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What Causes Constant And Severe Chest Pain In A 26 Year Old Man?
Posted on
Mon, 6 Jun 2016
Medically reviewed by
Ask A Doctor - 24x7 Medical Review Team
Mon, 6 Jun 2016
Answered on
Tue, 5 Jul 2016
Last reviewed on
Question : My son, who is 26 years old, has been experiencing debilitating chest pains for several weeks. He has been to a number of doctors. It takes two weeks to get an appointment with family physician and the emergency room is unaccessable (we left after three and a half hours when they told us it would be a couple of more hours wait) EKG tests and x-rays come back negative. Medications have had no effect on pain. At this point, we have no diagnosis and no effective treatment and are at a loss as to where to go now.
We live in XXXXXXX VA and need some advice. This lad is suffering to the point of mental anguish and we're getting nowhere.
We live in XXXXXXX VA and need some advice. This lad is suffering to the point of mental anguish and we're getting nowhere.
Brief Answer:
I would explain as follows:
Detailed Answer:
Hello!
Welcome and thank you for asking on HCM!
I carefully passed through your question and would explain that your symptoms and would explain that it is important performing a comprehensive differential diagnosis of different causes that may lead to this clinical scenario:
1- Inflammation. Costochondritis could be the cause of his symptoms. Is the chest pain exacerbated by body movements, respiration or coughing? This could indicate possible inflammation of the soft tissues (muscles, ligaments, etc). I would recommend performing inflammation tests to investigate for this disorder.
2- Gastro-esophageal reflux or esophageal spasms could also mimic this clinical scenario. A fibrogastroscopy is necessary to exclude these disorders, including hiatal hernia.
3- Possible acute pancreatitis. It can cause pain in the lower chest, with other symptoms like diarrhea, etc.. Does he have any other symptoms? Are his symptoms triggered by eating?
4- Possible gallbladder stones. I would recommend performing an abdominal ultrasound to investigate for this possible disorder.
Myocardial ischemia has been ruled out by your repeated ECG. So, considering his young age, I would not recommend performing further tests to investigate for this disorder.
You should discuss about the above issues with his doctor.
Hope you will find this answer helpful!
Kind regards,
Dr. Iliri
I would explain as follows:
Detailed Answer:
Hello!
Welcome and thank you for asking on HCM!
I carefully passed through your question and would explain that your symptoms and would explain that it is important performing a comprehensive differential diagnosis of different causes that may lead to this clinical scenario:
1- Inflammation. Costochondritis could be the cause of his symptoms. Is the chest pain exacerbated by body movements, respiration or coughing? This could indicate possible inflammation of the soft tissues (muscles, ligaments, etc). I would recommend performing inflammation tests to investigate for this disorder.
2- Gastro-esophageal reflux or esophageal spasms could also mimic this clinical scenario. A fibrogastroscopy is necessary to exclude these disorders, including hiatal hernia.
3- Possible acute pancreatitis. It can cause pain in the lower chest, with other symptoms like diarrhea, etc.. Does he have any other symptoms? Are his symptoms triggered by eating?
4- Possible gallbladder stones. I would recommend performing an abdominal ultrasound to investigate for this possible disorder.
Myocardial ischemia has been ruled out by your repeated ECG. So, considering his young age, I would not recommend performing further tests to investigate for this disorder.
You should discuss about the above issues with his doctor.
Hope you will find this answer helpful!
Kind regards,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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