What could cause a chest pain?

Question

Hi doctor,

One year ago, I had chest pain. I thought that it may be due to some excessive spicy food I took last night, and also I did not sleep till late due to some work. So, I just ignored it and left for my work. That day, I had to go somewhere driving myself, and I thought it was just a minor chest pain and would go away eventually. Hence, I left with my car, driving myself. That pain did not go away but rather stayed with me the whole day, and by afternoon, it became worse.

That day I was so busy, and I was almost with an empty stomach. So, I had some food and thought it would go away. I felt a little better for some time, but the pain was still there. In the evening, I had to be admitted to a hospital, and they gave me medication like Sorbitrate, etc., but the pain was there. I did not faint, but I felt that I was going to. The hospital suggested the ICU, and when they were taking me there, I suddenly felt fine. The pain went away out of the blue;

I sat up on my bed from lying down and was feeling that I could go running now, just like nothing happened to me. Still, doctors suggested an ICU, and I got admitted. They did all tests in the next two days and discharged me with a suggestion of an angiogram. I got an angiogram within a week, and the report came back normal.

Now, my problem is, sometimes I feel very little chest pain, which is usually sharp. But it is sometimes vague in various areas of my upper body. I do not know what my problem is. Can you please check my reports? That incident occurred one year back, and I just recently did some usual basic tests.

Please tell me your suggestion.

Answer 1

Hi,

Welcome to icliniq.com.

I want to assure you that you have nothing to worry about, as everything will be fine if proper care and treatment are followed. I have thoroughly gone through your case and reports (attachment removed to protect patient identity) and can well understand your genuine health concerns. You have a regular coronary angiography report. Nothing was found abnormal in it. There is nothing serious noted in the attached echocardiogram.

Your recent blood work has been totally unremarkable, and no harm has been observed. No lipid profile derangement to pose a cardiac risk. But, you had supraventricular tachycardia of unknown origin with chest pain one year back. Such a pain is usually seen in young adults who remain busy in their daily life routine.

This is the disease of the modern era. People experience more stress at work, take very little rest, get little quality sleep, do not exercise, consume a junk diet, and often opt for less nutritious diets. Fluid and electrolyte imbalances, as well as nutrient deficiencies, can lead to muscular weakness and aches.

Undefined painful chest areas are also a problem with smokers and alcoholics. If you take alcohol, smoke, or use any other illicit drug, please try to leave that. I want to run a battery of tests that are necessary to be done right now. Once you get the reports, upload them to a follow-up.

I hope this helps.

Please revert so I can assist you further.

Answer 2

Hi,

Welcome back to icliniq.com.

It is necessary to screen the liver and kidneys in such cases of pain. Your blood reports (attachment removed to protect patient identity) show no significantly remarkable finding to get worried right away. There is not much deranged. A little higher limit of the liver enzymes is seen, for which nothing is needed to do right now as far as medications are concerned. But remember, such patients with borderline laboratory findings need periodic follow-up.

So, I put you on a follow-up list. After every eight weeks, you need to go for the tests written below. Upload the reports for my opinion. I will preferably suggest you choose the best laboratory for blood work so that nothing is left undetected due to the false technique of the laboratory. Your Hepatitis B and C tests are negative in the reports. But the reports are done on the kit, and false negative fluke test results are very common with that method.

The tests to be done are CBC (complete blood count) with ESR (erythrocyte sedimentation rate) and differentials, HBSAg (hepatitis B surface antigen) and anti-HCV (by ELISA), serum electrolytes, LFTs (liver function test), RFTs (renal function test), thyroid profile and ultrasound abdomen.

I would prefer you also go for ELISA (enzyme-linked immunosorbent assay) viral screening of the liver. Your weight loss is due to the lifestyle modification, not due to any disease. There is no suspicion of cancer. In cancer the results are manyfold higher, and you need not worry.

Avoid alcohol, even the one or two episodes too. It is not good for your liver. Some medications also cause increased liver enzymes. So, we have to look after it periodically. Try to adjust your sleep habits in a rhythmic way. Sleep at the same time every day.

For prevention, I suggest avoiding smoking if you do.There is almost no risk to the heart based on all the reports seen throughout our discussions.

I hope this helps.

Please revert so I can assist you further.

Answer 3

Hi,

Welcome back to icliniq.com.

I have gone through your reports(attachment removed to protect patient identity).

Yes, you have a significantly low vitamin B12 level, and your vitamin D level is too low. I suspected hepatitis because your symptoms look like that. But it does not mean you really have hepatitis. Let us wait for the ELISA reports. Suppose someone had unprotected sex with a hepatitis patient six months ago.

In that case, it is possible to experience symptoms today, as after six months, we say it has become a chronic disease. Additionally, within six months, the body defends against the infection and tries to wall it off. If it fails in doing so, the symptoms appear after a lag period.

Also, it is necessary to screen you, as you live in an area where viral hepatitis is prevalent, and every sexually active person should be tested on a slight clinical suspicion. Liv 52 DS, an herbal supplement, is claimed to be good, but the benefits are not scientifically proven by much of the research. If you wish, take it once a day for no more than two to four weeks. If you do not develop a fever, then there is no problem.

You don't need to have a fever for sure. You are fortunate if you don't get sick often. Yes, it is good to keep an eye on your blood pressure. However, digital blood pressure monitors are largely ineffective and are primarily used for reference purposes. It cannot provide an exact reading. I recommend that you get yourself checked with a mercury sphygmomanometer. Mercury machines are accurate for measuring blood pressure.

I hope this helps.

Please revert so I can assist you further.