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What could be the cause for Chest pain when all tests normal?

Apr 2014
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Answered by

Practicing since : 2004
Answered : 6485 Questions
I'm a 40 year old nonsmoking white male. Genetic history is a father with RA since his mid thirties. Mother was adopted. Last two years I have had steadily increasing pain in central chest area. No cough, no sharpness or increase corresponding to breathing. More of a constant ache. I notice it more at night, and it's bad enough it does at times wake me up. PCP says lung sounds are normal. Did a cardio consult and got ECG. Everything normal there. Heart is not the problem. Chest x-rays one year ago and again recently, both normal. H pylori negative (I assume, haven't heard from them). I am an x-ray tech and no expert but one rad dictated "enhanced perihilar markings" and my bronchioles do seem to be rather pronounced. I also took it upon myself to check for reflux on an admittedly limited barium swallow. Negative. Recent history: I noticed it about the same time as I started bicycle commuting to work, about 20 miles round trip, average 2-3 times a week. I have laid off at times and taken breaks for the winter time. It seems to hurt more after cardio exercise but lately I am feeling it almost all the time. I swept ceiling tile dust (not asbestos but mineral wool and some fiberglass) for almost ten years in my twenties. This is an area that worries me. Did my increase in physical actively later in life lead to some chronic irritation now? ILD? I haven't been to a pulmonologist yet but am thinking this is my next step. Some guidance please!
Posted Fri, 3 Jan 2014 in General Health
Answered by Dr. Indu Kumar 2 hours later
Brief Answer: Central chest pain may be due to reflux disease Detailed Answer: Hello XXXXXXX vanzant Thanks for writing to XXXXXXX According to me central chest pain may be due to reflux disease.It can be confirmed by Upper GI endoscopy.Barium swallow is not sensitive test for reflux disease. I don't think you have ILD. Chest X-ray and auscultatory findings are normal in your case.Crackles are typically found in ILD. Also chest X-ray is characteristic in ILD. Enhanced perihilar markings and pronounced bronchioles may be due to infection. Increased physical activity is not related to your symptoms. You are thinking right to consult pulmonologist.Investigations like Pulmonary function test should also be done.Other investigations can be done if needed. Proper treatment can be done after clinical examination and investigation reports. Get well soon. Hope i have answered your query. Further queries are most welcome. Take Care Dr.Indu XXXXXXX
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