Left sided chest pain-Not sure what it is.

[DrARDS]

So my Dad was ventilated for several weeks with Covid.

By Gods grace, he’s come round and now rehabilitating on a ward. He’s presently on nasal oxygen.

Now his present complaint is pain/discomfort on left side of chest when lying down-more so at night. He reports feeling hypoxic, even though saturation’s are within acceptable limits.

His CT chest has shown some fibrotic changes (Traction bronchiectasis) secondary to bilateral pneumonia from Covid, but they are hopeful some of this will resolve with time and they don’t know the long term implications just yet.

His heart function has been ok and the docs are happy with his echo/ECG.

He was previously fit and well. No respiratory or cardiac issues.

My question: Do these symptoms sound familiar to you? We’ve asked them to rule out PND and they’ve explored atypical Angina, but we are clutching at straws.

Other than oxygen, he’s on saline Nebs.

He was previously on Carbocysteine, but they don’t think that’s of benefit now as the mucus is clear and not plentiful and cough reflux is good.

Any ideas what it might be? Does it sound familiar? Any exercises/pharmacological or special investigations that might help?

All thoughts and advice appreciated. Thank you so much

[Tia4209]

Have they checked for Pulmonary Embolism. How long ago was his CT scan. I know lots of people who have good 02 sats but have still had PE ,

Blood clots are another effect of Covid 19 according to some research I have read.

[DrARDS in reply to Tia4209]

Hi Tia,

Yeh he has had PEs and been treated for this with appropriate anti coagulant therapy, but still it’s a good shout 🙏🏽

[Tia4209 in reply to DrARDS]

They can take awhile to disperse 3/6 months is average even on thinners and can continue to cause pleuritic pain for a long time. Your poor Father has been through do much and lots of recovery do. I hope he continues to improve.

[DrARDS in reply to Tia4209]

God bless. Thank you so much

[Bkin]

None of us here are medical professionals and really I don't know how anyone could advise as not everyone has experienced the virus and those who have may not have had the same experience as your Dad.

My advice would be to discuss the chest pain with the doctor.

It does seem apparent from what you have already been advised from the medical professionals that there has been lung damage as a result of covid-19 and need for the respirator treatment, probably recovery time will take quite a bit longer and things may change over the next 2 months after which if problems are still being experienced further tests can be carried out. But hopefully you will notice some improvement.

The hospital would have been treating the symptoms of the virus.

Regarding exercise your best speaking with the hospital physician or ask your GP for referral to any physio exercise instruction that would suit. The hospital and GP have a better understanding what would suit your Father in these circumstances.

Perhaps visit the supportline pages:

supportline.org.uk/problems...

Hope your Dad makes a good recovery.

Sorry I can't be of more help.

[DrARDS in reply to Bkin]

I really appreciate your words. Yes perhaps I’m a bit too eager to see improvement and i need to be more patient-easier said than done.

thanks for your help anyhow.

[Caspiana]

Hello DrARDS , 👋😊

Oh my, your dad is lucky to be here still. I think you need to be more patient. If he's been on a ventilator for weeks, he is definitely not going to bounce back to normal very soon. And also you may need to accept there are some changes, damages that may not heal quickly or at all. Take things slow, I am guessing he is having physiotherapy etc. to get him up and moving again? Once he gets moving, things usually start to improve in general. Take it a day at a time, speak to his doctor about the pain. Take care. xx 🌞🌿🌷

[DrARDS]

I know we are lucky and should count our blessings, but it’s this new onset of pain that has worried me a lot.

In icu he was on regular obs and had had 1-2-1 nursing. Now he’s on a ward, the cover is far from this and he just looked so distressed and helpless on FaceTime.

I know what you are saying. He knows it too-he’s a doctor (that’s how he caught it!). We totally get it will take time; 6-12 months, perhaps longer and things may never be like before, but I just don’t want things to exacerbate or be missed on that premise alone-that things take time to recover and to simply accept pain/discomfort/unusual symptoms.

God bless!🙏🏽

[Ergendl]

Can't help with your question, but praying your Father continues to improve and those caring for him manage to sort out this latest chest pain.

[DrARDS in reply to Ergendl]

Thanks! Appreciate it🙏🏽

[HungryHufflepuff]

Sending good wishes for your dad's continued recovery.

[DrARDS in reply to HungryHufflepuff]

God bless! Thank you so much. It continues to be a rollercoaster of emotion for our family.

[Hidden]

Recognise this post is older, also understand your family medical background better now - if still an issue, I’d ask about pericarditis. You can have a clear echo & ecg with this, and still have pain, and /or inflammation or fluid.

Symptoms are:

- feeling of tightness or compression or hard to breathe

-throat or area behind sternum rasps or hurts on inhaling

- other discomfort on breathing

- shortness of breath

- pain in chest cavity or radiating as referred pain to back, neck, shoulders, for some arms

- discomfort is worse in different body positions, for most it is worse laying down and worse overnight when we lay down for several hours.

- some find the discomfort eases on sitting up or forward.

- i also find my heart rate is more reactive, eg to going up a flight of stairs.

Pericarditis is usually immune response / inflammation related and I’ve read articles about much higher incidence of pericarditis with or after covid (sorry I didn’t keep any links).

Worth finding a doctor who has pericarditis experience, as many are missed or mis-diagnosed including with angina. Most docs incl A&E haven’t ever seen it. Took a second visit at Brompton to get diagnosed.

Pericarditis can become chronic or recurrent (30% of

cases) if not treated. Thickening of pericardial sac or damage to the heart muscle itself are small risks, as is tamponade if fluid builds (but that’s usually visible on echo).

Diagnosis is largely on symptoms, echo + CRP infection/ inflammation blood test. But tests often highly variable by individual, so can be unclear.

Trigger cause is usually viral (eg covid). Also many idiopathic instances.

Treatment can include diuretics or a procedure to drain fluid, plus anti-inflammatory dose of ibuprofen (1800mg I think, 3 tablets 3x daily) with gastro protector. And for many, colchicine is successful (an anti inflammatory usually used for gout but now a normal option for pericarditis).

[Hidden]

PS left sided chest pain can be due to gravity & blood - the heart is heavy with all the muscle & blood it contains, and it can squash the left lung, especially laying on back.

Proning is more comfortable for breathing.

I also find a hot water bottle on my tummy helps the left chest pain, as well as pushing gently inwards on ribs from the left. Best of all is lying on my left side.

But sleeping propped up may be the best pain relief.

[DrARDS in reply to Hidden]

Thank you so much for your detailed messages. Will defo get this investigated further 🙏🏽