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I have chronic Chest Pain for which I had been taking

Hydromorphone. I no longer take...
I have chronic Chest Pain for which I had been taking Hydromorphone. I no longer take that and was switched to Nucynta.In the past, I’ve had 3 PE’s & 1 DVT. I also have had GERD and anxiety issues among other issues.I’ve been having chest pain since about...8 last night. It comes and goes about every 5-6 min. or so & lasts about 5-10 seconds. It is moderate-extremely moderate in severity.We had cheesy pasta for dinner, if that helps.What’s going on? What should I do??
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Answered in 2 minutes by:
11/21/2017
Dr. Muneeb Ali
Category: Medical
Satisfied Customers: 9,926
Experience: MBBS, MD, MCCM. Currently working in Critical Care Medicine with 10 year experience in Medicine
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Hi,
Welcome to Ja and thanks for this question. I'm sorry to hear about your symptoms. Can I ask where exactly is the pain occurring, right or left or center of the chest? Any shortness of breath? Arm or jaw pain? Sweating? Altered taste in the mouth? Also what is your age and gender?
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Customer reply replied 8 months ago
Pain is more to the left of my chest, as always. No shortness of breath. Maybe a VERY tiny bit of arm pain. No jaw pain or sweating.
I don’t think I have an altered taste? What would that be like?I’m a 33 year old female.

Thanks for the additional information, let me just write down an answer for you and ill get back to you in a few mins. If you get a phone call request, that is an automated site response. I DID NOT send it. Thanks!

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Actually given your age and the history that you have described it is not likely that this pain is due to the heart. Infact i think this pain is more likely to be due to the gastrointestinal system. You could be experiencing worsening of the GERD which can present with pain which is different than the common heartburn. It can cause sharp stabbing pain or even a dull pain. This would be true because you also had a heavy dinner last night and the pain started soon after the dinner. If this is the case then using OTC prilosec at a dose of 10 mg twice a day for the next 7 days would be useful here. Cutting back on caffeine and alcohol would also help. Secondly, it is also possible that this pain is due to oesophageal spasms which are related to GERD but a separate disease process. This would cause pain due to intermittent spasms of the muscles of the oesophagus which would lead to sharp pain in the region. This can be worsened by certrain triggers including anxiety and GERD and heavy food products like the pasta that you had. This would be diagnosed with a clinical examination and also with the help of a endoscopy along with oesophageal motility studies. Most cases do respond to prilosec however certain patients require further treatment with calcium channel blockers as well as nitrates to help relax the oesophagus.

Now i DONT think that this is due to the heart given your age and past history AS WELL AS due to the absence of the characteristic symptoms like shortness of breath or sweating BUT if would still suggest getting an EKG done IF the pain worsens or if you develop any of the other symptoms that i asked about OR if the pain persists even after using OTC prilosec or if it persists till the morning. In that case it is advisable to get an EKG done to be on the safe side even though it is likely to be normal.

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Dr. Muneeb Ali
Category: Medical
Satisfied Customers: 9,926
Experience: MBBS, MD, MCCM. Currently working in Critical Care Medicine with 10 year experience in Medicine
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Customer reply replied 8 months ago
You were very thorough. Thank you. I have no more questions. Thank you again.

You are more than welcome, best of luck!

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