Left Upper Back and Chest Pain: Which Specialist to See? - Family Medicine

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Based on your description of persistent left upper back pain and chest discomfort, it is crucial to approach this situation with a comprehensive understanding of potential underlying causes. Given your history of mitral valve prolapse and the recent increase in pain severity, it is advisable to consult a specialist who can address both cardiac and musculoskeletal concerns.


Recommended Specialist
1. Cardiologist: Since you have a known history of mitral valve prolapse, it is essential to rule out any cardiac-related issues, especially since you are experiencing chest pain. A cardiologist can perform an electrocardiogram (ECG), echocardiogram, or other diagnostic tests to ensure that your heart is functioning properly and that there are no complications related to your existing condition.

2. Orthopedic Specialist or Physiatrist: If your cardiologist determines that your heart is healthy, the next step would be to consult an orthopedic specialist or a physiatrist (a doctor specializing in physical medicine and rehabilitation). They can evaluate your back pain, which may be related to muscle strain, postural issues, or other musculoskeletal problems. They may recommend imaging studies such as X-rays or MRIs to assess the spine and surrounding structures.

3. Neurologist: If there are neurological symptoms accompanying your pain, such as numbness, tingling, or weakness, a neurologist may be necessary to evaluate for any nerve-related issues.


Understanding Your Symptoms
- Musculoskeletal Pain: The pain you describe, located between the shoulder blade and the spine, could be due to muscle strain, poor posture, or even referred pain from the neck or upper back. Conditions such as myofascial pain syndrome or thoracic outlet syndrome could also contribute to your symptoms.

- Cardiac Considerations: Given your history of mitral valve prolapse, it is essential to monitor any chest pain closely. While mitral valve prolapse is often benign, it can sometimes lead to palpitations or chest discomfort. It is crucial to differentiate between musculoskeletal pain and potential cardiac issues, especially if the pain is new or has changed in character.

- Anxiety and Stress: Sometimes, anxiety can manifest as chest pain or discomfort, especially if you are experiencing stress related to your health. It may be beneficial to discuss this aspect with your healthcare provider.


Next Steps
1. Schedule an Appointment: Start by making an appointment with your cardiologist to discuss your symptoms and any recent changes. Bring a detailed account of your pain, including when it occurs, its intensity, and any associated symptoms.

2. Follow-Up with Musculoskeletal Evaluation: If your cardiologist rules out any cardiac issues, follow up with an orthopedic specialist or a physiatrist for a thorough evaluation of your back pain.

3. Consider Physical Therapy: If musculoskeletal issues are confirmed, physical therapy may be beneficial. A physical therapist can provide exercises to strengthen the back and improve posture, which may alleviate pain.

4. Monitor Symptoms: Keep a journal of your symptoms, noting any triggers, patterns, or changes. This information can be invaluable for your healthcare providers in diagnosing and treating your condition.


Conclusion
In summary, your symptoms warrant a thorough evaluation by both a cardiologist and a musculoskeletal specialist. By addressing both potential cardiac and orthopedic issues, you can work towards finding relief from your pain and improving your overall health. Remember to advocate for yourself and seek care promptly, especially if your symptoms worsen or new symptoms arise.