Exploring Additional Options for Diagnosing Chest Pain
I'm a 29-year-old male who has been dealing with left-sided chest pain intermittently for the last five months. This discomfort has been increasing in frequency, prompting me to consult both my primary care physician and a cardiologist in search of answers, but so far, no clear diagnosis has emerged. My body mass index falls within the normal range, and I maintain an active lifestyle, running or hiking between 20 to 40 miles weekly. Two years ago, I was diagnosed with high blood pressure. At first, my doctor advised cutting down on caffeine and sodium-rich foods, yet this did not seem to affect my condition. Now, I take a daily dose of 5mg amlodipine. While I've had a history of intermittent smoking during college, I haven’t smoked regularly for over five years. Additionally, I was born with a chest deformity described as a combination of pectus excavatum and carinatum. Doctors have mentioned that this deformity likely isn’t severe enough to be the cause of my pain, even though I haven't consulted a cardiothoracic surgeon. I’ve undergone several tests, including: - An ECG, which revealed a first-degree AV block but was otherwise normal. - A lipid panel showed normal results. - A comprehensive metabolic panel indicated a bilirubin level of 1.9, but the rest was normal. - A complete blood count came back normal. - A chest X-ray showed no abnormalities. - An echocardiogram indicated mild right ventricular dilation and a sclerotic aortic valve. - An exercise stress test yielded normal results. - A kidney ultrasound was conducted to eliminate kidney issues as a cause of my hypertension, and the results were normal. My primary care physician referred me to a cardiologist due to the combination of my chest pain, the deformity, abnormal echocardiogram findings, and high blood pressure. The cardiologist didn't express significant concern over my test results, suggesting that the echocardiogram interpretations could be influenced by my chest shape. He recommended trying omeprazole and ibuprofen to rule out other pain sources, but I was doubtful and, unfortunately, didn’t notice any improvement with these medications. I apologize for the lengthy message, but I am eager to know if there are any additional tests I should consider to help determine the underlying cause of my discomfort. Thank you for your time and assistance.
Answers (1)
8/22/2025, 10:32:45 PM
OpenHealth AI
Thank you for sharing such a detailed account of your situation. It's understandable to feel concerned given the ongoing chest pain, especially after thorough evaluations. Here's a summary of the main points:
Key Points: You've experienced persistent left-sided chest pain for five months, have an active lifestyle, a history of high blood pressure, and have undergone numerous tests without a definitive diagnosis. Your cardiologist has recommended omeprazole and ibuprofen to explore other pain sources, but you didn't notice improvement.
Explanation:
Chest pain can arise from various sources, and your detailed medical workup shows that many serious cardiac conditions have been ruled out. The presence of a first-degree AV block and mild right ventricular dilation does require monitoring, especially since your echocardiogram findings may be affected by your pectus deformity. It's good that you've already consulted with specialists—it indicates that you're taking the right steps to address this issue.
The medications suggested by your cardiologist were likely aimed at assessing whether your pain could be related to gastrointestinal issues (like reflux) or muscular factors, which might sometimes present as chest discomfort.
Next Steps:
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Symptom Tracking: Keep a detailed diary of your symptoms, noting when the pain occurs, its duration, intensity, and any associated activities or foods. This can help identify triggers.
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Consult a Gastroenterologist: Since the cardiologist recommended omeprazole, consider consulting a gastroenterologist for further evaluation of potential gastroesophageal reflux disease (GERD) or other gastrointestinal causes.
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Physical Therapy Evaluation: Given your chest deformity and ongoing pain, seek input from a physical therapist who specializes in musculoskeletal issues. They can assess whether your pain could be related to muscle tension or postural factors linked to your pectus deformity.
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Pain Management Consultation: If your pain persists, you might benefit from a referral to a pain management specialist. They can help explore other non-invasive treatments like physical therapy, or alternative medications that might provide relief.
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Review Lifestyle Factors: Continue to monitor your caffeine and salt intake, and ensure you are staying well-hydrated. You may also want to evaluate any stress factors in your life, as anxiety can contribute to chest pain.
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Follow-up on Cardiac Monitoring: Since you have a history of high blood pressure and some abnormalities noted on your echocardiogram, ensure regular follow-ups for monitoring these conditions, as recommended by your healthcare providers.
If pain levels worsen or new symptoms arise (like shortness of breath or severe discomfort), seek immediate medical attention. Regular follow-ups and open communication with your healthcare team are essential as you navigate this complex situation. Remember, you’re taking important steps by consulting specialists, and it’s okay to keep advocating for your health. Let me know if you need more details or have additional questions!
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