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Throbbing pain under right rib with nausea. What could this be?

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Practicing since : 2006
Answered : 1583 Questions
Hello thank you. I am a 57 year woman with a throbbing pain under my right rib It has been going on for three days and I can really feel the throbbing tonight. I'm nauseated too. When it started a couple of days ago , it was very sore and now its throbs.
Posted Mon, 25 Nov 2013 in General Health
Answered by Dr. Basheer Ahamed 1 hour later
Brief Answer: Anginal pain needs to be excluded. Detailed Answer: Hello, As you're already having medical history of Printz metals angina, the first possible cause of the chest pain is anginal chest pain. This is brought about by sudden coronary artery spasm (Constrictions of blood vessels of the heart). I suggest you to get an EKG done. Anginal chest pain will reveal abnormalities such as ST elevation on EKG. Since angina has potentials to cause arrhythmia's consult a cardiologist at the earliest and Get an ECG done. He may prescribe medicines for angina like nitrates and Calcium channel blockers which will help prevent the blood vessel constrictions, pain and other cardiac complications. Hope the answer helps you. Let me know it there is any clarification. Regards.
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Follow-up: Throbbing pain under right rib with nausea. What could this be? 52 minutes later
This pain is nothing liked any printz metal attack Ive ever had. Ive been in the hospital many times for this. So you are saying that the pain under my rib in my abdomen is the likely caused form printzmetals? Whne you say eliminated , you are saying this could be a heart attack, or just anytime someone get any pain around the chest you should check for heart attack?
Answered by Dr. Basheer Ahamed 10 minutes later
Brief Answer: Angina vs musculoskeletal pain.. Detailed Answer: Hello, I apologize if my previous answer caused more anxiety and confusion. I did not mean to do that. However with a back ground of Printz metal angina, any type of chest pain cannot be neglected. Moreover pain arising from heart need not be always similar. There are atypical presentations. Usually in females the Printz metal angina is not associated with Coronary artery disease (Heart attack). But it may exist in a small group of female patients; hence my concern. If heart attack is rule out then the most probable cause is musculoskeletal pain due to spasm of the intercostal muscles. In that case my advise is rest and analgesic and muscle relaxants to relieve the pain. I had two different response before I wrote my previous answer: 1. Suggest you rest along with pain medication and proton pump inhibitor (antacid). Further evaluation if you did not feel better. 2. Exclude cardiac chest pain first. If it's negative, then reassure you. I chose the second response since you had history of angina in the past. I am sorry if my answer was not up to your expectation. You are free to take a second opinion. Regards
Above answer was peer-reviewed by
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