Dd still ill, over six months and no diagnosis.

[PikachuSayBoo]

I'm at the end of my tether with it all. She's sitting her GCSEs this year and is crying in pain most days.

Until last Feb/March she was generally fit and well (apart from a case of shingles a year previously)

She started complaining of acute episodes of chest pain and breathlessness. Would be doubled over and crying. Generally worse in the evenings/night and worse when lying down.

I took her to out of hours one evening and they couldn't find anything wrong with her and said it could be stress. They recommended a blood test but dd refused.

These attacks continued and I was dubious about the stress diagnosis. She would go to bed quite happy and then an hour later come down crying. One night in a hotel she spent all night propped up in a sitting position as she couldn't lie down.

She finally agreed to a blood test mid/end July and her Vit d was a bit low (52) and although her Hb was ok her ferritin was low at 7. So she was put on vit d tablets, iron tablets, contraceptive pill to regulate her periods and mefanmic acid for pain relief.

So she's been taking these tablets for two months. She's to go back for a repeat blood test next month.

But she's no better. I would say she's worse. She says she's been crying at school all day as she's in so much pain. Still mainly chest pain and breathlessness but also stomach pains at times. She says she gets hot flushes, bad headaches and feels weak/dizzy/faint at times. Surely the tablets should have sorted out the anaemia/Vit d issue by now?

Ive also tried her on gavviscon as I read that lying down can make heartburn worse but that doesn't seem to have helped.

I'm worried this is really going to affect her exams. Not sure whether to wait another month for her blood test or go back to the Dr now. Won't they just say we need to give the medicstion longer to see if it works?

What a shame and what a worry... The only helpful thing I can add is that her ferritin is EXTREMELY low and that could cause a whole raft of unpleasant symptoms. I hope you get to the bottom of it and she returns to full health very soon X

Low Ferritin is often linked to celiac

Whilst obviously important to get cardiac causes ruled out, the breathlessness could be linked to a gastric issue. Reflux can irritate nerves in the oesophagus, and cause an unpleasant 'air hunger' sensation. Not nice and likely to increase anxiety, but very treatable. Definitely seems worth stopping the mefenamic acid and a trial of antacids for a bit.

If the pain is really only brief, it might also be worth considering something called pre-cordial catch syndrome. It causes really sharp chest pains that worsen when you breath in. Makes you want to breath really shallowly till it passes. Common in children and especially teens. I used to get it as a teen and it used to terrify me; grew out of it some time in my 20s. I only found out about it as an adult by accident. It's a bit of a medical mystery as to what causes it, but is apparently benign. If the symptoms match, you could add it to your list of things to ask your GP about!

Meant to say that anemia could still be responsible for a lot of those symptoms, including the breathlessness. It'll take time to get her iron back up to good levels from such a low base.

I think searching for obscure diagnoses is the wrong approach. Simply go back to the GP , say I don't know what the answer is but she was a previously well child and is now having daily chest pain and SOB, please can it be looked into as a matter of urgency. For eg chest X Ray , ECG , consider cardiology referral for echo .
Costocondritis is a common cause of non worrying chest pains.. There is usually tenderness over the ribs at the front. There is also acid reflux to consider and they could consider a stomach protector if symptoms fit. Just get her reviewed again and see what they say. She's not in the usual age for gallstones.
However asking for obscure blood tests and suggesting things can often lead people down the wrong path.. Just get her to describe exactly when and where the pain is, what brings it on, what makes it better, how often she gets it, and associated features like Sob or feeling sick, vomiting etc. then let the GP think about what to do next and take it from there. All the best .

Dn had chest pains from age 13 - 17. Attacks would cause severe pain, breathlessness, were worse lying down, and the pain would sometimes hit very suddenly and so painful it would literally floor her. A few times she was blue lighted to hospital when she had an attack out and about.

Doctors thought it was inflammation in the breastbone but were never sure why, they gave antibiotics and it would clear for a bit then come back. When attacks got really bad she was on hospital on IV antibiotics. Eventually a Dr suggested getting her tonsils out after another throat infection. A couple of months after her tonsils op it stopped and she hasn't had it again. Not sure if she just grew out of it, or if it was related to infections in her tonsils.

One cause of chest pain in young people is pericarditis , inflammation in the lining of the heart sometimes caused by a virus, sometimes by other things. Diagnosed by ECG and Echo.