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Ask Dr. Arun Phophalia Your Own Question
Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 35035
Experience:  MBBS, MS (General Surgery), Fellowship in Sports Medicine
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I have been having sharp and sore pains in my chest around

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I have been having sharp and sore pains in my chest around the heart region. It comes and goes, but lately it's been more persistent. The pains started more frequent after pregnancy.
Could this be a hiatal hernia?

Hello Kevin,
I am Dr. Arun and will be helping you today.

What did you EKG, chest x-ray show?
Since when is the pain?
How severe is the pain?
Do you have breathlessness, cough?

Customer: replied 4 years ago.

Hey Dr. Phophalia, I haven't had any X-rays. In fact when I was having another health problem the hospital didn't want to give me any X-rays what so ever because of how young I am.
The pain started with being intense pounding, short of breath, almost like someone was squeezing my heart. It wasn't persistent enough for me to really be concerned about. It has become much more intense and concerning now, especially since having a baby about a year ago. The pain has really been frequent lately; almost every day there's either sharp poking like pains around my heart, or a very sore pain in my esophagus/ heart area. Nothing has changed a whole lot in my routines, responsibilities, diet, etc. I did have a short coughing attack a couple weeks ago, I guess I could say since then my chest has been having the random pains and soreness. That's what made me think it might be a hernia.

The pain level varies. It mainly feels really sore in my chest, but at different times I have the intense sharp pains and such which last for only 10 minutes tops. Pain level scale wise it ranges from 7 to 10 with the quick attacks and for soreness only 2 to 5. The soreness isn't so bad just not great!

Medical history wise, I have had severe anxiety attacks but I feel I have learned to breathe those out and I was diagnosed with acid re-flux many years ago.



With recurrent pain, history of acid reflux and in a 22 year female; it is not likely to be a heart disease. Still standard of protocol is get an EKG and chest x-ray.

Following should be the possibilities;

1) GERD with the history of reflux would be prime consideration as it is one of the commonest cause for non cardiac chest pain.

2) Hiatus hernia

3) Esophagitis

4) Costochondritis; it is inflammation at the junctions of rib and cartilage or with the breast bone / sternum. Local analgesic ointment, or spray, chest brace and warm compresses with Ibuprofen is helpful. Another possibility is muscle sprain. Please read about the costochondritis;

5) Esophageal spasm

6) Myofascial pain syndrome

Investigations like Barium esophagogram, Esophagogastroduodenoscopy (EGD; camera exam), Esophageal manometry, Ambulatory 24-hour pH monitoring may be the next step of evaluation by your doctor. Anxiety and stress can increase any condition. Following meanwhile can help and should be tried (help in GERD and hiatal hernia):

1) antacids; Maalox

2) acid blocker; Prilosec

3) loosing weight, if overweight.

4) avoiding alcohol, citrus fruits and juices, chocolate, and tomato based products

5) avoiding large meals. Eat 5 small meals in a day.

6) wait three hours after the meal before you sleep.

7) elevate head end of the bed by 8 inches.

Please feel free for your follow up questions.

I would be happy to assist you further, if you need any more information.

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