Brief Answer:
I would explain as follows:

Detailed Answer:
Hello XXXX!

Thank you for asking on HCM!

I understand your concern, and would like to explain that your symptoms seem to be related to a gastroesophageal disorder (possible reflux, acute gastritis, esophageal spasms, or just dyspepsia).

Have you tried any PPIs( omeprazole, pantoprazole, lansoprazole, etc.). Have these drugs relieved your symptoms? It would be a strong argument in favor of a gastro esophageal disorder.

Have you checked your blood pressure?

Is your pain modulated by respiration or body movements?

Anxiety could also mimic this clinical situation. Your medical history for depression may be related to this symptomatology. Have you tried to take any anxiolytics (alprazolam, diazepam, lorazepam,etc.) during these days?

I would recommend consulting with your GP for a careful physical examination, a resting ECG, cardiac enzymes, a chest x ray study, an abdominal ultrasound and some blood lab tests:

- complete blood count
- inflammation tests (PCR, sedimentation rate)
- fasting glucose
- kidney and liver function tests,
- amylaze plasma levels (possible pancreatitis)
- electrolytes plasma levels etc.

If suspicions are raised for a GERD (gastro-esophageal reflux,), esophageal spasms or a hiatal hernia, a GI endoscopy should be performed.

A cervico-thoracic spine x ray study, followed by a spine CT scan should be performed to rule in/out a back bone disorder (like a disk displacement) which can cause back and chest pain with irradiating nerve pain in your arm.

Hope to have been helpful!

Feel free to ask any other questions whenever you need!

Best wishes,


Dr. Iliri

---