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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Is Chest Pain With Painful Breathing A Sign Of Pleurisy?

Hi
I have persistent left side (heart area) chest pain and left side pain going into neck ,upper left back pain ,often radiating into spinal area. Im nauseous, lost weight and just completed a course of antibiotics (clarimycetin) due to swollen glands and potential chest infection
I went to A+E on 8 January with above complaints . They did an ECG and bloods. No heart involvement shown then. Doctor there diagnosed costocondritis. I went back to my doctor yesterday as i felt worse and i was sent for another chest xray- awaiting results. Im feeling really ill not sleeping.. It does hurt when I take deep breaths . Im allergic to NSAIDs and im taking paracetamol 4hrly and I can manage nurofen. Using heat packs and hot water bottles. Im just wondering may it be pleurisy? Thank you.
Mon, 12 May 2014
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Internal Medicine Specialist,  's  Response
Sir/ Madam thank you for the query. Firstly, I must mention that you have not specified your age or gender. I am considering you to be a middle aged gentleman. Given your clinical history, it has been almost 4 months since you have been troubled by this complain. Your ECG revealed no cardiac abnormality (but that be an insufficient test to rule out a cardiological issue). As per your history, you chest hurts on taking deep breaths, which may point towards pleuritis (the pleuritic chest pain occurs due to friction between the parietal and visceral pleura on deep breathing). You also have a history of probable chest infection with weight loss, and lymph node swelling for which you were managed. Costochondritis, will be unlikely to remain for 4 months, and you are already taking paracetamol. As per your query, this might well be a pleuritic chest pain, probably as a consequence of lower respiratory tract infection (the CXR and some basic blood investigations are required). (It would also be good, if you would mention your smoking history, any h/o trauma or exposure to Tuberculosis)
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Is Chest Pain With Painful Breathing A Sign Of Pleurisy?

Sir/ Madam thank you for the query. Firstly, I must mention that you have not specified your age or gender. I am considering you to be a middle aged gentleman. Given your clinical history, it has been almost 4 months since you have been troubled by this complain. Your ECG revealed no cardiac abnormality (but that be an insufficient test to rule out a cardiological issue). As per your history, you chest hurts on taking deep breaths, which may point towards pleuritis (the pleuritic chest pain occurs due to friction between the parietal and visceral pleura on deep breathing). You also have a history of probable chest infection with weight loss, and lymph node swelling for which you were managed. Costochondritis, will be unlikely to remain for 4 months, and you are already taking paracetamol. As per your query, this might well be a pleuritic chest pain, probably as a consequence of lower respiratory tract infection (the CXR and some basic blood investigations are required). (It would also be good, if you would mention your smoking history, any h/o trauma or exposure to Tuberculosis)