Pericarditis and chest pain

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Submitted by Dr T on July 21, 2011 – 7:39am

Question: 
I’m a 32 year male. Generally healthy and used to be very fit until in Sept 2010 I developed a pain in my chest – at the time it was just t the right of my breast bone and I felt like I had a chest infection, seeing as I had had cold for about a fortnight before. I went to my doctor and was diagnosed as having pericarditis – they performed a chest X ray (normal) and an ECG (not normal – consistent with a diagnosis of pericarditis). A few days later I had an echo which they also thought confirmed pericarditis.
The pain didn’t go away and the symptoms if anything got worse. Worse pain and at various points any activity would make my heart start to pound and feel like it was beating irregularly.
I had another Echo in Jan 2011 and that was fine, though an ECG was not totally normal but better than the first one in Sept. I was given Colchicine to take. I did that for two months with not much benefit.
At various points it feel like it gets better but only gets worse again. The pain is sometimes pretty bad and generally feels like it’s at the right of my breast bone and at the centre of my back, though sometimes it feels more diffuse. I also generally feel unwell, as if I have  cold.
In April I had a CT scan. Everything normal. My pericardium looks entirely normal, as does everything else. Except I am still in pain. My cardiologist has nor referred me to a rheumatologist as she thinks it’s not my heart causing the pain any longer, and that the pericarditis was a separate condition which has now passed. She’s given me a month course of Prednisolone (40mg tapering to 5mg), which I’m nearly a fortnight into and which has had no effect yet – if anything the pain is worse.Any ideas? And if not ideas on the illness/cure, any thoughts on what sort of doctor I should see to do more inquiries? It is, as you can imagine, really getting me down by now. Thanks for reading.
 

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