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Smoker,chest pain,lung pressure,heart burn,inflammation

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Practicing since : 2001
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I am an athletic, jogging 24 yr old male who chews tobacco profusely and smoked cigarettes for about a year in the past. Over the past four years I have noticed a chronic and worsening throbbing tightness in my chest directly left and under my left breast. XXXXXXX breaths amplify the constriction and leaning or crunching downward and left on those ribs brings a sharp pain, though relatively mild. On rare occasions, a very sharp but brief pain in the chest occurs in concert with a micro second mind seizure (or so I would describe it, its a quick pop and I almost feel something click up top). I do not use drugs, other than alcohol. Sleep on my left side can be very uncomfortable, I feel as though my heart is crushing a tender left lung. I am no stranger to heart burn, but have not seen a doctor in approx 2-3 years. Over that same period I cannot remember ever being sick with fever, flu-like symptoms, or anything else for that matter. I suspect lung cancer or a rare cardio inflamitory condition. With no other symptoms and otherwise feeling incredible, I have not thought a doctor visit worth the cost. Any immediate concerns or suggestions?
Posted Tue, 24 Apr 2012 in Hypertension and Heart Disease
Answered by Dr. Rakhi Tayal 3 hours later

Thanks for writing to us.

After reading your complaints, I can think of 3 possible causes which could be responsible for the throbbing chest tightness under the left rib cage:

1)The first possibility is of pleuritis - You may have BRONCHITIS and the pain may be caused by PLEURISY, an irritation of the lining of the lung. This usually happens due to infective source and commonly a virus. Hard coughing may also cause pain in the muscles and chest wall. Drink plenty of fluids and anti-inflammatory medicines such as ibuprofen will help in relieving your symptoms.

2)The second possibility is of Peptic ulcer disease or Hiatal hernia. Diagnosis can be confirmed by upper GI endoscopy. Try raising the head of your bed about four inches with blocks. It also might help to avoid eating or drinking for two hours before you lie down. To help control the stomach acid, one should not drink alcohol or drinks with caffeine in them, or eat chocolate or spicy or greasy foods. Also take some antacid but if the symptoms are severe, then you may need drugs like proton pump inhibitors.

3) The second possibility can be of myositis or fibromyalgia. Overuse of muscles, anxiety, stress and other psychological causes play a role in such conditions. Mild antiinflammatory drugs and hot fomentation will help you.

Perhaps examination by a physician can rule these causes out. Hence I encourage you to consult a doctor.

I hope my answer and recommendations are adequate and helpful. Waiting for your further follow up queries if any.


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