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    What causes intermittent chest pain that radiates to the stomach?

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Posted on Tue, 11 Jul 2017 in Digestion and Bowels
Question: I am having intermittent pain that radiates around my chest, sometime it seems like it is my stomach, sometimes my back and sometimes my chest. I was on protonix and I know it is worse when I take this med, I have had X-rays and and an EKG and my doctor thinks it is gas so I am taking gas x with each meal. Any ideas?By intermittent I mean every minute it builds and then lets up. I recently had and endoscopy and a colonoscopy.
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Answered by Dr. Sunil 23 minutes later
Brief Answer:
Can be angina also.

Detailed Answer:
Hi there,
Thanks for the query.

Have gone through your narration and there are two possibilities-
1)Intermittent pain radiating to chest in a 78 years old patient can be suggestive of angina(cardiac pain).Ekg is just the baseline test of cardiology and can detect angina changes in less then 20% of cases .Pain not responding to PPI's(Protonix) is again suggestive of possibility of angina.
Gastric pain usually responds immediately to antacids.

I would initially suggest you to go for 2d echo and stress test to rule out possibility of angina. They are about 70% sensitive to rule out cardiac pain.

2)Gastritis or heart burn can cause pain in chest and can mimic cardiac pain.Take a proton pump inhibitor like Esomeprazole 40 mg twice daily along with a prokinetic drug (eg.Levosulpiride) for 3 days.This will provide you symptomatic relief from symptoms of acidity and gastritis and should provide relief in pain (you may need to obtain prescription for this from your local physician).

However initially a cardiac checkup should be done to be on safe side. Ekg is a over hyped test which often fails to detect cardiac problems.Secondly a completely normal endoscopy is again shifting diagnosis more toward heart issues.

Please answer-
How are your bowel habits?
History of heart burn,acid peptic disorder gas build up indigestion constipation etc?


In case you don't want to go for tests right now easy way out is next time when you feel heaviness measure your blood pressure if systolic(upper) is more then 100mm of hg take a tablet of isosorbide dinitrate sublinguially (5mg). Classical angina is usually relieved by nitrates.Easy way to rule out cardiac pain.

Thanks.
Above answer was peer-reviewed by : Dr. Kampana
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Answered by
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Dr. Sunil

Gastroenterologist

Practicing since :1982

Answered : 351 Questions

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