Peter Hibberd, M.D., is a doctor whose advice is based on more than 28 years of hospital outpatient and inpatient experience. He is an experienced emergency medicine physician, surgeon, and consultant. Dr. Hibberd is certified by the American Board of Emergency Medicine. He is also a fellow and active member of the American Academy of Family Physicians, an active member of the American College of Emergency Physicians, and a member and fellow of the American Academy of Emergency Medicine. Dr. Hibberd has earned numerous national and international professional certifications, memberships, and awards.

What Causes Severe Stomach And Chest Pain?

Monday, 19 July 2010 04:04 PM

Question: I'm a 62-year-old average male. About six months ago I started having severe stomach and chest pains. I had an abnormal EKG that was determined to be from a "branch bundle block." They said it was no big deal. I was overweight and had high cholesterol, so I dieted. I’ve reduced my cholesterol to 150, and I’ve lost 20 pounds and taken two inches off my waist, but I’m still in pain. I had a heart stress test done, but no problems were found.
An endoscopy done found a mass in my stomach where it goes into duodenal, but the biopsy was benign. I took Prilosec, hoping it would help. It controlled about 75 percent of my symptoms, but not all, so I had an angiogram which showed that even though I have mild coronary atherosclerosis, there were no blockages and my problems are not due to heart/circulatory. However, two aneurysms about 3.5 cm. were found, one on the ascending aorta, and one on the descending aorta.
My heart doctor says we'll watch them and to come back in a year. However, CT showed benign bilateral adrenal adenomas, which we’ll also watch. My primary physician agrees with the heart specialist — no big deal, pretty common, get CT every six months. Since I still had symptoms, I switched to Protonix instead of Prilosec. It cost $100 month and helps control 85 percent of my symptoms, but I’m thinking of switching back to Prilosec, because it only costs $25. My doctors suggest finding it in my budget to get the Protonix. I'm spending 50% of my monthly income trying to get a solution. I want to find the real cause and not take these meds forever. Any suggestions?

Dr. Hibberd's Answer:

Your frustration is clear. Remember that all these conditions didn't start at one time, and they will not all cause problems at one time either. So, tackle the ones you can modify. Trim your weight and maintain your healthy diet. Be assured that no cardiac intervention is necessary, and do all you can to avoid worrying about existing health disorders. You can do little harm by being optimistic and following your cardiologist's advice until they advise intervention. Keep your weight and blood pressure down to prevent enlargement of your aneurisms, and maintain close follow-up as they advise.

Your dyspepsia treatment has been clearly disappointing, so perhaps it is time for a second gastroenterology opinion. Ask if you have an infectious process such as H pylori, and insist on evaluation and further treatment until the cause of your dyspepsia is clear and fully treated. Hang in there, and try to look on the positive side of things while your health conditions are sorted out.

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