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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What does severe pain in the chest indicate?

My brother is 50 years old. He experienced a work-related back injury about 20 years ago: fell onto a fork lift causing thoracic spine fracture, cervical and lumbar disk herniations. Over the course of time since the accident, he received epidural steroid injections to alleviate pain, had several radiofrequency ablation procedures, and recently (this past May) had back surgery to correct the lumbar disk herniation. He now has been experiencing severe edema of both feet that is very painful, and he can barely walk; he has left-sided chest pain that is moderate to severe and radiates to his left arm and jaw; he is experiencing excessive sweating; his jaw locks and he has a hard time opening his mouth. He was just discharged from the hospital (we had him rushed into the ER) as all tests were negative (blood work, chemical stress test, chest x-ray, leg sonogram, echocardiogram). He is on many medications for pain management and from his recent back surgery. Would you have any idea as to a diagnosis for his recent heart pain?
Mon, 2 Jul 2018
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Endocrinologist 's  Response
Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice.

Left-sided chest pain that is moderate to severe and radiates to his left arm and jaw with excessive sweating are important symptoms that may suggest a heart attack or a coronary heart disease. You mention that all the tests that can diagnose a heart disease were normal and this exclude the cardiac origin of his chest pain. The chest X-ray exclude even the lung-related origine of this pain. So, considering all we said, I can deduct that it can be a muscle pain. I suggest to consult a local rheumatologist for the exact diagnosis and treatment.

Hope I have answered your query. Let me know if I can assist you further.
Regards,
Dr. Elona Xhardo
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