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I woke up with severe sudden chestpain, but they couldn't find anything
Sorry to say, but nothing much comes to mind (see below). You had just about all the tests I would have ordered and with them being negative, pretty much most possibilities have been excluded. I am concerned however about your elevated white count, because that doesn't happen in a vacuum.
Take a look here, for more information about your heart:
The tests showed your heart is not the problem, so let me explain some other and more remote possibilities:
A Hiatal Hernia comes in two flavors: a "sliding" HH, and a Para- Esophageal HH. Sliders are relatively common, but most don't cause symptoms. If they do it is because of stomach acid backing up into the esophagus, which isn't built to tolerate that, and you get an acid burn that over time may progress to a stricture with difficulty swallowing. Your symptoms don't sound like that all.
- Normal Esophagus
- "Sliding" Hiatal Hernia
- Para-Esophageal Hiatal Hernia
The para-e variety would have shown up on the CT scan and chest X-ray. Here, a portion of the stomach gets stuck above the diaphragm. If that opening is too narrow you may have pain and it could be a surgical emergency. I don't think you have that either.
Other possibilities include problems with peristalsis of your esophagus, and spasm is one of them (can be quite painful, often confused with a heart attack initially). It may be worth looking into this last option.
Esophageal spasms are abnormal contractions of the muscles in the esophagus (the tube that carries food from the mouth to the stomach). These spasms do not move food effectively to the stomach.
- Difficulty swallowing or pain with swallowing
- Pain in the chest or upper abdomen
Nitroglycerin given under the tongue (sublingual) may be effective in an acute episode. Long-acting nitroglycerin and calcium channel blockers are also used to treat esophageal spasms. Rarely, severe cases need surgery. The cause of esophageal spasm is unknown. Very hot or very cold foods may trigger an episode in some people. It can be hard to tell a spasm from angina or the symptoms of a heart attack. The pain may spread to the neck, jaw, arms, or back.
It is difficult to imagine however, that you would not have had symptoms in the past if that were the case.
Lastly, any person with sudden chest pain needs to be evaluated for a pulmonary embolism - a blood clot to the lungs. Besides pain, there is usually also trouble breathing and of course there has to be a source somewhere of that blood clot. Your tests would have shown if that were the case.
I am a cardio thoracic surgeon and dealt with all these problems a lot before I retired. These issues and your white count are what I'd look into.
Last, during my clinical practice if I didn't know what was going on (it happened!), the first thing to do was to make sure the patient was safe, the second, to repeat tests to look for changes after a period of time, the third, ask for help.
Hope this was helpful,
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