ER Visit for Ongoing Chest Pain. No clear diagnosis

Posted by blackrabbit79 @blackrabbit79, Dec 6, 2022

Background: Female, non-smoker, occasional drinker, 33, 186lbs, 5'4, white: chest pain (on and off for a month) and shortness of breath
Existing medical issues: asthma (which I thought this was related to), fatty liver, hashimoto's, and hypothyroidism

Rx: levothyroxine, 150mg sertraline, and clonazepam as needed.

I have had a "bruised like" feeling in the center of my chest (best way I can describe it–not sharp or heavy) on and off for a month. I was Rx'd fluticasone propionate and salmeterol inhaler to take once in AM and PM. After a few days of that, I noticed that the aforementioned chest pain almost was completely gone, but not 100%.

Went to ER yesterday (Monday) for shortness of breath. Had chest pains Sunday night. Usually occur when taking deep breaths but the pains I experienced last night kind of felt like I swallowed a lot of air and couldn't get it out. After being in the ER for 9 hours the doctors had no explanation for my symptoms.

I will link my abnormal test results. CBC was good. Liver enzymes elevated but I already knew that. Chest X-Ray showed clear lungs. The only finding was "right cervical rib present" but I only found that out from MyChart, my doctor didn't mention it.

The only out of range blood result was D-Dimer, Quantitative which was 0.71 ug/mL. The doctors took me to get a CAT scan to check out my lungs for any sign of PE. ALL CLEAR! You have no idea how relieved my mom and I were. It was a long scary day.

I have to go to the cardiologist for an ECHO and stress test in a few weeks, but I am afraid of what's going to happen in the meantime. Is my chest pain due to the asthma or heart? That is my main worry. I'm hoping it's asthma but who knows. I did have rheumatic fever as a kid in 1997.

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@blackrabbit79 How scary for you! I am glad they were able to rule out a heart attack, and that the cause is still under investigation.

You asked whether it is heart or asthma – those of us here on Mayo Connect are patients like you, so we can't diagnose your issue or interpret your test results.

But…last December I was chasing the chest ache and shortness of breath like you. After ruling out heart, it was determined that I needed different meds for my asthma. My pulmonologist (I also have Bronchiectasis) changed my meds, and life got better for me.

I will not share the name of the meds, as that determination needs to be made for each patient, but you may need a different set of meds.

So, follow up with the Echo, and if that's good, would you be willing think about seeing a pulmonologist?



Black. Rabbit, I have a similar chest pain that has remained undiagnosed for years. Like you I do have asthma. I don’t have any pets, sorry to say as I love animals. This may not be helpful but I will give you the benefit of my personal experience. I have noticed that I have to use a plastic chamber to inhale my asthma medication otherwise I get a pain in the chest from my inhaler. I have to spray the medication into the chamber then slowly and delicately inhale. I have to keep away from Smokey environments, I have to avoid aerosol sprays of all kinds because droplets will lodge in the deepest part of the lungs. This includes air freshener, hair spray, glass cleaners such as windex for example. I have to avoid furred or feathered animals especially cats because they groom themselves. Most people think if the have an animal allergy that it’s the fur they are allergic to. That may be the case but in a lot of cases it’s actually the saliva that they are allergic to. It dries on their fur and flakes off in tiny invisible particles that you then inhale and a allergic reaction ensues. I believe that when the airways become inflamed the muscles of the chest and diaphragm tense up and this causes chest discomfort. Relaxation can help relieve the muscle spasm symptoms but it’s not perfect by any means. I hope you find the answers you are looking for to ease your discomfort. Personally one thing that pointed me in the right direction is to mentally review and assess what is in my environment to see if anything pops out as possible culprits. You may be reacting to things that never occurred to you. Hope you find answers and I would love to hear from you on this.

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