Patient's Query
Hello doctor,
I have been using Dextroamphetamine and Amphetamine for about three years now. About a year ago, I started experiencing chest pains that would quickly go away after a while. There were also a few occasions when I abused my medication and took too much. Since the last time this happened (about six months ago), I have experienced squeezing chest pains that last longer and longer. I can no longer drink alcohol because my chest hurts significantly afterward. For the past three weeks, I have experienced a constant squeezing pain in my chest that does not go away. I have had an echocardiogram, multiple EKGs, a stress test, and a CTA scan of my chest, but the pain is still getting worse. What should I do?
Please help.
Hello,
Welcome to icliniq.com.
This is likely gastritis and reflux disease. Pain occurs due to acid reflux and esophageal spasms. You should avoid a fatty, oily, and spicy diet. Take a walk after eating instead of resting. Opt for multiple small meals rather than heavy ones. Maintain regular sleep habits and avoid stress. Refrain from smoking and alcohol for a few days, approximately two to three weeks. Elevate the head of your bed or use pillows while sleeping.
You should be prescribed a combination of Pantoprazole and Domperidone or Esomeprazole and Domperidone to take once daily before breakfast for two weeks; if you experience relief, continue for an additional two weeks. If you do not find adequate relief, consider adding Oxetacaine and Sucralfate syrup, taking two teaspoons three times a day for a week. Consult your specialist doctor and take the medicines with their consent.
Regards.
Patient's Query
Hello doctor,
Thank you for the reply.
I have already seen a gastroenterologist who turned me away. After my endoscopy, my gastritis was treated, and I completed my medication several days ago. This squeezing pain is spreading and affecting my breathing. Can coronary spasms be ruled out? These chest pains started after my Amphetamine abuse.
Hello,
Welcome back to icliniq.com.
Yes, we always consider the possibility of cardiac ischemia in such scenarios. However, since you mentioned that you have had constant squeezing for three weeks, this is less likely to be related to cardiac ischemia. Additionally, you indicated that alcohol made it worse, which again points to gastritis and reflux, as alcohol strongly induces acid production and irritates the mucosa. Did you have an ECG (electrocardiogram) at any time during your chest pain? If so, it should have shown some changes during the episode. If not, you should have an ECG during pain or undergo Holter monitoring when the pain is intermittent.
Based on what you mentioned, gastroesophageal reflux seems to be the likely cause. Did you experience relief with your gastritis treatment? Also, do you smoke heavily? Smoking can damage the lungs and their lining, causing significant pain in the chest, especially pleuritic pain that increases inspiration. Overall, I believe you should try antacids, such as proton pump inhibitors (PPIs), and a local anesthetic gel like Oxetacaine gel, and monitor for relief.
Regards.
Patient's Query
Hello doctor,
Thank you for the reply.
So, can all the tests I have undergone definitely rule out any life-threatening issues?
Hello,
Welcome back to icliniq.com.
They will likely rule out life-threatening issues. However, you should gradually decrease your use of the drug, as high levels at any time may predispose you to acute cardiac issues, arrhythmias, and other problems. Therefore, it is important to avoid abuse.
Regards.
Patient's Query
Hello doctor,
Thank you for the reply.
I have not abused it in several months, but the pain is still there.
Hello,
Welcome back to icliniq.com.
Yes, then it is unlikely to be cardiac. A coronary spasm and similar issues would only occur while the substance is in the system. The effects will not be permanent, and if they were, they should have been evident in the tests you have undergone. Therefore, it is not related to the heart.
Patient's Query
Hello doctor,
Thank you for the reply.
Would any type of anxiety medication help ease my chest pain? The gastroenterologist told me it was likely due to stress.
Hello,
Welcome back to icliniq.com.
Yes, you should take a tablet combination of Etizolam and Propranolol at bedtime for anxiety. Consult your specialist doctor, discuss with him or her, and take the medicines with take the medicines with their consent.
Patient's Query
Hello doctor,
Thank you for the reply.
So what should I do if pain persists after all of this?
Hello,
Welcome back to icliniq.com.
If the pain persists, you should try NSAIDs (nonsteroidal anti-inflammatory drugs) for a week, such as Naproxen 250 mg taken twice a day. This can worsen gastritis and reflux disease, which is why I want to ensure that we are not dealing with those issues. Additionally, we may perform a chest X-ray and a CT (computed tomography) scan if needed. Does this pain increase after meals, when lying down or at night? Does the pain intensify when you apply pressure to your chest, or is it deep inside?
Patient's Query
Hello doctor,
Thank you for the reply.
I just received the results of my CT scan. I have a hairline fracture in my back. However, that does not explain the chest pain I experience after a night of drinking, does it?
Hello,
Welcome back to icliniq.com.
Yes, it can, especially if the spine is involved and there is a possibility of nerve compression. What kind of pain do you experience? Is it a burning, tingling, or numbness sensation, or does it feel like a band constricting your chest? Was there any trauma? If trauma occurred after drinking and caused the hairline fracture, it could lead to nerve compression and result in neuropathic chest pain. In such cases, a nerve stabilizer like Pregabalin may be needed.
Patient's Query
Hello doctor,
Thank you for the reply.
Yes, it feels like a tingling burning sensation that radiates across my chest and makes it hard to breathe. I also feel an intense squeezing on the left side of my chest.
Hello,
Welcome back to icliniq.com.
Is there any mention in the CT (computed tomography) report regarding the vertebrae, disc space, etc.? You should be prescribed Pregabalin 75 mg at bedtime, and if tolerated, increase to twice a day. You should also take vitamin B12 supplements once a day, which is a nerve vitamin. Consult your specialist doctor, discuss with him or her, and take the medicines with take the medicines with their consent. Additionally, you should seek an orthopedic opinion.
Patient's Query
Hello doctor,
Thank you for the reply.
I will have more information about the fracture tomorrow, so I will be sure to let you know.
Hello,
Welcome back to icliniq.com.
Okay. Take care.
Patient's Query
Hello doctor,
Thank you for the reply.
I found out that I had a mild concussion after the fall, and my fracture was in the middle of my back. These chest problems have been getting progressively worse since the fall, but they are especially severe after a night of drinking.
Hello,
Welcome back to icliniq.com.
Do you have your CT scan report? It is likely neuropathic pain caused by nerve compression. Compression pain often feels like a band-like sensation and may be associated with burning, tingling, or numbness. You should consider taking a nerve stabilizer like Pregabalin and a nerve vitamin.
Regards.
Patient's Query
Hello doctor,
Thank you for the reply.
After several months, I am still experiencing a squeezing, burning pain in my upper left chest. The pain is worse during intense exercise and right before I fall asleep. I have been evaluated by a GI doctor and treated for gastritis, cleared by a spinal doctor for a compression fracture and annular tears in my thoracic spine, and have undergone multiple EKGs, a stress test, a chest X-ray, an echocardiogram, and a CT scan by a cardiologist.
This all started last fall. In November, after consuming excessive amounts of alcohol and snorting Dextroamphetamine and Amphetamine, I experienced chest pain and went to the hospital the following night. This was not the first time I engaged in such behavior that semester. Since then, the pain has only worsened and become more persistent. The only medication I have been prescribed is Buspirone for moderate anxiety, which helps, but I do not believe anxiety is the primary issue.
Should I seek a second opinion from another doctor? Can all heart problems be definitively ruled out based on the tests I have had? Additionally, I have been told by several people that they have heard me waking up gasping for air. Could sleep apnea be causing this chest pain, and what type of doctor should I see to investigate this?
My symptoms include burning chest pain, a sensation of a knot in the heart area, palpitations, severe anxiety associated with the pain, trouble breathing (I also have asthma), fatigue, light-headedness, nausea, difficulty exerting much energy, and chest pain when singing or shouting for extended periods.
Please help.
Hello,
Welcome back to icliniq.com.
It is unlikely to be cardiac pain, as your presentation is not typical of cardiac issues, and the tests you underwent are reliable. Therefore, it does not appear to be cardiac-related. Additionally, sleep apnea does not typically cause this type of chest pain. However, given your other symptoms, such as gasping for air, it may be helpful to consult a pulmonologist or a sleep medicine specialist. You could also discuss the chest pain with them.
Alternatively, you may want to seek a second opinion from an internal medicine doctor who can review your records and medical history to determine if anything has been missed or if there are any additional diagnostic clues. The pain is most likely musculoskeletal in nature, rather than anxiety-related. If you have not already tried it, a one-week trial of an NSAID like Naproxen might be beneficial.
The possibility of nerve compression should also be considered and ruled out by a doctor. It would be helpful to be evaluated by a local internist for a thorough review and examination to explore other potential causes.
I hope this helps you.
Thank you.
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Answered byDr. Sagar Ramesh Makode
Medically reviewed byDr. K. Shobana
Same symptoms don't mean you have the same problem. Consult a doctor now!
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