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10-05-2010 08:33 AM

Mystery chest pain - Hiatal Hernia?
I am trying to figure out a mystery chest pain.

A few days ago, while walking around home, I had a sudden, sharp, cramp like pain around the flank of 5th to 6th left rib. I had difficulty walking, talking and could not find a confortable position to stand, sit or lie down for 30 minutes.

Pain then receded, but it felt like I had limited amplitude in that area when inhaling. When sleeping, the only confortable position was lying on the right side. Sleeping on the left side, on my back or face down painfully pressured the area. Also, when lying on my left side, at a certain angle, I could hear the heart tump against something and it gave a gastric, almost bowel like, sound.

During the day, bending over seemed to move around stuff in the same area and resulted in a dull pain. It has been now 4 days since the event and I now feel pretty good. I have had at least three similar episodes in my life. I consulted a physician each of the other times.

First time, in 2002, I was 17. Same sharp pain while studying in library. Got hospitalized. Doctor concluded that there was no heart problem, and the radiography of my lungs showed nothing. Still, because of my 6 feet 1 inch, 175 pounds and athletic backround, the doctor concluded that it was a very small spontanious neumo-thorax. I was fine after a couple of days.

Second time, Feb 2010. During the night, while sleeping, same sharp pain in the flank. I consult. Doctor checks my heart and is alarmed by the low thirties bpm, but he concludes it is not my heart and thinks I pulled a muscle. He gives me pain killers and muscle relaxant.

Third time, Mai 2010. Dont remember when it started. Went to the hospital. Again, doctor is alarmed by low HR but after ECGs, x-rays, and ultrasonography + a check by a cardiologist, they concluded that my heart is top shape and think I again pulled a muscle.

Now, while trying to figure out what is the common denominator to all of this I flashed that:

-In 2002 On that day, I was starting to squat with decent weight for one of the first times.

Started following Crossfit main site in September 2009

-In Feb of 2010 I was working at loading real heavy material in a truck, alone.

-In Mai 2010 I was training harder then ever before in my life.

-A few days ago, I was working on a 1RM back squat.

Each time, I can remember a moment where I have to fight harder then usual to get the job done, usualy in a less then perfect position.

[B]I am wondering if I could be having episodes of a hiatal hernia caused by the valsalva maneuver in squat position, or something else related to high chest pressure.[/B]

How can I verify my theory? Any insight?

Steven Low 10-05-2010 10:53 AM

Re: Mystery chest pain - Hiatal Hernia?
Hmmm. First thing I woudl think if you get pain in your back during exercise is it's likely a strain, especially if its off to the side of the spine. Strains tend to resolve themselves by healing and scarring over so its unlikely you get it repeatedly except during exercise when you aggravate it again.

The fact that its at rest is weird. I would probably think its a subluxed rib or slipped facet.

I would at least get it checked out with an orthopedic doc... or if you want by a chiro or PT who can evaluate that sort of stuff.

I suppose it COULD be a hiatal hernia... however, usually valsalva doesnt do that.

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