What Causes A Painful Spot In The Upper Left Chest?

Posted on Wed, 20 Sep 2017

Question: I have a pain in my upper left chest to where I can pinpoint the exact spot. I have had this off and on for a long time. I had a stress test done awhile ago and everything came back fine. I have been coughing a lot where sometimes the coughing helps to clear the feeling. I have had GERD in the past so I am wondering if it may be a digestive disorder since I seem to feel heartburn as well(sometimes)or if it may be heart related. I am on medication for anxiety and have been for years. This thought of it may be heart related is really starting to increase my anxiety. Do you have any advise, suggestions on where I should go from here? I am 5'9 and about 170lbs.

Answered by Dr. Ilir Sharka (2 hours later)

Brief Answer:
My answer as follows:

Detailed Answer:
Hello!

Welcome and thank you for asking on HCM!

Regarding your concern, I would explain that your symptoms do not seem to be related to any cardiac disorders.

Besides, your recent cardiac tests have resulted normal.

So, there is no reason to worry about any heart issues.

The fact that your chest pain is always located in one spot and it is relieved by coughing, may be indicative of a musculo-skeletal pain or a lung disorder (bronchitis).

Gastro-esophageal reflux can not be excluded either, but it is not typical for its pain to be located in just one point.

Coming to this point, I would first recommend trying an anti-acid or PPI (omeprazole, pantoprazole, etc.). If it helps improve your symptoms, it would indicate gastro-esophageal reflux or gastritis as the main cause of your complaints. In such case a fibro-gastroscopy would be necessary to investigate for gastritis.

If this does not help, I would recommend trying ibuprofen or acetaminophen. These drugs can help relieve musculo-skeletal pain (including costochondritis).

If even this does not help, and you have persistent cough, I would recommend performing a chest X ray study and some blood lab test (complete blood count, PCR, ESR) for inflammation to investigate for a lung disorder like bronchitis. Pulmonary function tests may be needed too.

Hope you will find this answer helpful!

Wishing good health,

Dr. Iliri

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Ilir Sharka (28 minutes later)

Thank you. I also forgot to share that recently, it started as if I had a burp stuck in my chest that wouldn't come up. It was getting very annoying and that's when I tried GasX. The pain I feel in my chest is more like a burning pain but like I said before, it is in one specific spot. I still have a cough which I feel like I need to do purposely to make it clear. In regards to your suggestion of "omeprazole, pantoprazole", is this something that needs to be prescribed or is it over the counter? If it is over the counter, what is it called?

Thank you,
XXXXXXX XXXX

Answered by Dr. Ilir Sharka (48 minutes later)

Brief Answer:
My answer as follows:

Detailed Answer:
Hello again XXXXXXX

Yes, it could be gastro-esophageal reflux or gastritis.

A lung disorder like chronic bronchitis can not be excluded, considering your cough.

Regarding omeprazole, it can be taken over the counter with the name of prilosec. I would recommend trying it in the morning.

If the pain persists, I would recommend performing the above mentioned tests.

Hope to have been helpful!

Wishing all the best,

Dr. Iliri

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar