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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Severe Pain Under The Breast. Gall Bladder Removed. MRI, CT Scan And Ultrasound Normal. Anything To Be Concerned New?

For years I have had attacks of severe pain under my left breast .First time it occured I thought I was having a heart attack . Doctors have riled out heart problems. These attacks last betweek 30-60 min and occur once or twice a month. Gallblader removed, no help. I have have mri , ct scan , cat scan, ultrasound, but no one finds the problem. Any help appreciated.
Fri, 15 Nov 2013
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Internal Medicine Specialist 's  Response
Hi there,

Thanks for your query.

From the brief information provided, the intermittent chest pain can be due to Post-cholecystectomy dumping syndrome, a condition in which, excess of bile and acid tend to regurgitate into the food pipe, which leads to pain in the center of the chest as well as left side of chest and occasionally, bitter fluid into the mouth.

Further, though doctors have ruled out heart problems, Prinzmetal's angina is still a possibility, in which there is a transient spasm (narrowing) of the blood vessels supplying the heart and causing transient angina. There is no physical narrowing of these blood vessels. hence, all tests, including ECG, TMT, 2-D Echo, Thallium scan and even angiogram can be normal. This possibility is particularly high in those with risk factors, such as obesity, chronic smoking, regular alcohol intake, high blood pressure, presence of diabetes and high cholesterol levels.

Further, occasional, transient spasm of the chest muscles between the ribs can cause similar pain.

There is no harm in taking anti-acid drug such as omeprazole twice daily + domperidone thrice daily for a month and see if you get similar chest pain while on these drugs.

Consult your doctor and apprise him of my opinion. I am certain that he agree with me, order required tests, and- based on the reports- will prescribe suitable treatment as advised.

If you find my response helpful and informative, do not forget an “excellent” rating to my answer, to encourage all doctors- engaged in social service- to render sound advice to the FREE queries.

Lastly, if you need a detailed and prompt answer, you may post a "Direct Query (Premium)" addressed personally to me, providing as much detailed information about your problem(s) as possible; age/gender; addictions (if any ;medical history (if any); current medications (if any) and known allergies.

Fond regards and have a nice day

Dr. Rakesh Karanwal
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Severe Pain Under The Breast. Gall Bladder Removed. MRI, CT Scan And Ultrasound Normal. Anything To Be Concerned New?

Hi there, Thanks for your query. From the brief information provided, the intermittent chest pain can be due to Post-cholecystectomy dumping syndrome, a condition in which, excess of bile and acid tend to regurgitate into the food pipe, which leads to pain in the center of the chest as well as left side of chest and occasionally, bitter fluid into the mouth. Further, though doctors have ruled out heart problems, Prinzmetal s angina is still a possibility, in which there is a transient spasm (narrowing) of the blood vessels supplying the heart and causing transient angina. There is no physical narrowing of these blood vessels. hence, all tests, including ECG, TMT, 2-D Echo, Thallium scan and even angiogram can be normal. This possibility is particularly high in those with risk factors, such as obesity, chronic smoking, regular alcohol intake, high blood pressure, presence of diabetes and high cholesterol levels. Further, occasional, transient spasm of the chest muscles between the ribs can cause similar pain. There is no harm in taking anti-acid drug such as omeprazole twice daily + domperidone thrice daily for a month and see if you get similar chest pain while on these drugs. Consult your doctor and apprise him of my opinion. I am certain that he agree with me, order required tests, and- based on the reports- will prescribe suitable treatment as advised. If you find my response helpful and informative, do not forget an “excellent” rating to my answer, to encourage all doctors- engaged in social service- to render sound advice to the FREE queries. Lastly, if you need a detailed and prompt answer, you may post a Direct Query (Premium) addressed personally to me, providing as much detailed information about your problem(s) as possible; age/gender; addictions (if any ;medical history (if any); current medications (if any) and known allergies. Fond regards and have a nice day Dr. Rakesh Karanwal