Unexplained chest pain on the left side
December 15, 2013 | 50,00 EUR | answered by Dr. med. Frauke Gehring
Hello,
Four weeks ago, I went to the hospital with strong chest pains and was kept there for a day. ECG and ultrasound were inconclusive. Inflammatory markers in the blood were slightly elevated...
Three days later, at the general practitioner, the inflammatory markers had risen again... Diagnosis: Virus...
A week later, the pains in the left chest area were gone.
Another blood test showed that all inflammatory markers were normal. However, coxsackie viruses were detected... three days later, I experienced sharp pains in the left chest area again in the evening and took ibuprofen again...
Another blood test showed all values were normal and no viruses were detectable... Lung function, ECG, and X-ray of the lungs were inconclusive!
These pains mostly occur in the evening or at night, causing me to wake up and not be able to sleep...
This has been going on for four weeks now, during which I was pain-free in the second week, and saw an osteopath twice who apparently helped me...
Would you recommend further examinations or could this Bornholm disease actually cause these pains to be so prolonged?
The pains are mostly stronger in the evening and at night, and each heartbeat causes a sharp pain when I exhale and hold my breath.
The pain is only on the left side.
Two weeks before all this started, I got two titanium implants in the lower left jaw, which have not caused me any problems so far.
Best regards,
Christian
Good day,
Based on your examinations and the nature of your pain, it can be confidently assumed that you do not have coronary heart disease (circulatory disorder). It can also definitively be ruled out that the implants are the cause of your discomfort.
You mentioned that Coxsackie viruses were detected; I assume that antibodies against them were detected, as a direct virus detection cannot be reliably performed. If a serious Coxsackie infection, such as Bornholm disease, had occurred, the antibodies would have remained elevated in the blood for a longer period of time. The negative titer shortly thereafter suggests against a relevant Coxsackie infection.
This type of infection typically causes painful pleurisy. This pain is persistent and burning, making it difficult to breathe and lie on the affected side (the latter is also a symptom of thoracic spine blockade), and Ibuprofen only provides temporary relief, if at all. X-rays show corresponding changes, and often the pleurisy involvement can also be heard. The normal X-ray findings also speak against Bornholm disease.
With a fair amount of certainty, these pains are caused by a blockade of the thoracic spine; the fact that the osteopath was able to help you supports this. In this case, a nerve is pinched, causing sharp pain in its distribution area (from the back to the chest). Ibuprofen reduces swelling in the affected structures and nerve, providing some relief. However, if the recurring blockages are not addressed through physical therapy or muscle strengthening, nerve irritation will continue to occur.
In summary, I suggest a thorough orthopedic examination to confirm the recurring blockade in the thoracic spine area. This should be followed by an active exercise treatment rather than passive manipulation (osteopathy, "adjustment").
I do not see any indication of Bornholm disease or any other internal medicine condition. The slight increase in Coxsackie titer was likely due to brief contact with these common viruses, which did not lead to illness, only to this serological incidental finding.
I wish you a speedy recovery!
Warm regards, Dr. Höllering, specialist in internal and general medicine.
