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Ask Anthony Bray, MD Your Own Question
Anthony Bray, MD
Anthony Bray, MD, Doctor
Category: Health
Satisfied Customers: 10341
Experience:  14 years as clinician in the field of Family Practice
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for dr. anthony bray: im worried im having a heart problem.

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for dr. anthony bray: im worried im having a heart problem. can you help?

Anthony Bray, MD : Hello!
Customer:

hi again dr. i actually wasnt worried about a heart problem until i asked someone on here, but ive talked to you before and trust your opinion

Anthony Bray, MD : Refresh my memory ( I have spoken with several people recently with heart concerns and I don't want to confuse your history with someone else!)
Customer:

im mr. pancreatic cancer...age 25

Anthony Bray, MD : Tell me what your concerns are....
Customer:

well i wasnt concerned at all until he told me this

Anthony Bray, MD : Oh OK !! Yes that brings into focus quite well!!
Customer:

im having a sharp pain in my lower left ribs, it comes and goes

Customer:

but it shoots into my left shoulder

Customer:

when it comes

Customer:

no other symptoms

Anthony Bray, MD : Well first if SHARP quality of pain is not usually cardiac in nature ...
Customer:

this is more sharp

Customer:

i have ZERO pain in my chest

Customer:

it feels like its right in my lower left rib cage

Anthony Bray, MD : It so far sounds possibly musculoskeletal --- does it hurt to twist your trunk right / left?? Raising arms hurt??
Anthony Bray, MD : Does it hurt to take deep breath???
Customer:

honestly no

Anthony Bray, MD : Is it tender to press near the sternum or over the ribs??
Customer:

im sitting here breathing in deep and im fine

Anthony Bray, MD : Any exercise that may have induced problem??
Customer:

no, no pain at all pushing

Anthony Bray, MD : no shortness of breath , right??
Customer:

laying down, it bugs me a little more

Customer:

none

Anthony Bray, MD : What about bending at waist forward and then standing up? Bending to each side??
Anthony Bray, MD : any nausea??
Anthony Bray, MD : anything that makes pain worse or better??
Customer:

just did all those

Customer:

nothing

Customer:

no nausea

Customer:

nothing really makes it better

Customer:

just comes and goes

Anthony Bray, MD : Any abdominal pain?? Does it radiate to the back??
Customer:

sometimes its not even there....for a little bit this morning, i felt and it hurt it bad, but then went away

Customer:

no abodominal pain

Anthony Bray, MD : how often and for how long does this pain bother you??
Customer:

and nothing in the back

Customer:

this pain started last night after dinner

Customer:

literally just comes and goes

Customer:

i cant give you a real time frame....im sorry

Anthony Bray, MD : There is nothing in your history ( not age / not quality if pain/ not location of pain) that makes me suspect a cardiac cause at all!!
Customer:

this other person on here told me that since its shooting up into my shoulder and arm

Customer:

that its a heart attack and i should go to the ER

Customer:

that freaked me out big time

Anthony Bray, MD : I would tend to suspect some musculoskeletal cause --- sharp character and short duration -- you might benefit from Aleve 2 tablets twice a day for Two weeks and this may help it to settle down...
Anthony Bray, MD : if you have connective tissue injury of the skeletal frame then that could be your cause ...
Customer:

but heart attack

Customer:

?

Anthony Bray, MD : Well relax!!
Anthony Bray, MD : You are 25 years old and the prospect of coronary artery disease at your age is NOT likely at all!!
Anthony Bray, MD : you said it did not hurt to take deep breath either... Pulmonary causes that can radiate to shoulder could include pulmonary embolism / pneumothorax/ pneumonia / pleurisy ( pleuritis )
Anthony Bray, MD : None of these seem likely since you have no pain with taking deep breath...
Customer:

it does not

Customer:

no

Customer:

but as you know, if you remember me, im very very nervous and scared

Customer:

and someone just told me that i could be having a heart attack

Customer:

imagine me now

Anthony Bray, MD : I have never seen a person your age with a heart attack!!! ( other heart conditions rarely ) youngest heart attack patient in my years if experience was diabetic smoker with high blood pressure and cholesterol and he was 36...
Customer:

i was also thinking maybe trapped gas

Customer:

i was very gassy this morning

Customer:

all day really

Customer:

but would that cause pain to shoot up?

Anthony Bray, MD : Yes I understand!! The opinion has fanned your anxiety and fear but I assure you that at your age your symptoms do not represent a heart attack!!
Anthony Bray, MD : You could have separate sources of side and shoulder pain for one possible explanation here!!
Anthony Bray, MD : i think doctor's exam may be helpful if this remains as a bothersome symptom but I do not think you need to be seen emergently at all !!
Anthony Bray, MD : Some injury of the rig cage itself may be the reason for the left rib area pain...
Customer:

i dont think its anything

Anthony Bray, MD : the should pain may be separate...
Customer:

rib cage related

Anthony Bray, MD : I would examine both areas for functional range of motion and for tenderness for example...
Customer:

but again, a heart attack?

Customer:

i dont wanna worry about that

Customer:

and this pain is not presistent by any means

Anthony Bray, MD : If you had some reason for enlarged spleen then that could cause an ache at the lower aspect of the left rib age area .... Mono for example can do this....
Anthony Bray, MD : It's not a heart attack --- relax with regard to that!!!
Customer:

ok

Customer:

ill relax in that aspect

Anthony Bray, MD : Without benefit if exam I can't tell you exactly what it is causing the discomfort but ?? Heart attack >> no way !!!
Anthony Bray, MD : Ok -- good -- I hope this helps !!
Anthony Bray, MD : Let me know if you have further questions or concerns!!
Customer:

thank you as always dr.

Anthony Bray, MD : i will be happy to get back with you!!
Anthony Bray, MD : You are very welcome!!
Anthony Bray, MD : take care and best regards XXXXX XXXXX!!
Anthony Bray, MD : Anthony Bray MD
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