Dr. Yermal Tanmai Deelip
Cardiology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hi doctor,
I am a 20-year-old female. My height is 5'1" and weighs around 160 pounds. I am having sharp burning pain in my chest and back in the mid to left side between the shoulder blades and under the breast bone. It lasts between 30 minutes and a few hours of this sharp pain. Usually, it becomes difficult to breathe or move my upper body until it goes away. As a kid, we visited a doctor for some chest pains, but the doctor said they could not say anything wrong other than a possible heart murmur. There is a history of heart disease in my family.
Hello,
Welcome to icliniq.com.
I have gone through your query. I would like to know some more details about your present complaint. What type of murmur has your doctor described? History of which heart disease your family has and who has it? Is your chest pain associated with any other symptoms like breathing difficulty, palpitations, giddiness? Does this pain gets aggravated on movement or on exertion? Is it localized or diffuse? Is there any tenderness i.e. pain increases on pressing with the hand? Any reddish discoloration on localized area of pain? Since when you are having this pain? If possible attach all the available reports like ECG, echo and any other reports. Kindly get back with the above details for further discussion and management.
Patient's Query
Thank you doctor,
I was tested for heart pain when I was 7 or 8 years old so it has been a while since then. The doctor said it was not conclusive and my parents never did more tests into it so I do not know, but can ask my mom and try to track down that information. My grandfather had a heart attack in the 90's which he needed to have double bypass surgery and had a pacemaker installed. My great aunt died early of a heart attack before I was born. When the best pain happens I am usually short of breath and feel lightheaded, dizzy which usually leads to a little bit of a headache. It gets worse with any movement and when I rub or press on the painful area it feels a little more painful. There is no redness or discoloration. The pain comes and goes from day to day without any seeming reason or cause, it is rather random. I do not have any of those reports since it was so long ago and my parents never followed up with the doctor who worked with me.
Hi,
Welcome back to icliniq.com.
I appreciate your description of the present symptoms. Your pain that you have described seems to be probably due to costochondritis, though cannot be very sure unless I examine. This is possible due to some injury or trauma over the chest or heavy weight lifting. And the murmur and all that you had previously seems to be a different issue altogether. You need to get evaluated to rule out any cardiac disease with some investigations like ECG (echocardiography) and echo. But due to this COVID-19 pandemic it is difficult I believe to reach out the hospital and get evaluated. So you can take a few medications that I will prescribe for time being, if you are feeling better with that you can get evaluated little later. But in case your symptoms worsen you need to go hospital and get evaluated soon. I do not think there is a reason to worry as of now. On follow up also let me know if you have any kind of stress or anxiety or insomnia at present. Follow the medications and instructions as below: Tablet Combiflam (Paracetamol and Ibuprofen) twice in a day for five days, Pan 40 mg (Pantoprazole) once in the morning before breakfast for five days. Local application of any topical painkiller or analgesic that is available. Application of heat compresses or heat pads at home. Take rest and avoid heavy weight lifting and avoid movements that aggravates your pain. Kindly follow up after taking the medicines and to review your symptoms for further management if required.
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Cardiology
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