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Suggest Treatment For Pain In The Sternum While On A NSAID

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Posted on Thu, 22 Sep 2016
Question: I often experience a pointed pain on the sternum side of my heart in the afternoon. I have no fatigue or weight loss. Am very healthy. Am 70 year old male. What would cause that kind of pain?
doctor
Answered by Dr. Dr. Meriton Siqeca (24 minutes later)
Brief Answer:
Does not seem anything serious

Detailed Answer:
Hi and thank you for your question. Welcome to HCM. I understand your concern.

Sir, there are a lot anatomical components within the ribcage, every single one of it having specific symptoms or combination of symptoms. The most fearful origins of pain originated from this area are the heart and the lungs, but none of them produce this kind of sharp, in-one-point situated pain. This is most probably due to the outer, superficial, locomotory system of the ribcage, meaning an acute or chronic inflammatory process of the ribs or muscle situated in between them. In this regard, I would recommend you to take a short course (5 to 7 days, thrice a day) of over-the counter non-steroidal anti-inflammatory drugs (NSAIDs: ibuprofen, ketoprofen etc.).

However, since you are a 70-year old man, as a cardiologist, I have to advise you to do a check-up for the heart, including an EKG (to evaluate heart electrical system in resting state), an echo cardiogram (to assess heart structures) and a cardiac stress test (to see whether changes in electrical system are stimulated by exertion).

I hope I was helpful with my answer. I am happy to help, if you have follow-up questions.

Best regards,
Dr. Meriton
Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Dr. Meriton Siqeca (13 hours later)
Thank you for the advice. Followup Q1: what is the difference between taking a NSAID thrice a day for 5 to 7 days and just taking a half an aspirin a day permanently? I like the idea of not taking something permanently, but have often thought that I should be taking something that reduces my risk of a heart attack. Both my father and mother had heart problems and my father died of heart attacks, the second of which got him.
doctor
Answered by Dr. Dr. Meriton Siqeca (52 minutes later)
Brief Answer:
The class is advised for this kind of pain

Detailed Answer:
Hi again and welcome back.

Acetylsallicylic acid (aspirin) is a well-know and commonly-used, and proved drug that has great benefits in primary and secondary prevention of myocardial infarction. It is used for this purpose, due to its anti-aggregant properties. Although effective even in treating acute inflammatory states such as fever or other, NSAIDs are more effective to treat pain elicited from problems with musculo-skeletal system. Therefore, I recommended them. I understand that you have an important familial factor. This is one important factor more which points towards the routine cardiac check-up I recommended in the original answer.

I hope my answet is helpful. If you do not have further questions, close the discussion and rate the answer.

Kind regards,
Dr. Meriton
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Dr. Meriton Siqeca (46 hours later)
For my second followup question, I would like for you to elaborate on your diagnosis of my heart pain as being probably coming from "the outer, superficial, locomotory system of the ribcage, meaning an acute or chronic inflammatory process of the ribs or muscle situated in between them." Rather than treat the symptom with a 5-7 day course of NSAID, I would like to treat the source of this inflammation. I believe the source is my working position. I am a programmer and sit in a 45 degree reclining position 8 hours a days. Over the years I have found that this is the only position I can stay in and not have back pain. Unfortunately, by about 3 or 4 pm I am getting this sternum-side-of-the-heart inflammatory pain. Is there anything you can recommend that would alleviate this other than a course of drugs?
doctor
Answered by Dr. Dr. Meriton Siqeca (7 hours later)
Brief Answer:
My answer is as follows:

Detailed Answer:
Hi again, Sir, and welcome back.

Well, indeed, assuming one certain position for a long time during a day may be underlying this pin-point pain. I can see you are against medication. You may find it helpful, if you change the chair, to a more comfortable chair, which provides more back support. After all, even if this changes, I do not think that symptoms will go away "just like that". Therefore, I would prefer the short course of NSAIDs I recommended. Also, please do not forget, about the recommendation for the cardiac check-up I ellaborated in the original answer.
Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Prasad
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Answered by
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Dr. Dr. Meriton Siqeca

Cardiologist

Practicing since :2009

Answered : 775 Questions

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Suggest Treatment For Pain In The Sternum While On A NSAID

Brief Answer: Does not seem anything serious Detailed Answer: Hi and thank you for your question. Welcome to HCM. I understand your concern. Sir, there are a lot anatomical components within the ribcage, every single one of it having specific symptoms or combination of symptoms. The most fearful origins of pain originated from this area are the heart and the lungs, but none of them produce this kind of sharp, in-one-point situated pain. This is most probably due to the outer, superficial, locomotory system of the ribcage, meaning an acute or chronic inflammatory process of the ribs or muscle situated in between them. In this regard, I would recommend you to take a short course (5 to 7 days, thrice a day) of over-the counter non-steroidal anti-inflammatory drugs (NSAIDs: ibuprofen, ketoprofen etc.). However, since you are a 70-year old man, as a cardiologist, I have to advise you to do a check-up for the heart, including an EKG (to evaluate heart electrical system in resting state), an echo cardiogram (to assess heart structures) and a cardiac stress test (to see whether changes in electrical system are stimulated by exertion). I hope I was helpful with my answer. I am happy to help, if you have follow-up questions. Best regards, Dr. Meriton