ZocdocAnswersDo I have acute pericarditis or musculoskeletal chest pain?

Question

Do I have acute pericarditis or musculoskeletal chest pain?

lately ive been feeling chest discomfort.i assume it was my anxiety until one day I got off work and felt a sharp pain to my chest.the pain would come and go every 5 to 30 mins.i went to kaiser urgent care that night they did en ekg and looked at a x ray I did a few days before that (due to a spasm in leftside of my rib) and the doctor said I just have chest wall pain.i did a follow up immediately the next day with a primary doctor and they told me the same thing and just take asprin and use and heating pad.the next day the pain got worse so I went to a differrent kaiser did blood work x ray ekg and everything was normal.so today I went to my jobs doctor (an urgent care clinic)they did an ekg and diagnosis me with acute pericarditis.i dont know who to believe because ive been to 4 different doctors and 3 is telling me the same thing but my jobs doctor.i just did a stress test and im waiting for the results

Answer

I am sorry to hear about your symptoms. The different messages from different doctors are certainly frustrating. In your case, I recommend you schedule an appointment with a cardiologist. It will be necessary to fully review your medical history, including any risk factors for a heart attack. A thorough physical exam is also important in evaluating the cause of chest pain. Finally, a cardiologist can review your EKGs and stress test. Only after reviewing all this information will it be possible to determine the cause of your pain. As you mentioned, costochondritis, of inflammation of the joints connecting your ribs and sternum, can lead to chest pain. Pericarditis is inflammation of the sac that normally surrounds the heat. This is often caused by viral infection or an autoimmune disorder. In some cases, this inflammation can lead to a significant amount of fluid accumulating within this sac. This can lead to compression of the heart, which is a serious condition. Treatment of pericarditis typically involves non-steroidal agents like ibuprofen as well as colchicine. If the fluid is compressing the heart, then drainage is typically necessary. In any one with chest pain, it is also necessary to rule out coronary artery disease as a cause. I recommend you discuss these possibilities with a cardiologist.

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