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Question

23 Jul 2006

which is which
I have in the past suffered with an ulcer. In the past few weeks I have had a discomfort/pain between and a little below the breasts.
At one time I thought it could be gallbladder, as after a few spoonfuls of food I felt I'd over eaten...could not burp (although felt like I needed to) and when i could, its like bile taste that comes up.
There is a family history of heart attacks. I do not suffer with high blood pressure, in fact it is normally below average. I am 43 years old.
Last night after been in bed for at least an hour in relaxed mode, i had a gnawing pain around the breast bone area and my left arm ached.
How can one tell what the pain is...whether ulcer, gallbladder or heart. I take ultak for my ulcer when it flairs up which seems to sort it out, but these pains lately dont seem to be the same that I can remember.
Answer 341 views
Expert
HeartDoc

01 Jan 0001


Dear Helen,

Your problem is one which confronts doctors daily. From the patient’s viewpoint, it can be almost impossible to differentiate cardiac from stomach/oesophageal pain. Many a patient has been treated for ulcers when what they really had all along was angina.

You are in a bit of a pickle here, as women most often do not experience classical angina symptoms as do men, so heart problems tend to be underdiagnosed in females. The fact that you do not report other associated symptoms like dizziness, sweating or irregular pulse leans towards the problem being non-cardiac. Also, your history of ulcer and the bile reflux point towards a gastro-intestinal problem. BUT, here it is very important not to fall into the trap of labelling: just because you have had a proven ulcer before does not mean that these symptoms must necessarily be caused by a recurrence. You do have a family history of heart disease, so you cannot afford to ignore this.

The best thing you can do Helen, is to consult a specialist. A physician would be able to give you a broad overview, but a cardiologist would be in a better position to investigate and positively exclude a heart problem. This may be the better route to take: if you know for sure its not your heart, then you can take your time sorting out the ulcer. If you don’t know for sure that your heart is okay, you may waste valuable time messing around with ulcer treatment. We operate on so many patients who have had their gall-bladders removed, only to be still stuck with the original pain, which was angina all along. So I would suggest that you get the heart sorted out first.

Good luck.

HeartDoc
The information provided does not constitute a diagnosis of your condition. You should consult a medical practitioner or other appropriate health care professional for a physical examination, diagnosis and formal advice. Health24 and the expert accept no responsibility or liability for any damage or personal harm you may suffer resulting from making use of this content.
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