Hello doctor, I need an advice and an opinion about a chest pain I have been having for the past four days. About four days back, I was at the family farm doing some cleaning. It was dusty everywhere and so when I finished, I coughed and felt the dust went inside my chest. Since then, I have been having a chest pain, right above my right nipple, the pain is kind of in the bone. So, when I press on my chest bone beneath or above my right nipple, I feel some pain. The pain sometimes comes to my neck or my side, and today it came to the left side of my chest which got me worried. The pain usually happens when I take a deep breath. It is not continuous. A month back, early morning while I was at work, it was a dusty day. Shortly after work started, I felt a pressure on my chest and a shortness of breath. So, I went to the ER, and they transferred me to the cardiology unit because my troponin was elevated. It was at 0.7. They did EKG, and it was normal. Later on that day, my troponin was elevated to 4.3. So, they did an ECO, and it was normal. The following day, my troponin was down to 3.4. They thought I had some kind of blockage and so they did a cardiac catheterization and found everything was normal. there was no blockage. I have no diabetes or blood pressure. I follow a low carbohydrate diet with intermittent fasting. My blood pressure and EKG during my stay at the hospital was normal. So, I was diagnosed with pericarditis, an inflammation of the outer part of the heart.
Hello. There are two possibilities in you, first is of musculoskeletal pain, which is originating from muscles and bones resulted due to coughing and stretch over the bones and muscles. And another possibility is of viral infection which commonly follows such exposures. This leads to inflammation of pleura and pericardium (lining of lungs) called as pleuritis or pericarditis. Both the pain will increase on deep breathing. I guess you do not have any fever, cough, rhinitis, etc., which may or may not be associated. Was there any history of heavy weight lifting or trauma to the chest? This is unlikely to be caused by heart blockages and does not appear worrisome. But, considering the history of pericarditis in last month, you should get one hemogram with ESR (erythrocyte sedimentation rate), ECG, chest X-ray and troponin done especially if symptoms persist. Also, vitamin D levels, of which deficiency is very common and predispose to such musculoskeletal pain. We also need to rule out other infections of the lungs because such exposures frequently lead to infections and above investigations will help in deciding the cause. You may use Diclofenac gel or spray for local application for symptoms relief. So, overall the first possibility is of musculoskeletal pain, which I guess should settle in another 3 to 4 days and does not appear worrisome, but should be evaluated. You may need vitamin D supplements after its testing.