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Forum Name: Cardiology Symptoms

Question: Chest Pain


 MikeB. - Tue May 08, 2007 4:36 pm

I'm a 36 year old male. About 2 years ago I went to my doctor with chest tightness and pain. He did a physical with an ekg and said everything was normal and blamed it on anxiety. Well, it never really went away and lately it has become worse. My chest feels tight all the time and I get some sharp pains randomly on the left side of my chest about 2 inches below my collar bone. About 2 weeks ago I started to get very bad indigestion which I've never had before. The chest pain happens when I'm relaxed or when I exercise, it really doesn't matter. I'm starting to worry a lot and I think that is making it worse or giving me an ulcer!

What should I do? Go back to my doctor again? See some sort of specialist? Not sure what to do...

Oh yeah, I'm not taking any medication or had any history of any illness or diseases. My Grandfather and Grandmother had heart issues late in life but that's about it.

Thanks,

Mike
 John Kenyon, CNA - Tue May 08, 2007 10:47 pm

User avatar Hi Mike - One thing you said is interesting: "My chest feels tight all the time." Is that literally the case, or do you mean it feels that way frequently? The difference is that most cardiac-related issues which cause chest tightness would not be constant for two years without something dramatic having happend a long time ago. On the other hand, anxiety can cause a fairly constant, vague sense of tightness in the chest. So can asthma, which more and more often is uncovered recently because of complaints of chest tightness rather than wheezing or shortness of breath. Is it possible you might have asthma? (There is a very simple test to rule this out). The doctor who pronounced the problem anxiety-related is probably right, but at a distance and with no specific test findings it is difficult to say with any degree of certainty. Did the doctor at least perform a 12-lead EKG? Anxiety also frequently can cause sharp, stabbing, left-sided chest pains, especially in the area of the left breast, though usually not so high up. This pain you describe also could be related to a respiratory problem such as asthma, since one may be using accessory muscles, which makes them sore and painful. It's just a thought.

If your doctor did even a cursory cardiac workup it would help to know that and would help support the anxiety theory. There is also the possibility of chronic chest wall irritation, which is not dangerous or serious, but can cause the same sort of pains and discomforts that you describe. This is usually treated with antiinflammatory meds such as ibuprofin.

I hope this helps put your mind at east. If you have any more information I'd be happy to hear it.

Good luck to you.
 MikeB. - Tue May 08, 2007 11:02 pm

Thank you for the informative reply! When I said constant I guess I meant frequent as it isn't all the time but it seems to be very frequent lately. I'm not sure of the type of ekg that was done but I do remember there were quite a few leads as they had a hard time getting them to stick the my hairy chest! The sharp pains in my left chest area are slightly higher than the nipple and a little towards the middle of the chest from the nipple. I don't think I have asthma as I have never had a problem breathing. I do have allergies but not usually breathing related, normally sinus and eyes.

I see you are in DC, I live in Bethesda...

Thanks again,

Mike
 John Kenyon, CNA - Tue May 08, 2007 11:21 pm

User avatar You're very welcome. Absent any hint of asthma and knowing that your doctor did do what sounds like a 12-lead EKG (the usual), then anxiety is certainly at least a possibility, and it would seem far less likely that the problem is cardiac-related. It may well be a chronic chest wall irritation or inflammation, such as Tietz' Syndrome, which is inflammation of the cartilege between one or more ribs where they join the sternum. One way to check for this would be to exert moderate pressure on the affected area with one or two fingers. If you find the area is tender when pressed upon, you almost certainly have Tietz' (or costochondritis). This responds well to OTC drugs like ibuprofin (as Advil or Motrin). If there's no local tenderness then anxiety becomes a more likely cause.

Even if the pain is frequent rather than constant, if it were cardiac-related, it would likely have produced more or worsening symptoms long before now.

Actually I'm just outside of DC, so we're practically neighbors!

Good luck to you. Let me know if you've checked for local tenderness.

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