i'm 19 i have severe chest pains and pain in the lower left side of my back?

Question

hey i have severe chest pains and pain in the lower areas of my back- almost on the side. both sides hurt but the left side is agonizing. i'm afraid to visit the doctor- even after being advised that i should- i feel as if i don't have an emergency and like doctors will be wasting their time. and somehow i feel embarrassed... do u know where the pains come from?

i hear that it's indigestion.. from what may i ask---- i don't even eat- i barely have an appetite and i have dropped 18 pounds in the last 6 months... i look anorexic and i'm 5'3' at only 100 pounds

Answer 1

Okay - let's have a think about the possibilities.

From the outside in, your pains could come from:


Skin - classically from shingles but other skin rashes or skin conditions can be painful. Shingles is often associated with blisters and a classic rash. You would need to see a doctor about this to get the special antiviral medication you would need.

Chest wall - ribs, intercostal muscles - these could be sore if you have been struck on the chest (eg been in a fight or in a car accident). Viral illnesses can cause inflammation of the ribs typically where they join on to the sternum (breast bone). The pain here is often worse when you breath or with movement of the chest wall (coughing, laughing ... movement of the trunk).

Chest wall - spinal muscles - these can be sore if you have strained them (in activities, particularly lifting heavy objects) or again with trauma to the chest. If you also have a fever and are unwell in an infected kind of way (sweats, shivers, poor appetite, feeling like you have a bad flu) then you could possibly have some sort of abscess or infection there - rare, but possible.

Spine - you are too young to have much arthritis in your spine. However you can still have a variety of ailments that cause "chest pain" which arise from your spine. Disc protrusion and disc bulges can compress nerve roots and give rise to a shooting electrical nerve pain that goes around the side and around to the front. Infections of the spine or areas around the spine would give you pain in the back, associated with fevers/chills/loss of appetite etc. Cancer of the spine - very uncommon at your age.

Lungs
(1) pleurisy - viral illnesses and autoimmune diseases can give rise to inflammation of the lining of the lung (pleura) classically a pain that hurts most when breathing or coughing (ie when the lungs are moving)
(2) pneumonia - gives a similar pleurisy pain, associated with the infective signs - fever/chills/loss of appetite. PNEUMONIA CAN KILL YOU (I found out today an elderly patient I arranged an admission for a fortnight ago struggled on with a severe pneumonia and eventually died 5 days later) particularly if you are old/extremely young (like less than 1 yo)/or especially infirm with medical illnesses
(3) pulmonary embolism - the "economy class syndrome" ie. clot in the lung - can be very insidious with minimal complaints or can give this pleurisy pain again as the lining of the lung is inflamed when the lung has no oxygen to a portion. The clot (usually comes from the legs) travels in the veins to the heart with the de-oxygenated blood and then travels out to the lungs where the blood is re-oxygenated. But the clot sticks somewhere and blocks the circulation to that part of the lung. Very tricky to diagnose. May require a blood test to exclude, or perhaps one (or more) of a variety of special scans. PULMONARY EMBOLISM CAN KILL YOU - all it takes is a sizeable clot to block off both pulmonary arteries and you fall down dead before you can call the ambulance.
(4) pneumothorax - air between the lung lining and the chest wall - can occur with trauma (esp with rib fracture), penetrating trauma, or spontaneously (esp in young tall skinny people, esp in asthmatics) - again with the pleurisy type pain, shortness of breath - need a Chest X-ray to diagnose this. PNEUMOTHORAX CAN KILL YOU - some types cause a one-way-valve effect with more and more air accumulating in the chest, compressing the heart and great vessels and eventually blocking bloodflow out of the chest

Not convinced to go to the doctor yet? Read on!

Heart
(1) Ischaemic heart disease - very unlikely in a person in your age group and gender. The "heart attacks" we see in young people are usually associated with amphetamine or cocaine use. There is a small group that are caused by vasculitis. Any drug that closes up your blood vessels can close up blood vessels in your heart and cause lack of oxygen to the heart muscle. This in turn leads to chest pain and cardiac muscle cell death. Different pain to the lung pains. ISCHAEMIC HEART DISEASE CAN KILL YOU
(2) Pericarditis/myocarditis - usually viral or autoimmune - can sometimes have a pleuritic type chest pain, or can be constant and mimic a heart attack. This is usually diagnosed on ECG (EKG if you're in the States) and/or by a process of excluding other causes

Great Vessels
Dissecting aneurysm classically causes a tearing back pain. AORTIC ANEURYSM CAN KILL YOU if it ruptures and pours blood into your chest. This is quite a rare condition

Oesophagus
Gastro-oesophageal Reflux (GORD) (oh yes, GERD if you must) can cause a burning pain usually central and up and down in the front of the chest. This is occasionally worsened with posture being better on standing up and worse on bending over or lying down.

Kidney Stones
These typically cause a pain on one side of the back or the other - and the pain can radiate down into your groin. The pain is classically described as extremely severe - worse than childbirth (is what the men say) or as bad as childbirth (or sometimes not quite as bad).

Other things I'm not going to reference. Look them up yourself if you think this is what is going on: gastritis, pancreatitis, biliary colic, (hepatitis - liver is on your right)

Now - what should you do about all this? I think you need to go see a doctor who can ask the proper questions and examine you properly before moving on to some special tests.

Enough of these things can kill you that you should give thought to attending an emergency department rather than seeing your usual doctor.

Answer 2

Well the fact that you're not eating and you wiegh so little isnt going to help...it could be that you're not getting enough nutrition and you're getting muscle cramps coz of that.

Frankly what do you think doctors are for? Do you think they're going to stay judging you? Doctors see thousands of patients who will eventually result in having nothing at all but simply giving them the peace of mind of knowing that is part of a doctor's job. If you're worried go to the doctor as soon as possible.

Answer 3

Chest pain can mean angina or some sort of a heart related problem. The pain on the sides of the back could be related to kidneys. Please go see the MD asap. Remember, prevention is better and cheaper than cure :)

Answer 4

my friend had that hes 17 he said he thought he was having a heartattack but he wasnt lol neways everyone said it was indegestion but w/e.... hey vistit the doctor my friend did and he feels a whole lot better now ♥ they have people go in their for stubbing their toe**my lil sister** so dont risk it and go <3

Answer 5

You have Lung Cancer of the Friorties (the outer skin)