Pericarditis and chest pain follow up

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Submitted by Dr T on July 21, 2011 – 7:43am

Question: 
Thanks for the reply, Dr T.
I had an initial ECHO a few days after the chest pain in September 2010. The doctor said it was fine, but subsequently another doctor said the ECHO showed – something like – ‘a bright or highlighted’ pericardium which was consistent with pericarditis. (She also said my ECG was exactly what she’d expect from pericarditis).
I had a further, seemingly more detailed, ECHO in January 2011, which was conducted by my cardiologist, and she said it was entirely normal. I’ve taken a ton of ibuprofen, and then colchicine for two months, and now prednisolone. The painkillers were slightly effective but I can’t say cured anything as the symptoms always returned. I guess the doctor does now think it’s some form of inflammation which isn’t pericarditis, but she did not say costochondritis. It isn’t particularly tender to touch anywhere on my chest or back, though I generally feel as if I have some sort of infection. But my chest X rays, CT scans and sounds are all normal.
My father also died of a heart attack when he was 38. But seeing as I was healthy and fit before this incident, and have had these symptoms for getting on a year – you could probably rule out angina (as I’d have had a serious incident by now)? Likewise a pulled muscle or something stupid like that isn’t going to have lasted so long? Any thoughts on where I go next greatly appreciated.
 

Hi Chris,
I agree with you entirely. Costochondritis certainly excluded with what you have told me. All the more reason to stop Prednisolone! Has anybody looked into a GI problem such as esophageal spasm?

Read this blog:
https://www.cardiachealth.org/ca-blog/severe-sudden-chestpain-but-they-

I quote the last paragraph from this blog to show that sometimes it can be very difficult to find a cause and what to do in that case:
“Last, during my clinical practice if I didn’t know what was going on (it happened!), the first thing to do was to make sure the patient was safe, the second, to repeat tests to look for changes after a period of time, the third, ask for help.”

Hope this was helpful,
Dr T
https://www.cardiachealth.org/

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