help in case of acid reflux.

Hope you will find this answer helpful!

Wishing all the best,

Dr. Iliri
Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Ilir Sharka

Cardiologist

Practicing since :2001

Answered : 9540 Questions

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Hi. I’ve Had Some Chest Discomfort About 2 Times This

Brief Answer: I would recommend as follows: Detailed Answer: Hello! Welcome to Ask a Doctor service! I passed carefully through your question and would explain that your symptoms are not typical of any cardiac disorders. I would like to know more about your pain: - Is it triggered by deep breathing or body movements? This could be indicative of a musculoskeletal pain. - Is it triggered by eating spicy food or large meals? This could be indicative of acid reflux. Coming to this point, I would recommend performing some tests to investigate for possible causes underlying your complaints: - a chest X ray study and a cervical spine X ray study - a resting ECG - complete blood count, PCR, ESR for inflammation. In the meantime, I would recommend trying taking ibuprofen. If this improves your situation, it would be another argument in favour of musculoskeletal pain. Another tip is to try an antiacid or PPI (omeprazole, pantoprazole, etc.) . If this improves your situation, it would be indicative of acid reflux. In such case , a fibrogastroscopy may be needed . Hope you will find this answer helpful! I remain at your disposal for any further questions whenever you need! Kind regards, Dr.Ilir Sharka, Cardiologist