Persistent Chest Pain: Causes and When to Seek Help

Q: Persistent Chest Pain: Causes and When to Seek Help

Hello： Regarding your chest pain and cough, I personally believe it may be caused by gastroesophageal reflux. <br>I recommend that you seek medical attention and take medications to suppress stomach acid. <br>If you wish to undergo further examination, an endoscopy can also be pe

Pain in the center of the chest?

Hello doctor, I started experiencing mild pain in the center of my chest around early March.
At first, I didn't pay much attention to it since it didn't affect my daily life.
Sometimes, I also felt pain in the upper left side of my chest, but most of the time, it was in the center.
After a while, since the pain persisted, I decided to see a doctor.
The first diagnosis was costochondritis.
However, after finishing the medication, there was not much improvement, and I began to experience a scratchy throat and the urge to cough.
During my second visit to another doctor, I had an X-ray taken, which showed no abnormalities, but it was noted that my bronchial tubes were slightly inflamed.
I was prescribed anti-inflammatory and cough medication, but there was still no significant improvement in my chest pain.
I visited a third doctor, and the situation remained the same.
Currently, my symptoms still include pain in the center of my chest, and when I lie on my stomach, I feel a tightness in that area.
Sometimes my throat is very itchy, while other times it feels fine.
I generally do not cough severely, but I do feel something unusual in my throat.
I have previously experienced prolonged coughing that lasted for two months before resolving.
I'm unsure if the cough is related to the chest pain, and whether my chest pain is simply due to muscle strain and inflammation, or if it is caused by other factors.
I would appreciate your clarification.
Thank you!

A Jie, 30~39 year old female. Ask Date: 2022/04/26

Dr. Lin Zhebin reply Family Medicine

Hello: Regarding your chest pain and cough, I personally believe it may be caused by gastroesophageal reflux.
I recommend that you seek medical attention and take medications to suppress stomach acid.
If you wish to undergo further examination, an endoscopy can also be performed.

Reply Date: 2022/04/26

More Info

Persistent chest pain can be a concerning symptom, and understanding its potential causes is crucial for determining when to seek medical help. Based on your description, it seems that you have been experiencing chest pain for an extended period, which has not improved significantly despite medical consultations and treatments.
Initially, your doctor diagnosed you with costochondritis, which is inflammation of the cartilage that connects the ribs to the sternum. This condition can cause localized pain in the chest, often exacerbated by certain movements or positions, such as lying down or twisting. While costochondritis is a common cause of chest pain, especially in younger individuals, it is essential to consider other possible causes, particularly since your symptoms have persisted.

The fact that you have also experienced throat irritation and a cough raises the possibility of a respiratory issue. Inflammation of the airways, such as bronchitis, can lead to chest discomfort and a persistent cough. If your cough is dry and accompanied by throat irritation, it could suggest that your airways are inflamed, possibly due to an infection or an allergic reaction.
It is also important to consider the possibility of gastroesophageal reflux disease (GERD), which can cause chest pain that mimics cardiac pain. GERD occurs when stomach acid flows back into the esophagus, leading to symptoms such as heartburn, chest discomfort, and throat irritation. If you notice that your symptoms worsen after eating or when lying down, GERD could be a contributing factor.

Given that you have undergone X-rays and other evaluations without significant findings, it may be beneficial to explore further diagnostic options. If your symptoms persist, a referral to a specialist, such as a pulmonologist or a gastroenterologist, may be warranted. They can perform more specific tests, such as a CT scan of the chest, pulmonary function tests, or an esophageal pH study, to rule out other underlying conditions.

In terms of when to seek help, it is advisable to return to your healthcare provider if you experience any of the following:
1. Worsening Pain: If your chest pain increases in intensity or frequency.

2. New Symptoms: If you develop additional symptoms such as shortness of breath, dizziness, or radiating pain to the arm or jaw, which could indicate a more serious condition.

3. Persistent Symptoms: If your symptoms do not improve with treatment or if they interfere significantly with your daily activities.

In conclusion, while your symptoms may initially suggest costochondritis, the persistence and nature of your chest pain warrant further investigation. It is essential to keep an open line of communication with your healthcare providers and advocate for further testing if your symptoms do not resolve. Remember that chest pain should always be taken seriously, and timely evaluation can help ensure that any serious conditions are ruled out.

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