There can be many causes of pain in the upper abdomen and lower chest, including angina pectoris (heart ischemia), or/and heart attack, and gallstone disease. In more than 95% of cases, an ultrasound of the gallbladder will detect any gallstones that might be present.
Less commonly, patients can have upper abdominal pain that is nearly identical to that caused by gallstones (and, often, such pain occurs following a fatty meal, as with gallstones), but are found to have no gallstones by ultrasound. A special HIDA scan (CCK-HIDA) may reveal abnormal function of the gallbladder and bile duct sphincter muscle (biliary dyskinesia) in such patients. When biliary dyskinesia is confirmed by CCK-HIDA scan, the treatment is generally the same as for gallstone disease (i.e., surgical removal of the gallbladder).
Sincerely,
Robert A. Wascher, MD, FACS
www.doctorwascher.com
Author, "A Cancer Prevention Guide for the Human Race"