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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Pain In The Center Of The Chest?

why do i feel a pain in my chest and exactly the same point on my back as if i were punced/hurtt there? i have shown cardiologist, he says no heart prob my cholestrol levels ok, but am overweight obese/ but pain persists, just in the centre of my breast.

Thu, 24 Sep 2015
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Cardiologist 's  Response
Hello!

Welcome and thank you for asking on HCM!

Regarding your concern, I would explain that a comprehensive differential diagnosis of many disorders affecting the mediastinal structures (bones, esophagus, lungs, musculoskeletal, aorta, etc) should be done.

I agree with your doctor on the fact that your symptoms don't seem to be cardiac related. A prolonged chest pain is not characteristic for any cardiac disorders.

From the other hand, I would like to know if your symptoms are modulated by respiration or body movements. This pattern would go in favor of a musculo skeletal disorder.

A back bone disorder (like chronic degenerative changes of the vertebral column), could mimic this clinical scenario.

Are your symptoms related to eating? A gastroesophageal reflux or esophagitis could cause similar symptoms with heartburn and burping.

I recommend consulting with your GP for a careful physical examination, a resting ECG, a chest x ray and some blood lab tests (complete blood count, PCR, sedimentation rate, kidney and liver function tests, blood electrolytes, etc.).

A fibrogastroscopy for possible esophagitis or gastritis and a cervico-thoracal x ray study may be needed to exclude the above mentioned disorders.

If all the above mentioned tests result normal, I would recommend taking some painkillers (ibuprofen, acetaminophen), which would help in case of a musculoskeletal pain.

I would also advise to perform a lot of physical activity and lose weight.

Hope to have been of help!

Best wishes,

Dr. Iliri
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What Causes Pain In The Center Of The Chest?

Hello! Welcome and thank you for asking on HCM! Regarding your concern, I would explain that a comprehensive differential diagnosis of many disorders affecting the mediastinal structures (bones, esophagus, lungs, musculoskeletal, aorta, etc) should be done. I agree with your doctor on the fact that your symptoms don t seem to be cardiac related. A prolonged chest pain is not characteristic for any cardiac disorders. From the other hand, I would like to know if your symptoms are modulated by respiration or body movements. This pattern would go in favor of a musculo skeletal disorder. A back bone disorder (like chronic degenerative changes of the vertebral column), could mimic this clinical scenario. Are your symptoms related to eating? A gastroesophageal reflux or esophagitis could cause similar symptoms with heartburn and burping. I recommend consulting with your GP for a careful physical examination, a resting ECG, a chest x ray and some blood lab tests (complete blood count, PCR, sedimentation rate, kidney and liver function tests, blood electrolytes, etc.). A fibrogastroscopy for possible esophagitis or gastritis and a cervico-thoracal x ray study may be needed to exclude the above mentioned disorders. If all the above mentioned tests result normal, I would recommend taking some painkillers (ibuprofen, acetaminophen), which would help in case of a musculoskeletal pain. I would also advise to perform a lot of physical activity and lose weight. Hope to have been of help! Best wishes, Dr. Iliri