Chest Pain Input Please

[li10up]

I want on a backpacking trip over Labor Day weekend. We left Thur. and arrived in the San Juan Mtns. of Colorado on Friday. We setup our basecamp and on Saturday we did a strenous day hike of 10 miles going to an elevation of 10,600 feet which was an elevation gain of about 3000 feet. Saturday night I awoke with chest pain that increased when taking a deep breath. However, after rolling onto my side for a few minutes the pain eventually went away. I've experienced this pain each night for the past 5 nights and a couple of times during the day. BTW, I left CO on Monday around noon. I went to my GP today and he doesn't know...he says he doesn't think is heart related since the pain went away when I moved to my side. But he still wants me to do a stress test. Anyone have any thoughts on what could be causing this?

[maillotpois]

Did you fly there (or take a long car trip there in which you were sitting still for a long time)? Are you on birth control? Have you had any leg cramping?

Regardless of the answer to the above, please please ask your doctor to order a D-dimer blood test - simple blood test. That's an indicator of clotting. You could possibly have developer a pumonary embolism. The odds are not high that you have, but could be deadly if you did.

ETA - the fact that it subsides depending on position could mean it is pleurisy, which is often secondary to PE. Please get that test.

[Dianyla]

Agree with maillotpois on the tip to investigate pulmonary embolism. Also, even though 10K is not that high, high altitude pulmonary edema should also be ruled out.

[KnottedYet]

I had some lovely odd symptoms once, and the doc ordered a d-dimer test. It was up around 500, which I guess was kind of exciting...

Anyway, please ask for the test. It only takes a blood draw, and it gives some important info!
(which could save your life, and I'm not kidding)

[Wahine]

I would 4th getting the d-dimer test. The chance that you have a blood clot is low but the consequences of missing it are BIG.

Having said that it sounds like a blockage of normal rib motion that could have been cuased by your back pack. Once you've ruled out the nasty stuff, go see a DO or PT that is trained in manual therapy, they should be able to help. Right now, you could try placing a tennis ball at the wall and leaning against it with your back but at the same level where the chest pain is or slightly higher. Roll the ball around the area with your back and see if it bings on your symptoms or hits some trigger points. If it does, it's even more unlikely that you have a clot and you might be able to ease you symptoms some with this type of self massage.

[li10up]

I did have a long bus trip to CO and I am on BC. I'm not having difficulty breathing so wouldn't that rule out the PE? 10K is high for someone who lives at 600 ft above sea level. I don't have an appt to see the doc again. Am waiting for them to call me with an appt for a stress test. Didn't have the pain last night but got it this morning. Rolling on my side didn't help this time.

[Pedal Wench]

I would go to the doctor for a followup sooner rather than later!

On a side note,... how was the hike? Where'd ya go and what trails did you hike?

[maillotpois]

Long bus trip plus BC are both risk factors for PE. Lack of trouble breathing - who knows what that means. While I did have trouble breathing, it was ONLY at the very high end output levels - fast climbing on a bike, for example. In everyday life, hiking, walking, climbing stairs, carrying groceries, riding my bike on flat or rolling terrain, I had NO trouble breathing at all. I also had a 100% oxygen sat level. And I had multiple, relatively large, PEs in both lungs.

Knowing what I know now, I wouldn't take the risk.

[li10up]

Well, I called my HMO and spoke to my dr.'s nurse. Asked about the d-dimer test. She said they can't give it - that I'd have to go to the ER for those types of blood tests. I've had the chest pain for 4 hours but now it seems to be subsiding. They didn't seem to think that PE was likely but said if I was concerned I should go to the ER. I just don't want to be the one to "cry wolf." Doesn't seem to be an emergency. If my dr isn't concerned...I guess I shouldn't be. They are working on scheduling my stress test.

[SadieKate]

Maillotpois didn't cry wolf either and I don't think her docs were worried -- thought it was asthma. While you may have to go to the ER to have the test done, your doc can sure order it. That's baloney.

[maillotpois]

In this case, don't listen to my signature line: it's not supposed to hurt.

When I finally called my doctors office on the Monday having had chest pain over the weekend they freaked out that I hadn't done anything about the chest pain. I guess I got lucky with my doctor.

I sure hope your doctor is right.

[Crankin]

Go to the emergency room!!!!!

[Kano]

I don't want to minimize the possibilities -- the bad stuff that's been mentioned is NOT to be ignored, but:

You say there was a long bus trip. I had an assortment of not-so-long airplane rides this last week, and ended each day of flying in some wicked pain too. Home since Tuesday night, things are finally starting to feel much more normal. Yup, over a week...

DH has decided he prefers window seats on airplanes. He seems to have decided that I really like center seats.

I'm not small enough to be comfortable sitting between two people who are larger than me. It's hard to spend a couple of hours at a time sitting with one's arms crunched tightly at one's sides as though FIRMLY duck-taped to the rib cage with no expansion space allowed for breathing. Oh, and in that curled position that those evil airplane seats force me into -- also aids in the reduction of breathing space...

It was seriously painful to lay in the strange bed at night, for the whole trip, and yes, the first couple of nights at home too -- so I have to ask:

Did you also enjoy the pleasures of not enough personal space during your trip???

Karen in Boise

[KnottedYet]

Your HMO is full of BS.

And I had minimal transient chest pains and NO difficulty breathing, so GET YOUR BUTT TO THE ER RIGHT NOW, DAMMIT and get the d-dimer test.

Do not pass go, do not collect $200, do not complain about it, just DO IT.

Once a clot issue is cleared, then you can have fun taking your time exploring other options. A clot problem can KILL YOU. It can turn YOUR BRAIN TO LIFELESS MUSH if a clot decides to spend quality time in a cerebral blood vessel. (that's what's known as a stroke)

Go to the ER, get the test your darn doc can't be bothered with, and let us all stop worrying.

It's all about us, you know!

BTW: a stress test could blow chunks into your heart/lungs/brain. I think your doc is being horribly negligent not clearing you for clotting issues before running a stress test. Sue his buns off. Or tell your next of kin to do it.

[Torrilin]

Mom has had multiple pulmonary embolisms. Always very exciting :P because she looks and feels perfectly normal until she's in *really* dire shape. Get the test. You can't tell by looking, unless you've got a CAT scan machine at home.