Sharp pains in chest reminiscent of electric shock

[Dani22]

I'm a 36 year old woman who is experiencing what feel like electric shocks or stabbing type pains on the left side of my chest. Most pains are located just below the breast, or run right across the left breast from the center of the chest. These are the most common ones and can occur, randomly, between 20-30 times a day. Only once did I have a similar pain start below the breast, to the left of the breast, mid rib cage. It shot up to my armpit and down the inside of my left arm to my elbow and was much sharper than the most recent pains. It lasted about 30 seconds and then dissapated. Most of the "shock" pains last about 5 seconds and disappear. I can't physically do anything to reproduce the pains... they just come and go when I least expect it. Today, a very sharp pain woke me out of a sound sleep. Other symptoms I have been experiencing lately is lethargy, and anxiety due to what's been happening. I work out regulary (bodybuilding and cardio since age 29) and have had to stop because my heart rate becomes very hard and fast just running up a flight of stairs after doing something as simple as laundry. I don't take any bodybuilding supplements or take anything out of the ordinary that would cause any of this. I've also been feeling a little lightheaded as of late, but that seems to come and go. I typically have the blood pressure and heart rate of a 12 year old, but lately have been experiencing a boost in both. Daily caffiene intake consists of two 6 oz cups of coffee in the morning, and pretty little else. I have had an EKG which came back normal, and am waiting on the results of an ECG, which the guy that did the exam said looked and sounded pretty normal, but ultimately, I would have to wait for the cardiologists to make the final call after they viewed it. To me, these don't feel like anxiety attacks. I've had those before and am very familiar with the feeling in the chest of tightness, sweats, dizziness, feeling of difficulty breathing, etc... but never have I felt these sharp stab/shock pains. Could this be a blood flow issue to the heart? Am I on the brink of a potential heart attack? I don't sleep well due to the fear of not waking up should one of these not be just a little pain, but something more severe. Any advice, or direction that I should be looking in, would be most appreciated. It's frustrating becuase the NP who has been helping me with this matter seems to almost be getting "annoyed" because anything she does for tests, all come back normal. I think she thinks I'm a hypochondriac. I'm not. I spent the better part of three years avoiding doctors because I didn't have insurance. Now that I do, I'm just trying to get a few things straightened out that have been of concern to me. Thanks in advance for any help that can be offered.

[John Kenyon, CNA]

Hello -

The good news is that cardiovascular-based pains never feel like that. They may follow the same general pathway, but heart pain is rarely even described as "pain", and is never sudden, sharp and fleeting. This sounds like a nerve problem, a neuralgia or possibly herpetic pain (caused by a nerve inflamed by a virus, usually herpes simplex). It's certainly not "all in your head." In fact it seems to be in your left chest mostly. Healthcare providers sometimes become frustrated when they can't hang a diagnosis on something, and neuralgia in this pathway is fairly unusual, but so long as it retains its present character it's unlikely to involve the heart in any way. Also, cardiac pain (or pressure, squeezing, whatever passes for "pain" in a given individual) rarely occurs in the left chest either, but usually begins beneath the sternum in the center of the chest, then begins to radiate out to one or both shoulders, the neck, throat and jaw, and down one or both (either/or) arm/s.

A nerve in the heart pain pathway,perhaps the phrenic nerve, sounds as though it is irritated or inflamed. Again, this is often due to a passing virus, sometimes for reasons that never become fully clear before the thing resolves. If it becomes disruptive there are medications to help block this sort of pain, but the "shock" type doesn't usually last too long. The lethargy and lightheadedness could also be attributable to a viral infection. These, of course, are difficult to ID unless they produce enough specific symptoms (like a rash along the course of the nerve involved, which seems unlikely in this instance but still could happen).

Once you've ruled out cardiac involvement (and you should, no question) if this continues, you may need a referral to a neurologist to get to the bottom of the cause or at least find a way to medically manage it. Neuralgia-like pain can be so disruptive as to be disabling if it becomes chronic.

I hope this is helpful. Best of luck to you. Please follow up with us as needed and update us after you get the cardiologist's reading of the EKG.