Sharp Chest Pain With Breathlessness

by Lenka
(Pretoria)

I am 14, and want to help diagnose my teacher. He said that the GP has ruled out all the usual suspects like PNEUMONIA. He has been prescribed something for pain and asked to see a specialist. I take a big interest in medical puzzles, and would really love some help with this case.

SYMTOMS:
- Chest pain (feels like a stabbing pain)
- Shortness of breath

Do you have any idea what it might be???

Stabbing Chest Pain With Breathlessness

Stabbing chest pain with chest pain has many causes. You mention that pneumonia with pleurisy has been ruled out by his GP presumably by clinical examination and by x-ray. This doesn’t fully exclude it, although other causes should be considered. What are these?

1) Pulmonary Emboli – this can cause sharp chest pain with shortness of breath. Blood clots form in the veins, often in the leg veins which can break off in to the circulation and go to the lungs. These lodge in the blood vessels that supply oxygen to the lung. If large enough, they can be life threatening so it is something that needs to be excluded at an early stage. This is done by performing a blood test called a D-Dimer test and if positive to do a scan of the lungs called a CTPA or less commonly these days a test called a V/Q scan. Treatment of this is with blood thinning drugs.

2) Pneumothorax – this is a collapsed lung that can occur spontaneously or can occur due to trauma. It is diagnosed by clinical examination and by chest x-ray. Treatment depends on the size of the Pneumothorax, but can be anything from observation, though to aspirating the air with a syringe and needle through to a chest drain being inserted.

3) Pericarditis – this is an inflammation of the membrane that surrounds the heart and has many causes. The most common is a viral infection which usually settles with anti-inflammatory drugs and rest.

4) Heart disease – Coronary artery disease and angina can present in many ways including sharp pains and/or breathlessness. Classically though it will present with angina pains described as a pressing sensation in the chest moving to the shoulder and down one or both arms sometimes with associated breathlessness.

5) Musculoskeletal Pain – Muscular or skeletal pain, often due to trauma or pulling a muscle can cause sharp pains in the chest and can make the sufferer fell breathless.

The above are the common causes, but there are others that I won’t go in to here. It is so nice to here of your keenest to help your teacher. I’m sure that his doctor will help sort out his chest pain problems for him.




My name is Dr Peter Thatcher MBBS, MRCPI and I am a consultant physician and gastroenterologist in the UK. I have an interest in internet based medicine and administer this site in my spare time. I hope you find this site useful and informative. If you have any suggestions, please Contact Me or if you would like to comment on my site, please do so by Clicking Here. If you like the site and would like to make a donation to support what I am doing please do so by Clicking Here. Thank you for visiting and please drop by again!