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>Guys/gals... If there's any unusual pain in your chest cavity at all, just drop whatever it is you're doing and get it checked out. It might not even seem that

by ginko 10y ago

>Guys/gals... If there's any unusual pain in your chest cavity at all, just drop whatever it is you're doing and get it checked out. It might not even seem that bad at the time... it didn't to me and it didn't to Jason Scott... just do it. Yeah, but where do you draw the line? I guess that will sound silly, but I'm always afraid that people think of me as a hypochondriac if I ran to the doctor for every little pain, most of them probably being some sprained muscle or indigestion.

xyzzy_plugh 10y ago
Doctors and cardiologists are used to false alarms. In fact, according to mine, cardiologists provide more diagnoses of pleurisy than pulmunologists. If it could be a heart attack, or similar life threatening thing, you go to emergency.
- tropo 10y ago
  I've gotten the "pleurisy" diagnosis, twice even, and I don't believe it. Pleurisy seems to be the catch-all default diagnosis for when they can't find anything wrong and just want you to go away. There isn't actual evidence in favor of pleurisy, just the inability to find something else wrong. In the first case, I'm pretty sure I had a panic attack. At least they served me bacon and eggs, probably hoping for a repeat customer with a real heart attack. In the second case, I'm pretty sure I pinched a nerve in my back. I got shoulder pain associated with movement. I then got pain in the front -- but remember that a nerve pinched in one spot can cause pain to be felt elsewhere. Other back-related issues in the days afterward lead me to my conclusion. I'm now way less inclined to go in to the emergency room. I don't want to spend 12 hours with an IV hurting my arm, no privacy, no sleep, and not being able to work on anything. One of the times the doctor even cleared me to go home, but the nurses didn't bother to remove the IV for hours afterward. Being in the emergency room isn't harmless; it is a place where diseases spread.
  - xyzzy_plugh 10y ago
    > Pleurisy seems to be the catch-all default diagnosis for when they can't find anything wrong and just want you to go away. There isn't actual evidence in favor of pleurisy, just the inability to find something else wrong It's a valid diagnosis: https://en.m.wikipedia.org/wiki/Diagnosis_of_exclusion https://en.m.wikipedia.org/wiki/Diagnosis_of_exclusion I once waited four hours to see a doctor because of a sharp pain in the left side of my chest when I breathed more than shallow. The doctor told me it was probably a muscle spasm and to take some Advil. I thought "what an asshole" as I left. About 20 minutes later, someone told me a joke, I laughed, and was cured. Turns out the doctor was right. If you had ECG, x-ray, CT scan, echo, and everything looks fine, then the treatment is the same regardless. If you think you had a panic attack or hurt your back, then communicate that to your doctor. It's important. Edit: thought I'd mention: my wife is currently diagnosed with pleurisy. She went to the ER due to shortness of breath and chest pain a month ago. We've done all the tests possible. She's still in quite a bit of pain. Pleurisy usually takes months to resolve. If you were diagnosed and it disappeared within a day or a week, then you were likely misdiagnosed. However, it does not necessarily mean the prescribed treatment was erroneous.
komali2 10y ago
https://www.ghc.org/healthAndWellness/?item=%2Fcommon%2FhealthAndWellness%2Fconditions%2FheartDisease%2FchestPain.html https://www.ghc.org/healthAndWellness/?item=%2Fcommon%2Fheal... TLDR: It's probably not a heart attack if you can pinpoint the pain, if the pain gets worse on a deep breath, the pain is related to movement of your shoulder or arm, or if it only lasts a few second. You should call a doctor if the pain is mild but consistent and is untreatable by pain killers, and remains regardless of if you're resting or not. You should call 911 or get to a hospital immediately if your chest pain is "crushing" or "squeezing," and especially if it is accompanied by ANY ONE of the following: sweating, shortness of breath, nausea/vomiting, pain that spreads from the chest to the neck, jaw, or one or both shoulders or arms, dizziness or lightheadedness, fast or irregular pulse, severe weakness, inability to walk. So yea you don't go to the hospital for every pulled muscle, but do your best to memorize the above symptoms of escalating seriousness, and you should be ok.
- gpawl 10y ago
  What do you do if you've had symptoms for weeks/months? Until you've been diagnosed with a heart attack, the word "mild" does mean much. People over the age of 35-40 have many chronic mild pains
  - komali2 10y ago
    If you've had symptoms for a few hours that are untreatable by medication (like I said), then you call your doctor. Your doctor will tell you whether or not to come in. If it's chronic old-person pain, your doctor will find that out, and tell you next steps. If you've had symptoms for weeks/months, well, I guess that's probably not a heart attack, good job? Still should have gone in within the first day.
    - tgokh 10y ago
      You're spot on with your previous post, but just wanted to add a note to anyone reading that if you've been having intermittent chest pain or discomfort for weeks/months, it still could be a heart problem (or reflux or a host of other things) that needs to be checked out. You could have a partial blockage of a coronary blood vessels (the blood vessels that provide blood/oxygen to the heart muscle itself) that provide insufficient blood flow, either when you're active, or randomly. (this is not medical advice!)
DanBC 10y ago
> Yeah, but where do you draw the line? You can search the English NHS Choices website. That gives calm mostly evidence based advice and lets you know when you should self care, or when you should see a doctor. For example, here's "chest pain": http://www.nhs.uk/conditions/chest-pain/Pages/Introduction.aspx http://www.nhs.uk/conditions/chest-pain/Pages/Introduction.a... It says there are a variety of causes, but it says you must never ignore it, and gives some criteria for when you should dial 911. In England we also have NHS 111, which is a free telephone advice line. It's not as good as it could be because fo obvious reasons they're risk averse.
- cmrdporcupine 10y ago
  Yeah we have something like this in Ontario ("TeleHealth") and from my experience the calls usually end with "Go to the doctor / emergency room" because they're mostly unwilling to tell you "you're fine, it's in your head" unless it's completely obvious.
  - jasonmp85 10y ago
    On the other hand, that kind of presentation can often COMPEL a doctor to prevent discharge, so lots of, uh, problem patients know they can eke out a few extra days if they mention those words to the right person.
crispyambulance 10y ago
Don't "draw the line" anywhere with chest pains. I say this as someone who has survived PE. In my case, I had pain that was a vague persistent discomfort combined with an evolving sense of panic. I hesitated for a day but then drove myself to the hospital just in time because it had progressed in the emergency room to searing pain where I "saw stars" upon each breath. Literally the most painful experience I ever had. When you walk into an emergency room and indicate you have chest pains, they will immediately try to assess whether or not you're having a heart attack. After that there are checks to rule out PE and you may have a CAT scan w/contrast fluid. There are other much less dangerous things that cause chest pain... stress-induced muscle pain is one. The problem is you can't be sure until its too late. Carry health insurance and don't try to second-guess chest pain.
- emmab 10y ago
  I've had PCS my entire life https://en.wikipedia.org/wiki/Precordial_catch_syndrome https://en.wikipedia.org/wiki/Precordial_catch_syndrome Definitely not worth going to the ER for.
  - MetallicCloud 10y ago
    Wow, thank you so much! I've had this my entire life, but never knew what it was, and never met anyone else who also got it. It's nice to be able to put a name to it.
    - pr0vitamin 10y ago
      Oh my goodness. I've had this my whole life too, and could never find out what it was! Wow, the relief I feel right now.
  - crispyambulance 10y ago
    OK, but you can say that because you happen to KNOW what it is, and that's fine. People drop dead too frequently because they wait too long to get help when they have unexplained chest pains that [they think] couldn't possibly be a heart attack.
catshirt 10y ago
hey man, there is a reason shortness of breath will get you rushed past the ER. almost lost a buddy once to a brain tumor around 25. he was light headed with slight pain for a 3 days. checked himself in on day 4 for slight but persistent pain. rushed into surgery immediately. wouldn't have lasted another day. don't take a chance. would rather be a hypochondriac than dead. a good doctor will respect that.

by ginko 10y ago

xyzzy_plugh 10y ago

Doctors and cardiologists are used to false alarms. In fact, according to mine, cardiologists provide more diagnoses of pleurisy than pulmunologists. If it could be a heart attack, or similar life threatening thing, you go to emergency.

tropo 10y ago
I've gotten the "pleurisy" diagnosis, twice even, and I don't believe it. Pleurisy seems to be the catch-all default diagnosis for when they can't find anything wrong and just want you to go away. There isn't actual evidence in favor of pleurisy, just the inability to find something else wrong. In the first case, I'm pretty sure I had a panic attack. At least they served me bacon and eggs, probably hoping for a repeat customer with a real heart attack. In the second case, I'm pretty sure I pinched a nerve in my back. I got shoulder pain associated with movement. I then got pain in the front -- but remember that a nerve pinched in one spot can cause pain to be felt elsewhere. Other back-related issues in the days afterward lead me to my conclusion. I'm now way less inclined to go in to the emergency room. I don't want to spend 12 hours with an IV hurting my arm, no privacy, no sleep, and not being able to work on anything. One of the times the doctor even cleared me to go home, but the nurses didn't bother to remove the IV for hours afterward. Being in the emergency room isn't harmless; it is a place where diseases spread.
- xyzzy_plugh 10y ago
  > Pleurisy seems to be the catch-all default diagnosis for when they can't find anything wrong and just want you to go away. There isn't actual evidence in favor of pleurisy, just the inability to find something else wrong It's a valid diagnosis: https://en.m.wikipedia.org/wiki/Diagnosis_of_exclusion https://en.m.wikipedia.org/wiki/Diagnosis_of_exclusion I once waited four hours to see a doctor because of a sharp pain in the left side of my chest when I breathed more than shallow. The doctor told me it was probably a muscle spasm and to take some Advil. I thought "what an asshole" as I left. About 20 minutes later, someone told me a joke, I laughed, and was cured. Turns out the doctor was right. If you had ECG, x-ray, CT scan, echo, and everything looks fine, then the treatment is the same regardless. If you think you had a panic attack or hurt your back, then communicate that to your doctor. It's important. Edit: thought I'd mention: my wife is currently diagnosed with pleurisy. She went to the ER due to shortness of breath and chest pain a month ago. We've done all the tests possible. She's still in quite a bit of pain. Pleurisy usually takes months to resolve. If you were diagnosed and it disappeared within a day or a week, then you were likely misdiagnosed. However, it does not necessarily mean the prescribed treatment was erroneous.

komali2 10y ago

https://www.ghc.org/healthAndWellness/?item=%2Fcommon%2FhealthAndWellness%2Fconditions%2FheartDisease%2FchestPain.html https://www.ghc.org/healthAndWellness/?item=%2Fcommon%2Fheal... TLDR: It's probably not a heart attack if you can pinpoint the pain, if the pain gets worse on a deep breath, the pain is related to movement of your shoulder or arm, or if it only lasts a few second. You should call a doctor if the pain is mild but consistent and is untreatable by pain killers, and remains regardless of if you're resting or not. You should call 911 or get to a hospital immediately if your chest pain is "crushing" or "squeezing," and especially if it is accompanied by ANY ONE of the following: sweating, shortness of breath, nausea/vomiting, pain that spreads from the chest to the neck, jaw, or one or both shoulders or arms, dizziness or lightheadedness, fast or irregular pulse, severe weakness, inability to walk. So yea you don't go to the hospital for every pulled muscle, but do your best to memorize the above symptoms of escalating seriousness, and you should be ok.

gpawl 10y ago
What do you do if you've had symptoms for weeks/months? Until you've been diagnosed with a heart attack, the word "mild" does mean much. People over the age of 35-40 have many chronic mild pains
- komali2 10y ago
  If you've had symptoms for a few hours that are untreatable by medication (like I said), then you call your doctor. Your doctor will tell you whether or not to come in. If it's chronic old-person pain, your doctor will find that out, and tell you next steps. If you've had symptoms for weeks/months, well, I guess that's probably not a heart attack, good job? Still should have gone in within the first day.
  - tgokh 10y ago
    You're spot on with your previous post, but just wanted to add a note to anyone reading that if you've been having intermittent chest pain or discomfort for weeks/months, it still could be a heart problem (or reflux or a host of other things) that needs to be checked out. You could have a partial blockage of a coronary blood vessels (the blood vessels that provide blood/oxygen to the heart muscle itself) that provide insufficient blood flow, either when you're active, or randomly. (this is not medical advice!)

DanBC 10y ago

> Yeah, but where do you draw the line? You can search the English NHS Choices website. That gives calm mostly evidence based advice and lets you know when you should self care, or when you should see a doctor. For example, here's "chest pain": http://www.nhs.uk/conditions/chest-pain/Pages/Introduction.aspx http://www.nhs.uk/conditions/chest-pain/Pages/Introduction.a... It says there are a variety of causes, but it says you must never ignore it, and gives some criteria for when you should dial 911. In England we also have NHS 111, which is a free telephone advice line. It's not as good as it could be because fo obvious reasons they're risk averse.

cmrdporcupine 10y ago
Yeah we have something like this in Ontario ("TeleHealth") and from my experience the calls usually end with "Go to the doctor / emergency room" because they're mostly unwilling to tell you "you're fine, it's in your head" unless it's completely obvious.
- jasonmp85 10y ago
  On the other hand, that kind of presentation can often COMPEL a doctor to prevent discharge, so lots of, uh, problem patients know they can eke out a few extra days if they mention those words to the right person.

crispyambulance 10y ago

Don't "draw the line" anywhere with chest pains. I say this as someone who has survived PE. In my case, I had pain that was a vague persistent discomfort combined with an evolving sense of panic. I hesitated for a day but then drove myself to the hospital just in time because it had progressed in the emergency room to searing pain where I "saw stars" upon each breath. Literally the most painful experience I ever had. When you walk into an emergency room and indicate you have chest pains, they will immediately try to assess whether or not you're having a heart attack. After that there are checks to rule out PE and you may have a CAT scan w/contrast fluid. There are other much less dangerous things that cause chest pain... stress-induced muscle pain is one. The problem is you can't be sure until its too late. Carry health insurance and don't try to second-guess chest pain.

emmab 10y ago
I've had PCS my entire life https://en.wikipedia.org/wiki/Precordial_catch_syndrome https://en.wikipedia.org/wiki/Precordial_catch_syndrome Definitely not worth going to the ER for.
- MetallicCloud 10y ago
  Wow, thank you so much! I've had this my entire life, but never knew what it was, and never met anyone else who also got it. It's nice to be able to put a name to it.
  - pr0vitamin 10y ago
    Oh my goodness. I've had this my whole life too, and could never find out what it was! Wow, the relief I feel right now.
- crispyambulance 10y ago
  OK, but you can say that because you happen to KNOW what it is, and that's fine. People drop dead too frequently because they wait too long to get help when they have unexplained chest pains that [they think] couldn't possibly be a heart attack.

catshirt 10y ago

hey man, there is a reason shortness of breath will get you rushed past the ER. almost lost a buddy once to a brain tumor around 25. he was light headed with slight pain for a 3 days. checked himself in on day 4 for slight but persistent pain. rushed into surgery immediately. wouldn't have lasted another day. don't take a chance. would rather be a hypochondriac than dead. a good doctor will respect that.