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I went to the ER for chest pains about two weeks ago and the…

Customer Question
I went to the...

I went to the ER for chest pains about two weeks ago and the doctors said it was die to low potassium. Even with diet changes the pain hasnt completely subsided and its worse at night or mid afternoon. Some nights are better than others, but I dont know what symptoms to watch for with chest pain or whats dangerous

Doctor's Assistant: Have you ever dealt with this before? Are you having any shortness of breath?

Yes, its not always noticeable though. I am a college student and I have anxiety issues. So, im not sure if chest pains are due to anxiety/ muscle strain or something more serious

Doctor's Assistant: Anything else in your medical history you think the doctor should know?

I am prescribed 30 mg of Adderall IR a day and had to stop anxiety medications because they worsened anxiety/panic attacks. Ihavent gotten much sleep due to both the chest pains and my anxiety about school work and other things

Submitted: 7 months ago.Category: Medical
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Customer reply replied 7 months ago
Posted by JustAnswer at customer's request) Hello. I would like to request the following Expert Service(s) from you: Live Phone Call.
Customer reply replied 7 months ago
Let me know if you need more information, or send me the service offer(s) so we can proceed.
Answered in 8 minutes by:
11/21/2017
Doctor: Dr. Arun Phophalia, Doctor replied 7 months ago
Dr. Arun Phophalia
Category: Medical
Satisfied Customers: 38,712
Experience: MBBS MS. Post doctoral fellowship in Sports Medicine. General surgeon and sports medicine specialist
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Welcome to Just Answer.
Answers here are for education and information.
I will respond shortly with an answer, or further information request.

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Customer reply replied 7 months ago
Is there any way we could speak over the phone?
Doctor: Dr. Arun Phophalia, Doctor replied 7 months ago

Since you were examined at ER; heart is unlikely to cause chest pain.

I would consider following for your symptoms;

1) Esophageal spasm
2) Esophageal motility disorder
3) Esophagitis.

Following treatment may help you;

a) Calcium channel blockers (diltiazem, nifedipine) decreases the spasm and improves the movements of the esophagus.
b) Relaxation techniques.
c) Noncardiac chest pain in the setting of esophageal spasm and esophageal movement disorder (dysmotility) often shows good response to antireflux therapy, even in the absence of typical gastroesophageal reflux symptoms.
d) Reassurance and control of anxiety is extremely important.

Anti reflux therapy is;

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.

Following also would be helpful;

A. Herbs;

1) Cranberry
2) Peppermint

B. Homeopathy

1) Nux Vomica
2) Pulsatilla

C. Nutrition and supplements;

1) Multivitamin; vitamins A, C, E, the B vitamins, and trace minerals, such as magnesium, calcium, zinc, and selenium.
2) Probiotic supplement
3) Omega 3 fatty acid
4) Avoid; cookies, crackers, cakes, French fries, onion rings, donuts, processed foods, and margarine.5) Also avoid; white breads, pastas, and especially sugar, red meats,
6) Eat lean meats, cold water fish, tofu, beans, olive oil

Helpful investigations to establish and confirm the diagnosis are;

1) Esophageal manometry; evaluates esophageal motor pattern.
2) Esophagram / Barium swallow
3) Ambulatory esophageal manometry
4) CT scan of the chest.

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Customer reply replied 7 months ago
I have recentley had sharp chest pains only lasting a few seconds in middle of chest. I also have inflammation on left collar bone and a little bit on center of chest. My skin is also splotchy (red and white) with more red finger tips. Ive had palpatations and left upper side pain with left shoulder, armpit, and back pain.
Customer reply replied 7 months ago
Oh and left neck pain/ stiffness I am having trouble resting, this chronic pain has been keeping me awake mosg nights
Doctor: Dr. Arun Phophalia, Doctor replied 7 months ago

There are few other reasons of your chest pain;

1) Pinched nerves in neck.

2) Costochondritis

3) Myoascial trigger point.

All can be concomitant.

Anxiety can exacerbate them.

Myofascial trigger point can be associated with degenerative disc disease in neck causing pinched nerves. Trigger points may develop after an initial injury to muscle fibers. This injury may be a noticeable traumatic event or repetitive microtrauma to the muscles. The trigger point causes pain and stress in the muscle or muscle fiber. As the stress increases, the muscles become fatigued and more susceptible to activation of additional trigger points. When predisposing factors combine with a triggering stress event, activation of a trigger point occurs. Myofascial trigger point is a hyperirritable spot, usually within a taut band of skeletal muscle or in the muscle fascia which is painful on compression. The treatment is following;

1) passive stretching of the affected muscle after application of sprayed vapocoolant

2) physical therapy

3) deep electrotherapy; iontophoresis, phonophoresis, short wave diathermy, electrical stimulation

4) local analgesic patch / ointment / spray

5) anti-inflammatory analgesics; Ibuprofen (Motrin / Advil)

6) ischemic compression therapy; pressure on the points

7) massage

8) steroid shots.

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Doctor: Dr. Arun Phophalia, Doctor replied 7 months ago

Anxiety can be treated by the following measures by yourself;

1) Cognitive-behavioral therapy (CBT) and operant-behavioral therapy (OBT); done by a psychologist.

2) Relaxation training and biofeedback.

3) Hypnosis

4) Acupuncture and acupressure

5) Yoga

6) Meditation

7) Group sporting activities

8) St. John's wort

9) Melatonin
10) Valerian root.

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Doctor: Dr. Arun Phophalia, Doctor replied 7 months ago

You may seek a consultation at urgent care.

Polychondritis should be ruled out for your present symptoms.

This is viral inflammation of rib cage joints.

Motrin can help you.

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Doctor: Dr. Arun Phophalia, Doctor replied 7 months ago

A very unusual cause in young patient like you for your symptoms can be Shingles.

But this would be diagnosis on exclusion (ruling out rest of common causes we had discussed).

It is privilege assisting you.

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