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Ask Dr. Natasha Your Own Question

Dr. Natasha
Dr. Natasha, Board Certified Physician
Category: Cardiology
Satisfied Customers: 12910
Experience:  Training in cardiology emergencies.
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i have chest pain week

Customer Question

i have chest pain for a week
Submitted: 1 year ago.
Category: Cardiology
Expert:  Dr. Natasha replied 1 year ago.
Dr. Natasha : Hi
Dr. Natasha : thanks for requesting me
Dr. Natasha : what is going on?
JACUSTOMER-917ocq9h- :

chest discompfort/pain for a week

Dr. Natasha : How old are you?
Dr. Natasha : any other medical problems or medication?
JACUSTOMER-917ocq9h- :

not a sharp pain, mostly focused at the top outer parts of the chest, both sides like near the armpits in a 2-d drawing but not at the armpit level. it's more anterior, but also not shallow anterior, more in the center. Feels like a cramp. I have AS (ankyl. spondylitis and take naproxyn 500mg and a concomitant stomach med) but never had a sensation here. 47 yrs old, white male. I went to the ER 2 days ago to check it out- i dont think its heart related and inded blood work and EKG (ie the wet stickers they place on chest and near legs for 2 mins were negative --they wanted to do more tests like stress test but it was 2am and i wanted to go home. But it is at times very uncomfortable/pain but again not sharp pain. It originally started seven days ago like a rod of discomfort from right to left including over center but not in heart area and not in clavicle area either. like in the middle, like where a person would rest a barbell

JACUSTOMER-917ocq9h- :

also xray chest negative

Dr. Natasha : Reading
Dr. Natasha : Did they screen you for a pulmonary embolism ?
JACUSTOMER-917ocq9h- :

i'd have to research that to know what that is but i'll take a stab and say no what they did was blood work, EKG and chest xray. They also took vitals all fine. I did mention to them that i had this bacteria like feeling in my throat and wanted a swab but they said its likely allergies definitely unrelated and they'd do it later, but i left the hospital as i mentioned, and in any case today that throat etc feeling is gone and i indeed do feel pretty good from that respect

Dr. Natasha : Well in terms of your work up, if you are still in pain, you would need a d-dimer or ct of the chest
Dr. Natasha : I would still recommend a cardiac stress test
Dr. Natasha : if those are negative then you can assume it is muscle related but I would get the above studies first
JACUSTOMER-917ocq9h- :

I want to ask you in order to understand better: are you saying although I feel it has nothing to do with my heart, that I still need to do those and if so how soon. btw i also dont think it's a muscle. It feels closest to the AS type pains EXCEPT that (a) I never had it in this spot (I have had in the back under the shoulder blade and by the ribs and that IS painfully sharp), (b) this does NOT exponentially increase in pain with movement as the AS pain does, (c) the pain is not sharp, (d) the pain/discomfort does not feel like it is going along any joint per se and I am not sure if there is even a joint where the chest sensations are

JACUSTOMER-917ocq9h- :

Are you there Dr?

Dr. Natasha : I am here
Dr. Natasha : the way medicine works is by assessing worst possibility first and eliminating that
Dr. Natasha : you have never had this pain before
Dr. Natasha : you are in your late 40s
Dr. Natasha : this could be musculoskeletal pain
Dr. Natasha : so you need to entertain other possibilities like coronary artery disease and pulmonary embolism
Dr. Natasha : if this is negative then you can treat with Motrin etc for pain
JACUSTOMER-917ocq9h- :

So if those are negative youre thinking just muscoskeletal no big deal

Dr. Natasha : Yes
JACUSTOMER-917ocq9h- :

and no real urgency on the other stuff if i feel i'm ok, just a medicine thing to do to exclude severe stuff, just a pro forma checklist

JACUSTOMER-917ocq9h- :

i'm talking about the pulmonary and heart- i dont see the urgency

JACUSTOMER-917ocq9h- :

sorry, let me rephrase. In terms of the severe stuff (heart), aint i right that empirically if I the patient feel good and cant see it logically that it would be the heart (plus some tests were done and negative), then empirically overwhelmingly overwhelmingly not the heart, right?

Dr. Natasha : I have seen indigestion as the only symptom for heart disease
Dr. Natasha : Try Motrin- if it doesn't help - or you get worse- get the other stuff done
JACUSTOMER-917ocq9h- :

i'll skip the motrin,. I can take it, just worried a little if it means something, but i am comforted by the tests i already did. OK so if it gets worse, like a step up, then i'll go.

JACUSTOMER-917ocq9h- :

? I am satisfied just some delays and stepped out without the final final finalization of this, but likely she agrees. I'm ok with paying, worth it

Dr. Natasha, Board Certified Physician
Category: Cardiology
Satisfied Customers: 12910
Experience: Training in cardiology emergencies.
Dr. Natasha and other Cardiology Specialists are ready to help you
Expert:  Dr. Natasha replied 1 year ago.
Our chat has ended, but you can still continue to ask me questions here until you are satisfied with your answer. Come back to this page to view our conversation and any other new information.

What happens now?

If you haven’t already done so, please rate your answer above. Or, you can reply to me using the box below.
Customer: replied 1 year ago.

Dr

I'm sorry I didnt know that rating had to be better than good for you to get credit and I cant figure out how to change the rating and get you the credit. My good means good, like in the usual sense. I want you paid and hope you know how to fix this or to reach me again if i need to be the one to fix..i just cant figure out how to do this...like a trap.

Expert:  Dr. Natasha replied 1 year ago.
It's all good. I will check in with you in 3 days
Expert:  Dr. Natasha replied 1 year ago.
Hey how are you?

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