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Dr. David
Dr. David, Board Certified MD
Category: Medical
Satisfied Customers: 45945
Experience:  Board Certified Physician
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Went to casualty last Tuesday with severe deep aching central

Customer Question

Went to casualty last Tuesday with severe deep aching central chest pain, sweating, nausea and was weak. They took me into resus as my pulse was 171bpm. ECG was clear just fast, chest X-ray was clear and 12hr trop test was clear. They put it down to musculoskeletal pain but wasn't sure. Only think that showed up was an infection but I had just finished a course of antibiotics for a dental abscess. Wednesday and Thursday I had heavy central chest pain and a lot of discomfort in my left shoulder. Friday afternoon the severe chest pain started again it actually woke me up. It lasted about 15mins. Later that evening I rang nhs direct and they sent an ambulance. Again I was admitted and all tests were clear but was given more antibiotics as bloods said I still had a chest infection. Saturday morning I went from my bed to the toilet and back and spent 15mins with severe nausea so bad that tears were coming down my face. I was discharged yesterday with tramadol, paracetamol, antibiotics and my usual medication. Yesterday morning again my left shoulder was uncomfortable then the pain hit my chest!! It lasted 4hrs and was agony. It doesn't hurt when I move so I am convinced it is not a muscle!! It literally feels like a train has hit my chest. Anyway the doc came and said I'm not text book but could be pericarditis and arranged for me to have a scan this Wednesday and to repeat bloods. I would of thought ECG, X-ray and bloods etc would have shown pericarditis up. All the docs said my chest is clear. Now I have a deep aching pain slightly to the left the back of my neck really stiff and the top of my left shoulder uncomfortable. Last night I was a little bit breathless and the room was spinning. Any ideas cos this pain is way to much for a muscle or acid reflux. I also don't think it's panic. I just know something is wrong
Submitted: 3 years ago.
Category: Medical
Expert:  Dr. David replied 3 years ago.

Dr. David :

This is Dr. David

Dr. David :

ECG and chest xray can miss pericarditis.

Dr. David :

a chest CT scan is better at looking at the chest.

Dr. David :

you should get a cardiac echo to check for pericarditis.

Dr. David :

or a chest CT scan.

Dr. David :

if pericarditis is found you might need steroids and NSAIDs to help decrease the swelling and inflammation of the pericardium.

Dr. David :

do you have a history of excessive anxiety or panic attacks?

Dr. David :

excessive anxiety and panic attacks can cause chest pain and shortness of breath and dizziness symptoms.

JACUSTOMER-fx6e11gs- : Yes I have borderline personality disorder and OCD but this is no way anxiety. Chest X-ray was clear. I now have pin point pain in the left side of my neck and left arm is weak and a very heavy feeling in chest
Dr. David :

I see.

Dr. David :

OCD is a type of anxiety disorder

Dr. David :

and can cause you to have pains in your chest and neck and feel like you have arm weakness.

JACUSTOMER-fx6e11gs- : Yes but this has been under control for a long time plus I don't feel panicky. The pain actually woke me up and paramedics said it wasn't anxiety or panic
Dr. David :

well, then you should ask your doctor for a cardiac echo

Dr. David :

and a chest CT scan to check for pericarditis.

Dr. David :

although this is very unlikely.

JACUSTOMER-fx6e11gs- : They are doing one on Wednesday morning with repeat bloods to check level of infection
JACUSTOMER-fx6e11gs- : Why do u not think it is pericarditis
Dr. David :

I see

Dr. David :

good luck with that.

Dr. David :

because of your age.

Dr. David :

and because pericarditis is rare.

JACUSTOMER-fx6e11gs- : Yes but surly I would feel anxious if it was anxiety and it literally feels like a train has ploughed into my chest
Dr. David :

I see.

Dr. David :

well good luck with the testing.

JACUSTOMER-fx6e11gs- : Nhs website says pericarditis accounts for 5% of chest pain hospital admissions so can't be that rare
Dr. David :

that is rare.

Dr. David :

why did you rate poor service?

Dr. David :

why do you keep rating poor service?

JACUSTOMER-fx6e11gs- : Didn't seem very professional. Did not really offer any advice. Did not seem to understand the level of pain I was in. Just kept saying good luck with testing :-(
Dr. David :

I am still here to help you.

Dr. David :

I am sorry you are in pain.

Dr. David :

you can use pain medications or go to the hospital if you are still in pain.

Dr. David :

you can ice your chest as well

Dr. David :

if you have pericarditis you will need steroid therapy and NSIADs like ibuprofen or naproxen sodium to help decrease pain.

Dr. David :

you keep rating poor service again.

JACUSTOMER-fx6e11gs- : I can't see how getting out of bed would make me have severe nausea if it was anxiety. Neither can I see anxiety make me come out in constant cold sweats when I'm asleep.
Dr. David :

have you had your thyroid hormone levels checked?

Dr. David :

what test showed infection?

Dr. David :

did you have an elevated WBC or white blood cell count?

JACUSTOMER-fx6e11gs- : Yes white blood cells were raised and they put me back on antibiotics. I'm guessing they checked my thyroid
Dr. David :

I would make sure they testing your thyroid hormone levels

Dr. David :

abnormal thyroid hormone levels can cause cold sweats.

Dr. David :

your infection could cause cold sweats.

Dr. David :

nausea can be from excessive stomach acid

Dr. David :

or nervous stomach

JACUSTOMER-fx6e11gs- : So where is the severe chest pain coming from
Dr. David :

could be pericarditis

Dr. David :

or a costochondritis rib infection

Dr. David :

or severe esophagitis

Dr. David :

or esophageal spasms.

JACUSTOMER-fx6e11gs- : U said that was unlikely
Dr. David :

yes, unlikely pericarditis.

Dr. David :

about 5%.

JACUSTOMER-fx6e11gs- : I honestly don't think it is anxiety. I just know. I also have mild pulmonary stenosis
Dr. David :

I see.

Dr. David :

well, the testing you will have will be able to tell if you have pericarditis.

Dr. David :

do you have any other questions for me?

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