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Forum Name: Cardiology Diagnostics

Question: 19 y/o F with consistent chest pain


 maralessthan3 - Sun Oct 25, 2009 8:57 pm

I am a 19 year old female and I have had consistant chest pains for the past year. They have recently been getting worse and seem to be localized to my left side. I was diganosed with anxiety and I do not currently take medications for it. I know the difference between my panic attacks and the pain in my chest and it is very concerning and seems to happen multiple time throughout the day now.

It comes completely randomly and sometimes its sharp or mild soreness. It happens even when I am resting and has caused a lot of restless nights.

I have been to the hospital a few times and they always dismiss it as an axiety attack. I also recently went to visit my doctor for a cold and my blood pressure was 160/80 on the left side and 140/70 on the other. He told me to come back in a month to retake it and see if it is the cold and cold medicines causing the spike. He also suspected my birth control which is Yaz, which I also stopped and started using an external form of birth control. I used to be extremely athletic exercising at least an hour a day, and for the past year stopped and gained a little but of weight.

I am nervous and concerned that all these symptoms are related. Should I see a cardiologist or just talk more with my primary doctor? And should I be concerned?
 John Kenyon, CNA - Thu Oct 29, 2009 11:15 pm

User avatar Hi there -- Whatever is causing the chest pains it's not likely your heart. First, this pain obviously isn't worsened by exertion, since you seem to tolerate exercise well, and besides that heart pain is almost never sharp, never causes tenderness upon pressure, is never highly localized, and is almost never felt on the left side. However, there are two possibilities and one, oddly enough, is actually anxiety, which is known to cause tetany and subsequent muscle pain in the left chest in some patients. More likely, though, because of the tenderness upon manual pressure, this may be costochondritis (Tietz's syndrome), inflammation of the connective tissue between the ribs and where they connect to the sternum. This can become chronic, can be caused by athletic workouts, repetitive motion lifting, or even something viral. It almost always responds well to non-steroidal anti-inflammatory (NSAID) drugs such as ibuprofin (as Advil) or naproxyn (as Aleve), but sometimes can be persistent. It is not in any way life-threatening nor related to the heart and is a superficial but often quite painful problem and can be re-aggravated.

Anxiety actually is one other possible culprit. Sounds funny, I know, but this is classic for chronic generalized anxiety and can really confuse the picture. It's worth considering, but first try an OTC pain med like naproxyn (Aleve) and see if that doesn't help relieve it.

The unequal blood pressure readings may have been due to a bad ear or noisy surroundings. It should be rechecked, as this can be a significant sign pointing to something unrelated to your chest pain, but if the pressures are consistently that far apart then you'd need to have at least an ultrasound study or CT of the chest to see if there may be coarctation of the aorta (a congenital narrowing of the main blood vessel carrying blood away from the heart). This is unlikely as it is fairly rare, but if present can cause problems and should be ruled out -- IF the BP continues to show up markedly unequal. If it was a freak reading a repeat should easily settle this issue.

The chest pain isn't coronary in nature. Most likely it's due to one (or both) of the factors mentioned above.

I hope this is helpful. Please follow up with us here as needed. Good luck to you!
 maralessthan3 - Mon Nov 02, 2009 5:22 pm

Thanks for the reply! I'll look into both of those options!

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