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What causes episodes of burning sensation in chest?

Answered by
Dr. Ilir Sharka


Practicing since :2001

Answered : 6434 Questions

Posted on Fri, 16 Oct 2015 in Hypertension and Heart Disease
Question: I have had three episodes of burning sensation at the mid section of my chestl It last a long time. I am not short of breath; nor is there any deep pain. I Woke up with it last night after a bad dream. I had shingles las December and at times have post pain still under my right arm and around the top of the right breast at times. I took an aleeve the first episode and it subsided and I went back to sleep for three hours and then woke up with it again but it was not as severe. I took a Lorezopam thinking it might be anxiety. At this point the sensation is gone. Please advise.
Answered by Dr. Ilir Sharka 2 hours later
Brief Answer:
I would explain as follows:

Detailed Answer:

Thank you for asking on HCM!

I understand your concern, and would explain that judging from your chest pain characteristics (a prolonged, superficial, well localized pain), seems that it is not cardiac related (not due to any possible myocardial ischemia).

As you had a history of recent diagnosed Shingles (Herpes Zoster infection), a careful physical inspection of the chest skin should be done to identify possible shingles eruption (they are quite characteristic). But even if no cutaneous eruption could be found, Shingles relapses seem to be the most probable explanation of your symptomatology.

You should know that Shingles is a chronic infection, where the virus stays in the nerve ganglia for years and is activated time after time. It can cause chronic pain, of a burning pattern (also called hyperpathy or neuropathy) from the chronic changes in the nerves.

Other possible causes of such an atypical chest pain may be
- a musculoskeletal disorder (inflammation, chostochondritis)
- esophageal spasms
- GERD (gastroesophageal reflux), though it is less probable to be relieved by aleve and lorazepam

As the two most probable explanations are shingles and a musculoskeletal pain, symptomatic pain relief drugs may be useful.

I personally believe that this is caused by shingles and coming to this point I would suggest:

- If you have cutaneous eruptions, you should use topic acyclovir cream
- For the persistence neuropathic pain gabapentine or pregabaline would be helpful. (They are antiepileptic drugs very helpful in chronic nerve pain).

Try to avoid the triggering factors of shingles relapses such as psychological stress, high temperatures, fever, insomnia, etc.

I would recommend performing a physical examination by your GP, a chest skin inspection, a chest x ray, a resting ECG, a complete blood count, PCR etc. and discuss with your doctor about the above mentioned issues.

Hope to have been helpful!

Feel free to ask any other questions, whenever you need!

Best regards,

Dr. Iliri

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

The User accepted the expert's answer

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