Discussions By Condition: I cannot get a diagnosis.

No idea whats going on..any help?

Posted In: I cannot get a diagnosis. 8 Replies
  • Posted By: CuriousandLooking
  • April 8, 2009
  • 11:35 PM

Hi..im new here but I've posted before but only as a guest..i just registered.

I'm a 20 year old black male. Non smoker, non drinker. I eat somewhat healthy but I live on a college campus so my access to "top quality healthy food" is a bit limited... I will say I have a soda habit (for the last 6 months) just in case that is of any help, though I've recently stopped drinking sodas all together (only a week)

Over the last few days I've been having some chest, back and abdominal pains.

I will list the symptoms below and try to be as thorough as possible:



On Friday night I had a really strange pain in the center of my chest. It wasn't really a strong sharp paint but a dull, gripping feeling. It was the weirdest pain I've ever experienced. It only lasted about 10-30 seconds but it was weird enough to make me question it and search online (thats how I found this place).
After that, Friday night and Saturday morning I experienced really sharp pains on both sides of my chest...usually right on my heart area...(the spot on my chest where i can feel my heart beat)...sometimes farther towards the outside edges of my chest..
On Sunday and Monday it calmed down a bit, just little sharp pains every now and then and an overall feeling of discomfort (just feeling 'down'...not myself)
On Tuesday it got better I think..again just random little sharp pains on my chest but I began to have pains in my back. About midway down my left side, and towards the top middle of my back.
Today (Wednesday) I woke up with a bit of back pain (mid-left) and was a bit nauseous this morning. It was weird because the pain and nausea only occurred when I was sitting and laying down. If I stood then the pain would not be as bad. This posed a problem because I had classes all day where I had to stay seated for 1-2hrs at a time. Also, when I sat down (in class) I would get a warm, uncomfortable sensation in my abdomen.
Now, the nausea is gone really and the back pain is not as bad but Im having pains in my chest again (random sharp pains on my left side...right above my heart). I also feel a bit fatigued. A bit of general fatigue but also a bit of muscle fatigue.
One other interesting thing. For the first couple of days my pains where not really triggered by movement or position or breathing or anything. Today when I woke up, it seemed that the pain was highly dependent on how I was positioned and would increase with breathing. Now, that is gone.


I've tried to be as thorough as possible. If any other info is necessary I would be happy to provide it. Thanks in advance.
I really appreciate it.

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8 Replies:

  • Let me add:I have been online looking for possible causes:These range from anxiety/stress to potassium or other vitamin deficiency to more serious issues.Over the last couple of days I've tried to up my intake of potassium and eat more healthily and drink more water, etc. Whether it will directly help this situation or not...this episode was enough to get me more concerned about my general well being.
    CuriousandLooking 7 Replies Flag this Response
  • Okay, well it's obvious that you're pretty much a healthy young fellow, so the prospect of a cardiovascular event or similar pathology would be extremely remote at best. Let's discuss some of the more probable options and we'll start with the ones less likely if that's alright. Pancreatitis can cause discomfort in the region described, initially sub-sternal and progressing to referred back pain midline and sub-scapular. It is often accompanied by GI distress as well. A simple test to determine your serum amylase levels would be diagnostic, but treatment is most often supportive in acute cases. Costochondritis is an inflammation of the cartilage that binds the rib cage together and can cause significant discomfort. It can arise for a number of underlying reasons, but often occurs in the absence of known cause. The treatment is usually with 800mg of motrin daily for 3 to 5 days. Gastroenteritis can also produce pain of the type described and is accompanied by GI symptoms of nausea, changes in bowel function, dyspepsia and a general malaise or washed out feeling. Viral or bacterial invasion is typically the cause and can be sustained for 10 to 14 days in some cases before return to normal function is experienced. My suggestion here is to eat light and stay clear of irritating food products, opting also for clear liquids in substitute for the soft drinks which not only contain acid but also increase gastric acid production in most cases. Get plenty of rest and watch symptoms for the next few days. If it persists, then direct evaluation by your primary care physician is certainly recommended. The internet is good for support and inquiry pertaining to post-medical evaluation, but never should be relied upon as a source for diagnostic health care concerns. If you are not experiencing any type of direct GI discomfort, ie indigestion, eructation or belching, reflux or altered bowel habits, then you can also try taking over the counter Motrin at the rate of 800mg per day for 3 or 4 days to determine if relief is experienced. In the absence of positive change, again I would recommend direct evaluation by your doctor. I'll also briefly cite that stress can also play a significant role in this type of complaint and if it's test time or you are under academic stress, then it could be contributory as well. Best regards, J Cottle, MD
    JCottleMD 580 Replies Flag this Response
  • Thanks for the reply. It was both informative and quick!I was unable to visit a physician today but I will try to tomorrow.BUT..my condition has changed a bit.The pain in my chest and back are pretty much gone. Only a slight (very minor) pain in my chest a couple of times today). However the pain in my lower left abdomen got pretty intense for a couple of hours. And now the pain is in my lower right abdomen. The lower right abdomen pain ranges from mildly uncomfortable to pretty intense at times but nothing like im bent over in pain. Its so weird to me because the pain keeps shifting. Is there any condition that would cause that? Its mind boggling to me (then again I'm not a doctor).Again thanks for all of the help and thanks in advance for any other help that anyone can give. :)
    CuriousandLooking 7 Replies Flag this Response
  • I just came back from the emergency room. The chest pains began to worry me again and I just couldn't sit around and dismiss them anymore. They weren't particularly bad but I thought it better to be safe and sorry.All of my abdominal symptoms are gone (for now at least)But I still have discomfort in the center of my chest.Its not a sharp pain..but a dull annoying pain..still feels like pressure a bit.They took my vitals, drew blood (for tests I suppose), and did an electrocardiogram as well as listened to my heart and lungs (im guessing) through a stethoscope. . They say all were normal. So hopefully that rules out anything cardiovascular.Just as JCottleMD suggested, the doctor encouraged me to take ibuprofen to see if that helps. Hopefully it does.Quick additional question: I've been reading a lot about mitral valve prolapse. Would this have been picked up on the ECG and/or through listening to my chest?
    CuriousandLooking 7 Replies Flag this Response
  • This seems to be very close to how my symptoms started out. My thread hasn't been cleared by the moderators yet, but mine started with some fairly persistent chest pain right along the sternum and I had gone to the ER twice within a week because it would worry me so much. I had the same tests done at the ER as you and those were all normal. I'm 20, male.Do you tend to get anxious frequently, or at least have you noticed an increase in your stress level? I've gotten ultrasounds for abdominal discomfort, chest X-Rays, ECG, etc over a month or two now, and all show normal. They say it could merely be anxiety, but I wasn't aware that anxiety could cause such widespread physical symptoms. Currently, I have a bounding pulse, daily pain in my chest and armpits/upper arms. How are your symptoms now? It'd be great to hear what you find out on the issue.
    Anonymous 42789 Replies Flag this Response
  • Okay, you don't have mitral valve prolapse. I'm not certain what among your symptoms would make you concerned about this disorder, but in most all cases MVP itself goes undetected by the patient. In some cases, more often in young women than men, panic disorder accompanies more remarkable cases of MVP. This does not in any way, however, conclude that everyone who experiences panic disorder needs to be evaluated for MVP. Again, this is most likely DaCosta's syndrome or at best, costochondritis and the ibuprofen taken as suggested should bring about relief. Your posting also seems to indicate that you are generally worried about your health and I'm constrained to point out that heart disease in someone so young would be highly unlikely in the absence of prior symptoms. Realize that stress at higher levels can bring about a broad range of physical symptoms in the absence of actual physical disease. Best regards, J Cottle, MD
    JCottleMD 580 Replies Flag this Response
  • This seems to be very close to how my symptoms started out. My thread hasn't been cleared by the moderators yet, but mine started with some fairly persistent chest pain right along the sternum and I had gone to the ER twice within a week because it would worry me so much. I had the same tests done at the ER as you and those were all normal. I'm 20, male.Do you tend to get anxious frequently, or at least have you noticed an increase in your stress level? I've gotten ultrasounds for abdominal discomfort, chest X-Rays, ECG, etc over a month or two now, and all show normal. They say it could merely be anxiety, but I wasn't aware that anxiety could cause such widespread physical symptoms. Currently, I have a bounding pulse, daily pain in my chest and armpits/upper arms. How are your symptoms now? It'd be great to hear what you find out on the issue.Well I took the Ibuprofen as JCottleMD and the physician that treated me both suggested. That helped the chest pain I was experiencing.This morning (at about 3am) I woke up to very severe abdominal pain (like someone was stabbing me in my abdomen and it was cramping up). It was the worst abdominal pain I've felt. I really think this could be due to something like constipation (as a result of my anxiety).I too believe that my symptoms may be due to stress or anxiety. However, im going to follow-up on my symptoms Monday at the student clinic at my university. I figure that will either help with my recent health anxiety or help detect any more serious issues that I should be aware of. Again, this is most likely DaCosta's syndrome or at best, costochondritis and the ibuprofen taken as suggested should bring about relief. Your posting also seems to indicate that you are generally worried about your health and I'm constrained to point out that heart disease in someone so young would be highly unlikely in the absence of prior symptoms. Realize that stress at higher levels can bring about a broad range of physical symptoms in the absence of actual physical disease. Best regards, J Cottle, MDI think you're right :)I really was never worried about my health (on the level that I am now) until the first pain I had in my chest a week ago. I think the chest pains may have been due to anxiety or stress (possibly from school).... Then the ensuing health anxiety may have just exacerbated the problem.
    CuriousandLooking 7 Replies Flag this Response
  • Well I took the Ibuprofen as JCottleMD and the physician that treated me both suggested. That helped the chest pain I was experiencing.This morning (at about 3am) I woke up to very severe abdominal pain (like someone was stabbing me in my abdomen and it was cramping up). It was the worst abdominal pain I've felt. I really think this could be due to something like constipation (as a result of my anxiety).I too believe that my symptoms may be due to stress or anxiety. However, im going to follow-up on my symptoms Monday at the student clinic at my university. I figure that will either help with my recent health anxiety or help detect any more serious issues that I should be aware of.I think you're right :)I really was never worried about my health (on the level that I am now) until the first pain I had in my chest a week ago. I think the chest pains may have been due to anxiety or stress (possibly from school).... Then the ensuing health anxiety may have just exacerbated the problem.Hi CuriousandLooking,You've been well-advised by Dr. Cottle. The fact that the chest pain you experienced was relieved with ibuprofen is testimony that the pain was either muscle-strain related (costocondritis), which is relatively common in adolescent/young adult males, or stress/anxiety related...which, once again, is far more common than one would think in the same age/sex demographics.Stress/anxiety is an extremely powerful emotional agent that can produce very tangible acute physiological symptoms. I have personally cared for individuals who, when in full-blown panic attacks, exhibit nearly identical physiological symptoms to those of a person experiencing an acute myocardial infarction (heart attack). Anxiety is indeed a force to be reckoned with...and one that is best kept to a minimal "healthy" level.Best regards,John
    JonMac 165 Replies Flag this Response
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