Discussions By Condition: I cannot get a diagnosis.

Chest and arm pain by cyst

Posted In: I cannot get a diagnosis. 3 Replies
  • Posted By: Anonymous
  • April 11, 2009
  • 06:16 AM

Over the past several months I've had a pain in my chest, centered on my sternum but it flares out to my sides sometimes. Now I have a daily pain on my inner arms (the part of the upper arm that faces the body) and armpits, and sometimes in the backs of my knees. My doc says I have a bounding pulse, and I've taken 800mg Ibuprofin in the past for the pain due to an earlier assumption that it was costochondritis or something similar. I have had a chest X-ray, an ECG (or is it an EKG?) and both show up normal.

I have a bump on my sternum that has been diagnosed as a sebaceous cyst. I had an ultrasound on it and it's been said to have liquids, therefore a cyst. It worries me though, because I have chest pain around the area where the cyst is. Sometimes I'll wake up and I have no pain, and things are great for a couple hours, then the pain will start again. Other days it'll start earlier.

At this point I'd like to say I have a very persistent anxiety for my health/life, and my diet usually consists of oatmeal, orange juice, cereal and PB+J sandwiches, with the occasional fast food meal. I feel as if I've lost muscle mass in that area as well, but I'm hoping that's due to malnutrition rather than something necrotic or something.

Anyways, if you need more information let me know. I'm constantly stressed over the possibilities and at this point I'd rather find out what it is even if it's unfavorable.

Thanks so much.

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3 Replies:

  • I'm sorry, in my haste to get this posted I neglected the basics. I'm male, 20, slim build. I've done some more snooping and found that armpit pain and muscle loss could be due to stress, so I'm a little less worried, if that's possible.
    Anonymous 42789 Replies Flag this Response
  • Well, I think you need to take a breath and relax. There would be no association between your symptoms and the presence of a sebaceous cyst. In fact, the procedure to have the cyst removed is quite simple and would likely reduce your anxiety if you have concerns that it is cancer or similar life-threatening problem. The pain in the sternum is most likely due to a phenomenon known as DaCosta's syndrome and arises commonly in the presence of significant stress or anxiety conditions. It is not associated with heart disease of any type. Alternatively, the pain could indeed be associated with costochondritis, which is an inflammation of the cartilage joining the bone structures of the rib cage. In most cases, however, costochondritis is limited in nature and doesn't represent a chronic disorder. If the symptoms have been relapsing/remitting over a period of time, then costochondritis is less likely and DaCosta's syndrome more likely. Pounding heart is also a symptom related to anxiety in this instance. Tissue necrosis is not a coincidental process by any means and the nature of its presence is quite graphic indeed. The prospect of actual muscle atrophy is unlikely as well, with changes representing far more than mere reduction in size or proportion. It is more likely that a reduction is size is symmetrical and due to a poor diet such as that described in your posting. I'm uncertain why your diet is relegated to the specifics mentioned, but be aware that although malnutrition in the clinical sense is unlikely, you need to concentrate on a balanced diet for a person of your age. I would also ask at this point whether an GI studies were performed with regard to the sub-sternal pain? It would not be uncommon for persons with stress and anxiety to have GI difficulties that present as upper epigastric pain. Best regards, J Cottle, MD
    JCottleMD 580 Replies Flag this Response
  • Thanks for your reply, you're a big presence on these boards, it seems. Although this reply is long, I'm just looking to better understand some things you talked about. Don't think I'm ignoring logic :)Would 3-4 months of recurring chest pain disqualify costochondritis as a possibility, then? That seems more to fall into the DaCosta syndrome you mentioned. I will ask my doc about getting the cyst removed as opposed to waiting for it to dissipate. The chest pain is not typically below the sternum (stomach area), but rather right along the sternum, sometimes fanning out along the ribs. I do have abdominal discomfort, but I haven't been to a GI (which I'll see about doing) and I've read a lot of abdominal discomfort can be due to anxiety. I typically eat those foods because I'm in college, they're easy to make and I don't spend a lot of money on food. I've been working on trying to vary up my diet recently however, so could any chest muscle 'loss' (for lack of a better word) be related to stress or would there need to be another factor involved? Again, thanks for helping out. Weekends are hard sometimes with no doc offices open...
    Anonymous 42789 Replies Flag this Response
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