Q: I am a 40 years old male suffering from chest pain for the last four years. Usually it starts slowly like contraction of some nerve / muscle in the middle of chest and and then it increases to fast, sharp contractions and expansions with unbearable pain. This usually happens for an hour. Initially I thought it is due to gastric problem, so consulted a gastric expert. I underwent ECG, angiogram, endoscopy etc. but all came normal. I don't have diabetes. I have migraine headache. How to manage this chest pain?

A:Pain described by you has to be due to any of the following: 1) Musculo-skeletal - This pain happens due to overuse of a group of muscles for example lifting babies for long time or sitting in one position and using the computer key pad for long duration. 2) Spasm of oesophagus occurs - following spicy food, sometimes during night. 3) Coronary artery spasm - ECG done at that time can show changes. 4) Spasm in the lung lubes or airways - usually picked by the spirometry analysis. 5) Spine problems. You need an intensivist (ICU doctor) to solve your problem.