Left Chest Pain: When to Seek Pulmonary Care

Q: Left Chest Pain: When to Seek Pulmonary Care

Hello Belle： Since your ultrasound and chest X-ray (which should have been done during your hospitalization) did not indicate any issues in the left lower lung, and there are currently no new blisters on your skin, it is not shingles. <br>Therefore, neuropathic pain remains the m

Left chest pain?

Hello Dr.
Yang,
Three weeks ago, I started experiencing intermittent sharp pain in the lower left side of my chest, which radiated to my back.
After a few days, the pain intensified and lasted longer.
Since I had gastritis last year, I initially thought it was gastric pain in my upper left abdomen, so I went to the emergency department of a large hospital.
An endoscopy revealed gastric erosion at the cardia.
However, two days later, I developed a high fever of 38 degrees Celsius and mild diarrhea.
I was then hospitalized for observation for four days; the fever subsided, and an abdominal ultrasound was normal.
The gastroenterologist suspected that the fever was caused by a viral infection, but I did not have any other cold symptoms.

After being discharged, although the sharp pain was gone, I continued to experience persistent pain, and I felt tenderness when wearing a bra.
Later, I visited another hospital's gastroenterology department, where the physician noted during the physical examination that the pain was localized to the lower left side of my chest rather than the upper left abdomen.
The doctor believed it was nerve pain caused by a virus.
Therefore, I was prescribed anti-inflammatory pain medication and gastric milk tablets, which I have been taking for four days, but I still feel pain, along with a dull sensation in my left chest and a slight headache.
Yesterday, the pain in my left chest suddenly worsened, and I felt a sensation of not being able to breathe properly.
I would like to ask the doctor if it is necessary for me to see a pulmonologist for further examination.
The intermittent nature of the pain and the inability to determine a definitive cause are quite distressing for my daily life.
Thank you in advance for your response.

Bei Er, 20~29 year old female. Ask Date: 2005/05/26

Dr. Yang Wenda reply Pulmonology

Hello Belle: Since your ultrasound and chest X-ray (which should have been done during your hospitalization) did not indicate any issues in the left lower lung, and there are currently no new blisters on your skin, it is not shingles.
Therefore, neuropathic pain remains the most likely diagnosis! The fever is likely caused by a viral infection and should be resolving now.
For severe neuropathic pain, you may take analgesics and muscle relaxants to alleviate the symptoms.
Additionally, please avoid consuming cold foods or beverages, stimulating drinks (such as alcoholic beverages or coffee), and try to avoid a lifestyle that is too stressful or busy.
It's important to maintain a calm demeanor and ensure you get enough sleep! By paying attention to these lifestyle details, your neuropathic pain should improve soon! Best wishes!

Reply Date: 2005/05/26

More Info

Dear Patient,
Thank you for sharing your detailed medical history and concerns regarding your left chest pain. Based on the information you've provided, it appears that your symptoms have evolved over the past few weeks, and I understand how distressing this can be. Let's break down your situation and discuss when it might be appropriate to seek further pulmonary care.

Your initial symptoms of intermittent stabbing pain in the left chest, which radiates to your back, could be attributed to several factors. Given your history of gastritis and the subsequent findings from your upper gastrointestinal examination, it is understandable that you initially associated the pain with gastrointestinal issues. However, the persistence of the pain, especially when wearing a bra, suggests that it may not solely be related to your stomach.

The fact that you experienced a high fever and mild diarrhea during your hospital stay raises the possibility of a viral infection, which can sometimes lead to post-viral pain syndromes, including neuropathic pain. This could explain the lingering discomfort you are experiencing in your left chest area. The use of anti-inflammatory medications and gastric protectants is a reasonable approach, but if your symptoms persist despite treatment, further evaluation is warranted.

The sudden onset of chest pain, especially if accompanied by a sensation of not being able to catch your breath, is concerning. While it is possible that your symptoms are related to musculoskeletal issues or nerve pain, it is crucial to rule out any serious underlying conditions, such as pulmonary embolism, pneumonia, or even cardiac issues, especially given the location of your pain.

Here are some recommendations for your next steps:
1. Seek Pulmonary Care: Given the nature of your symptoms and their persistence, it would be prudent to consult a pulmonologist. They can perform a thorough evaluation, including imaging studies like a chest X-ray or CT scan, to assess for any lung-related issues that may not have been previously identified.

2. Consider Cardiac Evaluation: Although your symptoms seem more aligned with gastrointestinal or musculoskeletal origins, it is essential to ensure that there are no cardiac issues at play. A cardiologist can perform tests such as an EKG or echocardiogram to rule out any heart-related concerns.

3. Monitor Symptoms: Keep a detailed log of your symptoms, including the timing, duration, and any associated factors (such as activity level or dietary changes). This information can be invaluable for your healthcare providers in determining the underlying cause of your pain.

4. Follow-Up on Neuropathic Pain: If your symptoms are indeed related to nerve pain, a neurologist may also be able to provide insights and treatment options to help manage your discomfort.

5. Lifestyle Modifications: In the meantime, consider making some lifestyle adjustments, such as avoiding tight clothing that may exacerbate your pain, practicing stress-reduction techniques, and ensuring you maintain a healthy diet to support your overall well-being.

In summary, while your symptoms may stem from a variety of causes, the persistence and nature of your pain warrant further investigation. Seeking care from a pulmonologist and possibly a cardiologist will help ensure that any serious conditions are ruled out and that you receive appropriate treatment for your symptoms. Please do not hesitate to reach out to your healthcare provider for further guidance, and take care of yourself during this challenging time.

Best wishes for your health and recovery.

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