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What Causes Pain In Rib Cage And Shoulder Blade When Suffering From PVC?

Posted on Wed, 27 Aug 2014

Question: Hello. I am a 38 year old male with a history of generalized anxiety and PVCs. I am 6 foot tall and weigh 275. (Overweight). I do not smoke. I have high triglycerides, low HDL and a fatty liver. Anyway, I started exercising daily about 3 months ago and now jog 3-4 miles per day trying to lose weight. Have lost 3 inches in waist but haven't lost any pounds (very frustrating). Anyway, over the past week I have a very tender xyphoid process and right rib cage pain (dull pain) that extends to my right shoulder blade. I can see a slight pulse in stomach when lying down and worried about an aneurysm. Please address this? Should I worry so much?

Answered by Dr. Benard Shehu (3 hours later)

Brief Answer:
Please refer to the following answer...

Detailed Answer:
Hi and thank you for asking HCM!

The pain you are experiencing may be related to your previous conditions (generalized anxiety and PVCs). However other problems (cardiac, aorta, pulmonary, gastrointestinal ect.) should be ruled out first.

If you were my patient i would like to run some preliminary examinations before reaching any conclusion.
- Cardiac Echo
- ECG Holter monitoring
- Chest x ray
- Abdominal ultrasound

If anything is abnormal other more specific tests are needed otherwise everything is ok.

Hope this was of help!
Dr. Benard Shehu

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Benard Shehu (11 hours later)

Thank you. One thing i noticed about pain is that its worse upon awakening in morning and feels somewhat better after large meal. It also worsens when straining to have bowel movement. It also feels better while jogging the four miles. Could this be GI related?

Answered by Dr. Benard Shehu (20 hours later)

Brief Answer:
The pain is GI related...

Detailed Answer:
Hi and thank you for following up!

From what you are saying the pain is more likely to be related with gastrointestinal problems.

So i recommend to run:
- Abdominal ultrasound (as mentioned earlier)
- Upper GI endoscopy.

Based on the results, doctors will decide the proper diagnosis and treatment.

Hope this was of help!
Dr. Benard

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Benard Shehu (1 hour later)

Thank you. I went to ER. Had troponin level of 0.12. Had nuclear stress test and ekg and both were normal. Kidneys were good. Still having same pain. They say its not cardio but then why would troponins be present? They should be zero.

Answered by Dr. Benard Shehu (1 hour later)

Brief Answer:
Troponin is not always 0...

Detailed Answer:
Hi back,

I am glad to know that your tests resulted normal. That means that the origin of your pain is not cardiac.

With regards to troponin levels, it is difficult to get its level 0 due to cells destruction (although minimal).

Furthermore, apart heart, troponin levels can be raised when other muscles cells are being destroyed (e.g.skeletal muscles).

All the best!
Dr.Benard

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Benard Shehu (2 minutes later)

Thank you so much!

Answered by Dr. Benard Shehu (2 minutes later)

Brief Answer:
Happy to be assisting you...

Detailed Answer:
Hi back,

You're most welcomed!

If no more queries, kindly close this discussion and rate my answer.

Thank you!
Dr.Benard

Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Raju A.T