Unexplained Left Chest Pain: Seeking Guidance for Further Evaluation

Q: Unexplained Left Chest Pain: Seeking Guidance for Further Evaluation

Hello, I would like to ask a question： "A few days ago, I experienced severe pain in my left chest and went to the emergency department at Mackay Memorial Hospital in Hsinchu. <br>Due to my hypertension, I had blood tests and an electrocardiogram, but no cause was found. <br>Afte

Left anterior chest pain with no identifiable cause?

Hello, doctor: I would like to ask you a question.
A few days ago, I experienced pain in my left chest and went to the emergency department at Mackay Memorial Hospital in Hsinchu.
Due to my hypertension, I had blood tests and an electrocardiogram, but no cause was found.
After my symptoms improved, I noticed that my snoring at night became worse, and I felt a sensation of something stuck in my throat, which was very uncomfortable.
It’s manageable when I’m not eating, but after meals or drinking, the sensation of something stuck in my throat becomes very bothersome.
A clinic doctor suggested that I go to a larger hospital for further examination, but I am unsure which department to visit and what tests to undergo to alleviate these symptoms.

Mr. Hsieh, 30~39 year old female. Ask Date: 2008/09/09

Dr. Wang Zhengzhong reply Family Medicine

Hello, I would like to ask a question: "A few days ago, I experienced severe pain in my left chest and went to the emergency department at Mackay Memorial Hospital in Hsinchu.
Due to my hypertension, I had blood tests and an electrocardiogram, but no cause was found.
After my symptoms improved, I noticed that my snoring at night became worse, and I felt a sensation of something stuck in my throat, which was very uncomfortable.
It’s manageable when I’m not eating, but after meals or drinking water, the feeling of something stuck in my throat becomes very uncomfortable." Despite examinations, no issues were identified.
I wonder if you have experienced burping or acid reflux, especially after eating.
I recommend consulting a gastroenterologist for further testing to understand the problem.
Thank you!

Reply Date: 2008/09/09

More Info

It sounds like you are experiencing a complex set of symptoms that warrant further evaluation. Given your history of left chest pain, high blood pressure, and the sensation of a foreign body in your throat, it is essential to approach this situation methodically to rule out any serious underlying conditions.

First and foremost, the left chest pain you experienced could be related to several factors, including cardiac issues, musculoskeletal problems, or gastrointestinal conditions such as gastroesophageal reflux disease (GERD). Since you have already undergone an electrocardiogram (ECG) and blood tests without any significant findings, it is crucial to consider other diagnostic avenues.

1. Cardiology Evaluation: Since you have a history of high blood pressure, it would be prudent to follow up with a cardiologist. They may recommend further tests such as a stress test, echocardiogram, or even a Holter monitor to assess your heart's function over a 24-hour period. These tests can help rule out any cardiac-related causes of your chest pain.

2. Gastroenterology Consultation: The sensation of a foreign body in your throat, especially after eating or drinking, could indicate esophageal issues. A gastroenterologist can perform an upper endoscopy (EGD) to visualize the esophagus and stomach, checking for any abnormalities such as strictures, inflammation, or reflux that could be causing your symptoms. Additionally, they may recommend a barium swallow study to evaluate how food moves through your esophagus.

3. Ear, Nose, and Throat (ENT) Specialist: If the sensation of a lump in your throat persists, consulting an ENT specialist may be beneficial. They can examine your throat and larynx for any structural issues or signs of inflammation that could be contributing to your discomfort.

4. Pulmonary Evaluation: Given that you mentioned increased snoring and potential airway obstruction, it might be worthwhile to consult a pulmonologist. They can assess for sleep apnea or other respiratory issues that could be affecting your sleep quality and contributing to your symptoms.

5. Musculoskeletal Assessment: If your chest pain is suspected to be musculoskeletal in nature, a physical therapist or orthopedic specialist may provide insights into whether your pain is related to muscle strain or other musculoskeletal issues. They can recommend appropriate exercises or therapies to alleviate discomfort.

In summary, I recommend that you seek a multidisciplinary approach to your symptoms. Start with a cardiologist to rule out any heart-related issues, followed by consultations with a gastroenterologist and ENT specialist to address your throat discomfort. If necessary, a pulmonologist can evaluate your respiratory symptoms. Keeping a detailed record of your symptoms, including when they occur and any associated factors, will be helpful for your healthcare providers in making an accurate diagnosis.

Remember, it is essential to advocate for your health and ensure that you receive comprehensive evaluations to address your concerns adequately. Don't hesitate to ask your primary care physician for referrals to the appropriate specialists based on your symptoms.

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