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What should I do next for epigastric pain with radiation to my chest?

Gastroenterology Health & Fitness

I'm a 50 years old Chinese female. I've been experiencing pain in the epigastrium with radiation to the left chest. The pain felt over the chest and epigastric region was sudden and appears as though a gas/ electricity has whizzed pass the area. It normally lasts for a short duration and recurs once in a while. In addition, I also experience pain in my back, over the shoulder/ scapula region and along the right middle section of the vertebra. 

DOCTOR’S ANSWER (2)
Thank you for your question. From your description, the cause of your symptoms is most likely due to acid reflux that is typical of gastro-esophageal reflux disease or GERD.
 
However, other non-gastric causes of similar symptoms include heart disease - especially if the pain occurs on exertion (eg climbing stairs) and radiates to your jaw or left arm. 
 
Epigastric pain that radiates to your back and shoulder tip may also be clues that it originates from your gallbladder (eg gallstones) or pancreas (eg pancreatic inflammation or pancreatitis).  Gallstone pain or biliary colic is often worse after meals, and may be accompanied with vomiting, fever and jaundice (yellowing of the eyes). 
 
I would suggest that you seek a formal consultation if these symptoms persist to ascertain the diagnosis and receive the appropriate treatment.  As some of these conditions are potentially serious - I would recommend that you see your family doctor or gastro specialist soon.
 
Many thanks,

Dr Kieron Lim

649 views 26 Mar 2018

As Dr Lim has pointed out in his reply, while it appears likely that the origin of your symptoms is probably of gastric origin, there are many other causes of abdomen pain, such as due to the gall bladder or pancreas as outlined.

However the most serious cause of the symptoms could be if the origin is from the heart. This usually manifests as chest pain or discomfort that is brought on classically by exertion i.e walking.

It's also accompanied by:

  • Sweating
  • Numbness/weakness 
  • Pain radiating down the left arm
  • Radiation of pain up to the neck or jaw
  • Breathlessness or severe fatigue

This becomes more likely if  there are risk factors for heart disease in the background such as positive family history, diabetes, high blood pressure or high cholesterol.

Stress does not help either.

Heart disease in women is not all that uncommon and yes, you should be formally assessed by a physician. Hopefully it will be nothing more than some gastritis - but it is better to come to that conclusion after all the relevant test etc are complete. 

Regards

Dr Nandakumar

643 views 26 Mar 2018
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