Confusion About Chest Pain

[PoloGreen94]

Hi all!

I have a question concerning a medical condition I am dealing with and would appreciate any input.

About two months ago, I began experiencing a mixture of dull and sharp chest pain when inhaling deeply. The pain would vary and would heavily be based on my posture when inhaling. If hunched over or laying flat on my back, I would feel the pain but if standing upright I would barely feel the pain when inhaling deeply if at all.
The pain would sometimes be focused in my right breast area but sometimes radiate to my mid and left chest, but mainly focused on the right.

The pain began a week or two following a dive in Hawaii, which was deep, max depth of 110 and the second dive at 70.

I am also a volunteer diver at an aquarium where I dive every two weeks. While diving in the aquarium I would feel the pain and it would be more pronounced. After not diving for a month in the aquarium I felt the pain was subsiding to some degree. When I dove just recently at the aquarium, I noticed the pain had returned that evening when inhaling deeply, in fact it was more pronounced. The aquarium is not deep, max depth of 12 feet. But the total dive time between two dives can be almost three hours. I also feel the pain while diving, especially when I take a deep breath.

I have had several tests done with my primary care physician. Here is my current health status:

Pulmonary Function Test: Normal
X-Ray: Some muscle spasms but lungs are clear. No sign of rib injury or pneumothorax
EKG: Normal
Blood Pressure: 104 over 68.
Very light daily smoker, 2-3 cigarettes per day. Sometimes none.
Light drinker, 2 drinks a week. (Not sure about smoking or alcohol and its effects on diving and this scenario but thought I would disclose as much info as possible).

My doctor seems to think it is a muscular/skeletal issue. He recommends me not making any open water dives until we verify what the problem is. He also suggests diving at even 40 feet would put immense pressure on my muscles and skeleton creating great discomfort.

A representative at DAN felt this sounded muscular/skeletal too. But said it is likely the horizontal profile, weight while diving, muscles being used, etc...which is what is causing the pain, particularly after diving in the aquarium. This also makes some sense to me, as your profile is horizontal and if I am on land hunched over I feel the pain too.

The weird thing is I never felt this pain in early April when I dove Hawaii. It has started since that trip.

My questions are:

1. Can pressure effect muscles and skeletal problems inside your body too as my doctor suggests?

2. Does this sound like an off gassing issue or gasses in my muscles? I don't feel like it is as it would go away after a short time.

3. Is my dive career over?

Thanks for any info.

 

[Bratface]

Ask DAN to help you find a doctor trained in dive medicine. There may be some near you or you may need to travel a bit. You need a professional opinion. Present all of your medical records when you go. You really won't get the answer you need on this forum.

 

[Bob DBF]

Not that this could have any bearing on your problem, and please continue with your doctors until you resolve the issue.

Several years back I had chest pains on my left side after a dive trip. After a lot of tests focusing on my heart, including a treadmill which was he** because I was beat from three days and 16 dives, it was determined that it was the way I took my tank off strained muscles across that side of my chest. I was glad that was it, but it kept a lot of medical professionals hopping for a while.

Let us know what happens

Bob

 

[DocVikingo]

My questions are:

(Q)1. Can pressure effect muscles and skeletal problems inside your body too as my doctor suggests?

(Q)2. Does this sound like an off gassing issue or gasses in my muscles? I don't feel like it is as it would go away after a short time.

(Q)3. Is my dive career over?

(A)1. If you mean pressure effects directly related to recreational scuba depths, the answer is no. However, stresses to the musculoskeletal system caused by donning/doffing/wearing heavy gear like gas cylinders and weight belts, certain positions assumed while diving and on land, etc. could result in problematic strain.

(A)2. No, it does not sound like an off-gassing issue, and almost certainly is not the result of gas in your muscles.

(A)3. While it cannot be said with complete certainty that diving will not end up being contraindicated, it appears very unlikely that you will not be able to eventually return.

Pain on deep inhalation may be result of inflammation of the pleural membranes, chest wall injury, pneumothorax, pulmonary embolism, and other pathologies. Based on your descriptions and the reported clinical findings (normal PFT, EKG & chest x-ray) to date, a cause related to chest wall muscles/tissues seems high on the index of suspicion. Quite simply, pulling on the injured tissue caused by deep inspiration triggers pain. Apparently both your PCP and the DAN employee with whom you spoke also suspect such. If the working diagnosis to date is correct, not additionally stressing chest wall tissues until they have healed may well be the solution.

Since your PCP has expressed concern over diving until the problem is further clarified, it would seem prudent to follow this recommendation.

Regards,

DocVikingo

This is educational only and does not constitute or imply a doctor-patient relationship. It is not medical advice to you or any other individual and should not be construed as such. Consult with your physician before diving.

 

[OMANDIVER]

Hi all!

I have a question concerning a medical condition I am dealing with and would appreciate any input.

About two months ago, I began experiencing a mixture of dull and sharp chest pain when inhaling deeply. The pain would vary and would heavily be based on my posture when inhaling. If hunched over or laying flat on my back, I would feel the pain but if standing upright I would barely feel the pain when inhaling deeply if at all.
The pain would sometimes be focused in my right breast area but sometimes radiate to my mid and left chest, but mainly focused on the right.

The pain began a week or two following a dive in Hawaii, which was deep, max depth of 110 and the second dive at 70.

I am also a volunteer diver at an aquarium where I dive every two weeks. While diving in the aquarium I would feel the pain and it would be more pronounced. After not diving for a month in the aquarium I felt the pain was subsiding to some degree. When I dove just recently at the aquarium, I noticed the pain had returned that evening when inhaling deeply, in fact it was more pronounced. The aquarium is not deep, max depth of 12 feet. But the total dive time between two dives can be almost three hours. I also feel the pain while diving, especially when I take a deep breath.

I have had several tests done with my primary care physician. Here is my current health status:

Pulmonary Function Test: Normal
X-Ray: Some muscle spasms but lungs are clear. No sign of rib injury or pneumothorax
EKG: Normal
Blood Pressure: 104 over 68.
Very light daily smoker, 2-3 cigarettes per day. Sometimes none.
Light drinker, 2 drinks a week. (Not sure about smoking or alcohol and its effects on diving and this scenario but thought I would disclose as much info as possible).

My doctor seems to think it is a muscular/skeletal issue. He recommends me not making any open water dives until we verify what the problem is. He also suggests diving at even 40 feet would put immense pressure on my muscles and skeleton creating great discomfort.

A representative at DAN felt this sounded muscular/skeletal too. But said it is likely the horizontal profile, weight while diving, muscles being used, etc...which is what is causing the pain, particularly after diving in the aquarium. This also makes some sense to me, as your profile is horizontal and if I am on land hunched over I feel the pain too.

The weird thing is I never felt this pain in early April when I dove Hawaii. It has started since that trip.

My questions are:

1. Can pressure effect muscles and skeletal problems inside your body too as my doctor suggests?

2. Does this sound like an off gassing issue or gasses in my muscles? I don't feel like it is as it would go away after a short time.

3. Is my dive career over?

Thanks for any info.

I am not a doctor. I have experienced and been diagnosed with muscular skeletal chest pain for years. I have and pass a dive medical every year with a specialist dive doctor. It has not prevented me taking part in any diving activity.

 

[DiverDownD3]

I too have been experiencing on and off chest pains. I went to my primary doctor and everything seemed normal (blood pressure, heart rate, blood work). They referred me to a heart specialist. EKG was normal. I have an echo today and a stress test on Thursday. I'm not sure if they planned it this way, but the doctor I'm seeing is a diver and was a dive instructor when he was in the military, so that does make me feel better he has dive experience. He said as long as these test turn out normal that I can return to diving. I've got to say staying out of the water has been very hard to do.

I honestly hope/think this pain is actually radiating from an old rugby shoulder injury. The heart doctor said this very well could be the case. Hope the test turn out ok.

 

[DiverDownD3]

Had the Echo and stress test done last week. Everything looked normal on the Echo, the doctor (not original doctor I saw) said that he saw some borderline results on the stress test, he didn't really give me too much detail after that, but he also did say at 31 and in decent shape that it's unlikely that I have CAD. He did also say that they get a lot of false positives on the stress tests. He was going to turn over everything to the original doctor to go over the results with me. Thing that is driving me crazy is the doctor has hospital duty this week and my follow-up isn't until next Thursday. Between wondering if I have something wrong with my heart and not being told not to dive with perfect dive conditions is driving me insane.

One thing that is comforting (and I'm guessing here) is if they would have saw something really abnormal they would have sent me for additional testing immediately and not wait 2 weeks to discuss test with me.

 

[iamrushman]

don't let the waiting for test results give you stress till you hear the results.....an echo is much more reliable that a stress test with all the artifact it creates...keep us informed and good luck to you....you'll be diving in no time.

 

[fireboat]

I went through a similar thing over 20 years ago. I did a stress test and they thought they saw something, so I had a cardiac cath performed, the gold standard for seeing if anything is going on. The cardiologist said everything was clean as a whistle.
The thing is, you can show a 12 lead to three different cardiologists and get three different interpretations.
At your age and condition , the odds are hugely in your favor. So, relax and make plans for your next dive.

 

[DiverDownD3]

At your age and condition , the odds are hugely in your favor. So, relax and make plans for your next dive.

Not going to lie, it's been tempting. I'm sure it's nothing, but figured I'd play on the side of caution. I'll know one way or another in a week.