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Dr. Andrew Rynne

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Suggest treatment for severe chest pain and heart palpitations

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Dr. Benard Shehu

Cardiologist

Practicing since :2004

Answered : 2257 Questions

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Posted on Tue, 20 Oct 2015 in Hypertension and Heart Disease
Question: I have had chest pain for several months now- like a pressing feeling. It came and went along with skipped beats, but a different kind of pain began 3 months ago- upper left side of chest, like a burning sensation. Not muscle or tendon, but uncomfortable. Have just now seen a new doctor who sent me for a lung scan (inhaling the radioactive gas). My question: skipped beats, chest pain that has now been constant for weeks...not heart-related (normal ecg, within normal range results for 48-hr monitor, normal stress test)...doctor believes this is a lung issue. Lung cancer? I am not overweight and have no symptoms of rheumatoid arthritis or pulmonary embolism.
Sorry- info above may be a little unclear. I am now waiting for the results of the lung scan and chest x-rays.
Also, along with the chest pain, my breathing is shallower than it used to be. Although tired a lot (feels like I'm fighting something), activity doesn't make pain better or worse. Nor does deep breathing, which I am able to do without discomfort (I just have to concentrate on doing it. When I don't consciously breath deeply, my breaths are shallow.)
thx.
doctor
Answered by Dr. Benard Shehu 47 minutes later
Brief Answer:
Following answer...

Detailed Answer:
Hi and thank you for asking!
I read your query very carefully and understood your concerns.

You are experiencing for the last couple of months chest pain and palpitations. From what you are describing you have done ECG, cardiac echo, Holter monitoring and stress test which all came back normal.

These findings combined with clinical data (the pain isn't typical for heart problems) exclude heart problems and other causes should be looked for determining what s causing your symptoms.

Although your symptoms aren't typical for pulmonary disorders. Once that cardiac problems are excluded, then your symptoms may be related yo pulmonary problems including lung masses and tumors. This is why chest x-ray is essential in the proper evaluation of your case. If any abnormality would be seen, then CT scan should confirm/exclude the diagnosis. This is why you should wait for the Ct scan results to exclude/confirm any pulmonary problems.

If pulmonary problems are excluded then your symptoms are related to Gastroesophageal reflux disease (GERD or acid reflux). GERD is manifested with chest discomfort and palpitations. To confirm the diagnosis you should do the following examinations:
- Abdominal ultrasound
- Upper endoscopy

Hope this will be of help!
Wish you health!
Dr. Shehu
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Benard Shehu 3 hours later
Thank you.
I do understand the sequence of testing, but no one has mentioned GERD. I do not have heartburn, and the chest pain is unchanged when I breathe deeply, switch position, or bear any relationship to the times when I eat or drink.

Could I ask you, since my current doctor feels, after a prelimiary examination, that the tests conducted so far have ruled out a cardiac issue, and point to a pulmonary cause, what pulmonary issues my symptoms point to, other than lung cancer? Again, I have no symptoms of rheumatoid arthritis, and none of the risk factors or symptoms for pulmonary embolism other than those I have mentioned.
Thanks.
doctor
Answered by Dr. Benard Shehu 6 hours later
Brief Answer:
Following answer to your query.

Detailed Answer:
Hi back,

As I said earlier GERD is a possibility only after excluding pulmonary problems (with normal pulmonary CT scan).

Now lets turn to your main query. Pulmonary problems (other than malignancies) that are associated with chest pain and palpitations include:
- Pulmonary hypertension
- Lymphoma and other benign lung tumors including Sarcoidosis.
- Pulmonary infections including tuberculosis, aspergilosis etc.
- Pleurisy. Inflammation of lung pleura may cause chest pain. Although the pain isn't typical for pleurisy it should be excluded.

My advice is to wait for Lung CT scanner results.
Wish you health!
Dr. Shehu

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