Chronic chest pain

Welcome to Mayo Connect, @babyblues262. As a cardiac nurse, you just mentioned that you know all the scary things that could go wrong. And yet, you’re living with this equally scary pain and anxiety. Oh my goodness, dear heart, this is no way to live with so much anxiety and fear of the unknown.
I bet you’ve had patients that kept kicking the can down the road instead of addressing a problem head on. What did you tell them?

I’m going to give you a good nudge to initiate an appointment request at Mayo. Here’s the link for you to make it easy. Just click and follow the prompt for a new patient. You can choose the Mayo Campus that would be most convenient for you. Rochester, MN Phoenix, AZ or Jacksonville, FL
http://mayocl.in/1mtmR63
You don’t need a doctor’s referral but it might be helpful to have your cardiologist’s input. I think you’ll feel a little less anxiety just knowing you took the step forward to a possible solution.

Do you live near a Mayo Campus?

@babyblues262 I wonder if it could be costochondritis …?
https://my.clevelandclinic.org/health/diseases/22167-costochondritis

I have lived with chronic chest pain for many years that is psychogenic in nature. It’s almost unbelievable how the pain mimics a cardiac event. Essentially a strong ache and soreness in the sternal area across the pectorals and up into the major neck muscles. I can reproduce it when I twist my torso side to side or back-and-forth. Costochondritis has been part of the differential, but I am told also that my anxiety causes my upper body to tense up constantly and the intercostal muscles and all surrounding fascia are always in a fight or flight state which causes the soreness and even some injury when I exercise. Nonetheless, it seems to present when I am under a lot of stress or after I do a fair amount of strenuous upper body movement through exercise or daily chores. I am someone who has suffered with anxiety and mild depression my whole life, and seem to have a physical make up where my psychological symptoms are also felt in the musculoskeletal body. The chest pain I have described has been a feature for many years and has caused me to get worked up by cardiologists, my PCP, neurologist, physical therapist, etc. In the end, it seems that there is absolutely nothing abnormal about my physical health, but this “neuropathy” continues to be something that I am challenged to live with. CBT has helped me discern true danger from the same old pain, but it is a struggle.

Thank you for your reply. I live in constant fear of everything that can go wrong. I tell people to stay off the internet when they're anxious, then I do the exact opposite.
I live about 4 hours from the Rochester, MN location.

That sounds so frustrating. It makes me mad when I see in the After Visit Summaries or provider notes that they think it's all my anxiety because they can't find a reason for the pain.

I have not looked into that before, thank you for the suggestion

Good point – the Internet can be a catalyst for more anxiety. If we use it as a de facto Medical professional. Nonetheless, it can sometimes shed some interesting information on situations that we are familiar with. I guess it’s a good thing that you live so close to the Mayo Clinic for when you have “real”emergencies 🙂

@babyblues262 I was in Emergency with chest pains some years ago, and the doctor on call took the time to explain to me what he thought could be the cause, after doing ECG, chest X-ray, etc. and ruling out a cardiac problem. Turned out it was costochondritis and once I knew what it was I could deal with it.

Other doctors on previous visits to Emerg. would just wave it off as “it’s all in your head” or a “panic attack” because I also had a history of that. In my experience if doctors know you have a history of panic disorder, fibromyalgia, or whatever, they tend to just chalk everything up to that if they don’t have an answer.

I have had daily chest pain for fifty years. As a young woman, I had swine flu, pleurisy, empyema, collapsed lung, surgery, drainage tubes, etc. The main surgical cut was like that of a thoracotomy, but no ribs removed. The pain can be sharp, throbbing, aching, all kinds. So I certainly understand what you are describing. It can be overwhelming!
I will just share my experience which was to treat the pain and the fear. For the first, I use PT (conventional and alternative), medication, exercise, twice daily hot baths, pain patches and creams, and will try anything I think might help. For the fear, I've used hypnosis, psychotherapy, meditation, journaling, and a calm lifestyle. I know this sounds like a lot, but I don't do it all at once! Basically I had to give up notions of diagnosis, cure, or overall sympathy from doctors (although I have had several very compassionate ones). Also, and this is difficult, I've worked on my fear of death (at 71 it might be easier or timelier than when I was younger).
It seems from what you wrote, if I understand it correctly, that the medical profession cannot find one physical cause for what is causing the pain. Can you accept that, or do you have a strong feeling otherwise that you still need to investigate the cause? Have you experimented with what makes you feel better? My life's journey took a turn for the better when a rehab MD told me: I don't know what is wrong but I think I know what might help. Once I could lower the physical and emotional pain my life became much more livable. I'll just add this in to your thinking. Of course a visit to Mayo could be very helpful. Sending you encouragement!

They have not found a physical cause for the pain as yet. I have another stress test coming up mid January, and I'm guessing theyll do a heart cath after.
Fear of death is a big deal for me. I am hugely afraid of dying and the thought that it is inevitable actually keeps me from doing many things. I don't see the point in things or creating when the end result is that my things will get redistributed and I'll be forgotten.