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What causes constant retrosternal chest pain lasting for few minutes?

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Posted on Thu, 26 Mar 2015
Question: Hi,

I am a nursing student doing an assignment and want to know what diagnosis a patient will be if he is 42 with retrosternal chest pain that's constant, dull in character, with intermittent stabbing episodes lasting a few minutes. Theres no nausea, sweating or vomit but he is pale in colour with dysnopea. He also has inverted t waves on the ecg but a normal chest xray. I suspect he has a pulmonary embolism or pneumothorax??? as he is obese with a 10 year smoking habit. He has a family history of hypertension and has had gall bladder surgery and spinal laminectomy
doctor
Answered by Dr. Swarnava Dattagupta (1 hour later)
Brief Answer:
ADVICE REGARDING CHEST PAIN

Detailed Answer:
Hi,
Thank you for posting your query in HCM
This is Dr. Swarnava Dattagupta answering your question.

I appreciate your question and your curiosity regarding this case.

See, from the features and the ecg reports, it seems like a case of myocardial ischemia. Also pericarditis can be the diagnosis from the ecg. Pulmonary embolism is a possibility too due to inverted t wave. For that a bedside cardiac echo might help.
Pneumothorax is ruled out from the normal x-ray findings.
I would ask you to do the following-
Do a repeat ecg
If 6hours have not passed, do a TropT and check the results.

Contact me with the results so that i can tell you further.
Hope I have answered your query.
Regards
Above answer was peer-reviewed by : Dr. Pradeep Vitta
doctor
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Follow up: Dr. Swarnava Dattagupta (2 hours later)
Thanks that gives me some good approaches to research. There wont be any results as its a case study only.
doctor
Answered by Dr. Swarnava Dattagupta (7 minutes later)
Brief Answer:
FOLLOW UP

Detailed Answer:
Hello again.
Thanks that i could lead you to a diagnosis.
I gave you an idea about what followups are to be done in such a case.
You can add them to your case study.

Regards.
Have a nice day.
Above answer was peer-reviewed by : Dr. Pradeep Vitta
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Answered by
Dr.
Dr. Swarnava Dattagupta

General & Family Physician

Practicing since :2013

Answered : 906 Questions

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What causes constant retrosternal chest pain lasting for few minutes?

Brief Answer: ADVICE REGARDING CHEST PAIN Detailed Answer: Hi, Thank you for posting your query in HCM This is Dr. Swarnava Dattagupta answering your question. I appreciate your question and your curiosity regarding this case. See, from the features and the ecg reports, it seems like a case of myocardial ischemia. Also pericarditis can be the diagnosis from the ecg. Pulmonary embolism is a possibility too due to inverted t wave. For that a bedside cardiac echo might help. Pneumothorax is ruled out from the normal x-ray findings. I would ask you to do the following- Do a repeat ecg If 6hours have not passed, do a TropT and check the results. Contact me with the results so that i can tell you further. Hope I have answered your query. Regards