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Forum Name: Miscellaneous Cardiology Topics

Question: unprovoked chest pains


 stray_cat13 - Fri Jan 04, 2008 5:24 am

i am a 19 year old female. i have been having random chest pains in the upper right side of my chest for over a year now. i have tried to figure it out by myself but with only reference books and a combat medics medical knowledge i have had no luck. this is what i have found can you PLEASE help me.

the pain occurs randomly, there is no obvious pattern. it can happen while im walking through the grocery store or while im sitting on the couch at home. its generally felt in the upper right side of my chest along the mid clavicular line though sometimes it is closer to the inside, and sometimes it radiates to the right shoulder and/or through to my back, and there have been a few rare times that the same pain has been felt in the same place on the left side and also at least one occurence that radiated all the way up the right side of my neck to my jaw. the pain is deep in my chest and starts out slowly but intensifies quickly then suddenly stops and then leaves behind an ache for a while which fades and goes away. the whole episode never takes more than ten minutes and seems to have no hindrance on my breathing.
other symptoms- tachycardia- resting pulse rate of 80-100 bpm,occasional dyspnea- not like i have trouble breathing but like i cant get enough air, occasional nausea sans vomiting.
at the time of the first occurence i was chain smoking clove cigarettes shortly afterward i quit cold turkey for a while because of training spent two months coughing up sputnum and with a uri but that was a result of bacteria and viruses being passed repeatedly around our barracks, mine just always seemed to go to my lungs, i assumed because of my being a heavy smoker before. at any rate i continued to have chest pain, and continued on as i went to ait where i picked up smoking again. (i currently have quit smoking and have been solid quit for two months)
my breath sounds are normal at all four points and i have had no problems with coughing since the initial illness in basic. at least nothing that was constant enough or frequent enough to be noticed. i ran a good deal in basic and in ait and did fairly well. i never seemed to have a problem with breathing or with my chest at all when i was running aside from the norm, so i ruled out the possiblity of it being lung cancer.
while i have a slight history of GERD in my family (my younger brother was just diagnosed with it being the cause of a severe cough, and my half sister has it) i don't have pain at any really specific time, either after ive eaten or before, its not provoked by laying down, i don't have the feeling of fluid built up in the back of my throat and i have never had irritation of my esophogeal tissues. so i don't know if that could be it or not
i have a very extensive history of heart problems on both sides of my family. ranging from an enlarged heart to my paternal grandfather dying at 45 by way of a major heart attack, and i have been told once before by a gym teacher when we monitored our heart rates in class that i had to go to the doctor to have my heart looked at because my heart rate was irregular and because once we brought it up it did not decelerate or it decelerated very slowly. but i have pretty much ruled out the possibilities of heart issues due to the fact that.... well ......its on the wrong side. if it were on the left side of my chest it would fit the bill for everything i have read about prinzmetals angina...but its on the WRONG SIDE.
last but not least. i don't know that its at all related but it seemed worth mentioning. i have anxiety...pretty bad. i have anxiety attacks that range from just a rise in my heart rate, a jittery anxious feeling, and an innability to concentrate or sit still, to full blown tachycardia, hyperventilating, fetal position, with my entire body shaking. i had read in one reference book that anxiety could be a cause of chest pain but the two problems never really crossed paths. i don't have the pains when im having and anxiety attack niether am i anxious when i have them, only during while im in pain do i get a bit anxious...but i think that can kinda be expected.
so thats all ive got im lost, nothing i try helps it and i cant find anything to match the symptoms. i realize im throwing a lot of information at you but i have been trying to figure this out on my own for the better part of seven months now with no success i have no insurance because i am in the national guard and not active, and if it turns out to be something serious then best case scenario i get discharged from the military, not at all what i want but the other possibility is that i present a danger to my unit as i am a medic and have to be relied upon in a deployment to be able to perform certain duties for the care of my fellow soldiers. my body needs to be as healthy as possible so it keeps working when i have to abuse it. i desperately need answers that i cant seem to find anywhere else.
 Dr. A. Madia - Wed Mar 12, 2008 12:27 pm

User avatar Hi,

Chest pain in a young female like you [19 years] is more likely non cardiac. Females are blessed with estrogen till menopause. Estrogen somehow seems to protect from atherosclerotic heart disease.

The pain you describe is not typical of cardiac pain. Contrary to populat belief, cardiac pain is more often central and retrosternal rather than on the left side. It ususally comes on with effort and subsides on rest, unless it is a heart attack.

Non cardiac pain comes on any time-resting or working-, is well localosed or shooting kind, may migrate, can increase on deep breathing but not necessarily so.

You may have family history but that need not necessarily mean you have heart disease, more so, not at your age. You have more of anxiety related symptom complex what with your jittery feeling, hyperventilation, tachycardia, fetal position etc.

Please rest assured, you are most likely not having major cardiac diagnosis. If you be a little firm in your mind, you are only going to be an asset to your army unit and will never let them down!

Apurva

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