Chest Discomfort: When to Seek Further Medical Evaluation

Q: Chest Discomfort: When to Seek Further Medical Evaluation

Hello, online user： There are many causes of chest pain, and it is recommended to see a pulmonologist for evaluation and examination. <br>If the emergency blood test results are normal, should further in-depth tests be conducted? This should be determined after a consultation wit

Chest tightness/chest pain

Hello doctor, I have been experiencing chest tightness and chest pain for more than half a month, and sometimes I have difficulty breathing.
On March 17, I went to the emergency room, and the doctor ordered blood tests which came back normal.
I was advised to see a cardiologist, and on March 19, I visited the cardiology clinic.
The doctor listened to my heartbeat and said my heart was fine, and prescribed medication.
However, after taking the medication for two days, my chest pain did not improve.
On March 22, I went to a family medicine clinic, where the doctor diagnosed me with intercostal muscle inflammation and performed a dry needling procedure to relieve some blood, which provided relief for a day.
On March 24, I still felt chest tightness and pain, now radiating to the area below my ribs and my back, with some pain in the center of my chest.
I also have a sensation of swelling in my throat and occasional hand tremors.
Should I go to a major hospital for further evaluation, or is it sufficient to continue visiting a general clinic? If I go to a major hospital, which department should I see? Given that the emergency blood test results were normal, should I undergo any other in-depth examinations?

Ting Ting, 30~39 year old female. Ask Date: 2016/03/24

Dr. Zeng Guosen reply Internal Medicine

Hello, online user: There are many causes of chest pain, and it is recommended to see a pulmonologist for evaluation and examination.
If the emergency blood test results are normal, should further in-depth tests be conducted? This should be determined after a consultation with a physician.
Thank you.

Reply Date: 2016/03/24

More Info

When experiencing persistent chest discomfort, especially if it is accompanied by symptoms such as shortness of breath, back pain, and throat swelling, it is crucial to seek further medical evaluation. Your symptoms could indicate a range of conditions, some of which may require urgent attention.

Given your recent medical history, including visits to the emergency department and consultations with both cardiology and family medicine, it is essential to consider a few factors before deciding on the next steps:
1. Nature of Symptoms: You mentioned experiencing chest pain, discomfort, and shortness of breath, which can be indicative of various issues, including musculoskeletal problems (like costochondritis or rib inflammation), gastrointestinal issues (such as acid reflux), or even cardiac concerns. The presence of back pain and throat swelling adds complexity to your symptoms, suggesting that they may not solely be related to the heart or lungs.

2. Previous Evaluations: The emergency department's blood tests ruled out immediate cardiac issues, which is reassuring. However, the persistence of your symptoms despite treatment raises the question of whether further investigation is warranted. The initial assessment by the cardiologist indicated no heart issues, but if your symptoms continue or worsen, it may be necessary to revisit this conclusion.

3. Potential Need for Imaging or Further Testing: Given that you have ongoing symptoms, it might be beneficial to undergo additional imaging studies, such as a chest X-ray or CT scan, to evaluate for any underlying issues that may not have been detected in previous examinations. These could include lung conditions, pleural effusions, or even gastrointestinal problems that could manifest as chest pain.

4. Referral to a Specialist: If you decide to visit a larger hospital, consider scheduling an appointment with a pulmonologist (lung specialist) or a gastroenterologist (digestive system specialist), depending on the nature of your symptoms. If there is any suspicion of a cardiac issue, a follow-up with a cardiologist would also be appropriate.
5. Emergency Care: If your symptoms worsen, such as experiencing severe chest pain, significant shortness of breath, or any new symptoms like fainting or severe dizziness, it is crucial to seek emergency care immediately. These could be signs of a more serious condition that requires urgent intervention.

In summary, while your previous evaluations have not indicated a serious issue, the persistence of your symptoms warrants further investigation. It is advisable to either return to a specialist or visit a larger hospital where comprehensive diagnostic tests can be performed. Do not hesitate to advocate for your health and seek the necessary evaluations to ensure that any potential underlying conditions are addressed promptly.

Similar Q&A

Chest Discomfort: When to Seek Further Medical Evaluation?

Last week, I visited a clinic due to chest tightness. I underwent an electrocardiogram (ECG) and a chest X-ray. After reviewing the results, the doctor said there were no significant issues and advised me to monitor my condition without prescribing any medication. Subsequently, t...

Dr. He Dongjin reply Cardiology
If you are still feeling unwell, it is advisable to visit a cardiology clinic for further examination. Changhua Hospital cares about your well-being.

Persistent Chest Discomfort: When to Seek Further Medical Evaluation

I've been feeling a tightness in my chest these past few days. I saw a doctor who said it might be related to my digestive system. I've been taking medication for a few days, but it hasn't improved. Sometimes the discomfort is more noticeable, and other times I don...

Dr. Hong Yuanbin reply Internal Medicine
Hello, many diseases can manifest as chest discomfort, including cardiac issues, pulmonary problems, gastrointestinal disorders, or musculoskeletal issues. If you experience persistent chest discomfort, it is advisable to visit a hospital for a thorough examination, which may inc...

Understanding Heart Discomfort: When to Seek Further Cardiac Evaluation

First, I would like to thank the doctor for taking the time to respond despite their busy schedule. About two years ago, I began to frequently experience chest tightness and episodes of my heart suddenly racing. After seeking medical attention, I underwent an electrocardiogram (E...

Dr. He Dongjin reply Cardiology
Hello, this sounds like typical autonomic nervous system dysfunction. You may simply need to consult a psychiatrist for a medication adjustment, and there should be no need for another cardiac examination. Pingan Changhua Hospital cares about you.

Understanding Chest Pain: When to Seek Further Medical Evaluation

Doctor: Hello, I have been experiencing chest pain for some time. I have also undergone an X-ray at the hospital, which showed no abnormalities. However, when the pain occurs, it also hurts to breathe, and there seems to be a lump on the right side of my chest. What kind of exami...

Dr. Li Shiwei reply Pulmonology
Hello: You can schedule an appointment with either the Pulmonary Medicine or Cardiology department for evaluation and treatment by a specialist. Wishing you good health.