“I have weird chest pain?”
I am 13 years old, 4'10", BMI is 18.5, I do not eat junk food/fast food, and am pretty physically active. I've been having chest pains and a headache for about two months now. It is often accompanied by left arm pain, shoulder pain, and sometimes jaw pain. The chest pain doesn't have pinpoint pain and it's either the right side or left side. I've been to the emergency room about five times now for this problem, but the EKG and x-rays were normal. My lab tests were all perfect. I recently had an echocardiogram and it came back normal. For the past few days, I have been also sweating more than usual, and yesterday before bed I had left side chest pain, stomach pain, and arm pain. I was able to go to sleep but woke up today with chest pain and sweating. I have severe anxiety, so my doctor has been saying it's either that or costochondritis, but I'm really not sure. Tylenol and hydroxyzine (anxiety med given by the emergency room) do not help.
For more detail...
My first emergency room visit diagnosed me with severe constipation and an ovarian cyst, so I had to take magnesium citrate for constipation but do nothing for the cyst. I was no longer constipated after that, but my chest pain did not go away. My next emergency room visit was for my chest pain. The EKG and chest x-ray came back completely normal, and so did my blood work. I still had constant chest pain. My third emergency room visit was - once again - for my chest pain, but all tests came back normal. The doctors found nothing wrong. It still persisted to my next emergency room visit, which then they prescribed me hydroxyzine for my anxiety. I did not go to the emergency room anymore after that, but then I had a really bad headache that lasted a long time accompanied by shortness of breath, chest pain, and arm pain so I had to go up there again. They gave me a Toradol shot, an EKG, and a chest x-ray, but the tests came but normal and the shot only helped a little bit. The headache has been persisting to the present day, and so has the chest pain.
A few weeks later, I felt really sick, had chest pain, a headache, mild shortness of breath, back pain, and body aches. My mom said to not go to the emergency room and to go to urgent care. At urgent care, they found out my ears were completely clogged and washed them out, but the headache did not go away. The doctor ordered a CAT scan for my headache but did nothing for the chest pain or shortness of breath. I was sent out with still persisting symptoms. The next week, I had a follow-up visit with my pediatrician. We discussed my chest pain and headache, and I told her everything I could possibly tell her, such as:
- Chest pain doesn't have pinpoint pain; sometimes dull, sometimes sharp, sometimes aching. Headache is dull.
- Chest pain doesn't have a pinpoint location but is typically either around my right or left breast, upper or lower left side or right side, under and in my armpit, and sometimes in the center or sides. Headache is either above my right ear or left ear, none of the pain happens at the same time (like if chest pain around my left breast, it's never around my right breast at the same time and vice versa).
- Headache and chest pain are usually accompanied by arm pain, jaw pain, shoulder pain, and back pain. Sometimes it's also accompanied by shortness of breath, stomach pain, nausea, very mild lightheadedness.
- I'm always very fatigued, no matter how much sleep I get.
The doctor held off on the CAT scan and made me an appointment with a cardiologist. She also said it may be psychological or musculoskeletal, and not always cardiac. The next Monday, I had an appointment with the cardiologist and had to get an echocardiogram done. Nothing bad was found and it was normal. They checked my blood pressure and it was a little low but did nothing about it (I was laying down for an hour without moving anyways). The doctor there said it may be costochondritis, or it may be caused purely by my anxiety. I still didn't believe it. The chest pain persisted, and so has the headache. I have been realizing that the chest pain starts more severely after I eat dinner (I eat oatmeal, an apple, watermelon, raspberries, and canned peaches for dinner every day).
Yesterday, before I went to bed, I felt awful. My chest pain kept moving from my right to my left side, it felt like it radiated to my arms, my upper stomach hurt, my back hurt a little, my wrist hurt, my shoulder hurt, and it literally felt like I was having a heart attack. I was crying and wanted to die. I did not want to wake up my mother, so I went to bed. Now, today, I woke up with chest pain and some arm soreness. Headache is still present. My mother tested positive for COVID-19 about a week ago, but I tested negative twice (I do not believe my chest pain is from the virus if I do have it because it has persisted for so long). After she shared the news, I started having shortness of breath every day. It felt like I could not take air into my lungs. The feeling went away after a bit, though. The nose is sort of clogged now.
I do not know if this is really from anxiety/musculoskeletal or if I am having an upcoming heart attack or undiagnosed heart condition. I'm very scared. I'm not sure if anything dietary has to do with this, but here is what I eat every day:
- Protein shake for breakfast, yogurt for a snack, dinner mentioned above, a cup of grapes for a snack, yogurt for a snack, a cup of chocolate milk.
- Sometimes I have sugary cereal, but only once a week.
- I take an indoor walk for 40 minutes a day for exercise and stand for almost the whole day.
- I'm on my computer the whole day after that, but standing up. I do not eat any junk food or fast food, although my family does.
- I get 8 hours or more of sleep a day.
Psychologically, I have severe anxiety, social anxiety, and selective mutism. I also have somewhat of a suicidal feeling I don't tell anybody about.
I'm sorry this is so long, I tried going into detail because I don't trust my doctors saying it's only anxiety. I feel like it's much more.
For more detail...
My first emergency room visit diagnosed me with severe constipation and an ovarian cyst, so I had to take magnesium citrate for constipation but do nothing for the cyst. I was no longer constipated after that, but my chest pain did not go away. My next emergency room visit was for my chest pain. The EKG and chest x-ray came back completely normal, and so did my blood work. I still had constant chest pain. My third emergency room visit was - once again - for my chest pain, but all tests came back normal. The doctors found nothing wrong. It still persisted to my next emergency room visit, which then they prescribed me hydroxyzine for my anxiety. I did not go to the emergency room anymore after that, but then I had a really bad headache that lasted a long time accompanied by shortness of breath, chest pain, and arm pain so I had to go up there again. They gave me a Toradol shot, an EKG, and a chest x-ray, but the tests came but normal and the shot only helped a little bit. The headache has been persisting to the present day, and so has the chest pain.
A few weeks later, I felt really sick, had chest pain, a headache, mild shortness of breath, back pain, and body aches. My mom said to not go to the emergency room and to go to urgent care. At urgent care, they found out my ears were completely clogged and washed them out, but the headache did not go away. The doctor ordered a CAT scan for my headache but did nothing for the chest pain or shortness of breath. I was sent out with still persisting symptoms. The next week, I had a follow-up visit with my pediatrician. We discussed my chest pain and headache, and I told her everything I could possibly tell her, such as:
- Chest pain doesn't have pinpoint pain; sometimes dull, sometimes sharp, sometimes aching. Headache is dull.
- Chest pain doesn't have a pinpoint location but is typically either around my right or left breast, upper or lower left side or right side, under and in my armpit, and sometimes in the center or sides. Headache is either above my right ear or left ear, none of the pain happens at the same time (like if chest pain around my left breast, it's never around my right breast at the same time and vice versa).
- Headache and chest pain are usually accompanied by arm pain, jaw pain, shoulder pain, and back pain. Sometimes it's also accompanied by shortness of breath, stomach pain, nausea, very mild lightheadedness.
- I'm always very fatigued, no matter how much sleep I get.
The doctor held off on the CAT scan and made me an appointment with a cardiologist. She also said it may be psychological or musculoskeletal, and not always cardiac. The next Monday, I had an appointment with the cardiologist and had to get an echocardiogram done. Nothing bad was found and it was normal. They checked my blood pressure and it was a little low but did nothing about it (I was laying down for an hour without moving anyways). The doctor there said it may be costochondritis, or it may be caused purely by my anxiety. I still didn't believe it. The chest pain persisted, and so has the headache. I have been realizing that the chest pain starts more severely after I eat dinner (I eat oatmeal, an apple, watermelon, raspberries, and canned peaches for dinner every day).
Yesterday, before I went to bed, I felt awful. My chest pain kept moving from my right to my left side, it felt like it radiated to my arms, my upper stomach hurt, my back hurt a little, my wrist hurt, my shoulder hurt, and it literally felt like I was having a heart attack. I was crying and wanted to die. I did not want to wake up my mother, so I went to bed. Now, today, I woke up with chest pain and some arm soreness. Headache is still present. My mother tested positive for COVID-19 about a week ago, but I tested negative twice (I do not believe my chest pain is from the virus if I do have it because it has persisted for so long). After she shared the news, I started having shortness of breath every day. It felt like I could not take air into my lungs. The feeling went away after a bit, though. The nose is sort of clogged now.
I do not know if this is really from anxiety/musculoskeletal or if I am having an upcoming heart attack or undiagnosed heart condition. I'm very scared. I'm not sure if anything dietary has to do with this, but here is what I eat every day:
- Protein shake for breakfast, yogurt for a snack, dinner mentioned above, a cup of grapes for a snack, yogurt for a snack, a cup of chocolate milk.
- Sometimes I have sugary cereal, but only once a week.
- I take an indoor walk for 40 minutes a day for exercise and stand for almost the whole day.
- I'm on my computer the whole day after that, but standing up. I do not eat any junk food or fast food, although my family does.
- I get 8 hours or more of sleep a day.
Psychologically, I have severe anxiety, social anxiety, and selective mutism. I also have somewhat of a suicidal feeling I don't tell anybody about.
I'm sorry this is so long, I tried going into detail because I don't trust my doctors saying it's only anxiety. I feel like it's much more.
Female | 13 years old
Complaint duration: 2 Months
Medications: Hydroxyzine
Conditions: Anxiety
5 Answers
Please call 911. Chest pain has serious implications, and a myocardial infarction must be ruled out. Sweating, especially at night is a sign of subacute endocarditis. A thorough examination and battery of tests are essential to come up with the diagnosis. Sometimes the sings are intermittent and more test, possibly overnight stay in the hospital it would be necessary to find the etiology of your sign and symptoms. Please, go to the hospital. Thank you.
See this link for some insight into your issues..
https://www.medicalnewstoday.com/articles/322184
https://www.medicalnewstoday.com/articles/322184
This is very detailed and I wonder if you'd be interested in seeing a psychologist for the anxiety weekly and a dietitian for an evaluation of your diet. I am not convinced what you're eating is ideal; your food choices, while not involving "bad foods," may be too restrictive and you could be missing needed nutrients.
As all medical tests have come negative, I'd try a sport term try of benzodiazepines. If that relieves the symptoms, I'd follow with Bupropion.
Hello,
As there is no objective evidence of medical conditions contributing to chest pain, unfortunately related to anxiety only, you need to get on medications for anxiety. Hydroxyzine alone is not adequate. You need to see a psychiatrist (starting on SSRI or SNRI antidepressants used for anxiety too in addition to Hydroxyzine). Also, you need to see a therapist one on one for supportive therapy and CBT. After 12 weeks of CBT, you will see lots of improvement.
Take care,
Dr. Chinthala
As there is no objective evidence of medical conditions contributing to chest pain, unfortunately related to anxiety only, you need to get on medications for anxiety. Hydroxyzine alone is not adequate. You need to see a psychiatrist (starting on SSRI or SNRI antidepressants used for anxiety too in addition to Hydroxyzine). Also, you need to see a therapist one on one for supportive therapy and CBT. After 12 weeks of CBT, you will see lots of improvement.
Take care,
Dr. Chinthala
