Dull Chest Pain on Right Side

[mlmrc]

Hi, I'm a 26 year old male and I have been experiencing dull pain on the right side of my chest. The pain generally lasts about 1 to 2 seconds and occurs anywhere from once every 20 minutes to 3 times a minute. This could happen for several days staight and then disappear for a month. The pain is dull but very localized, a few inches to the right of center and maybe a few inches deep. It almost feels as if it's in my right lung, but it doesn't seem to correspond with breathing or moving. I believe it's related to anxiety, but I'm unsure whether it's a cause, effect or both. However, it is definitely not psychosomatic. It's generally not very painful and mostly quite mild - but uncomfortable and worrisome nonetheless.
I am 6'1" and weigh 155 lbs. I'm not aware of any history of heart disease in my family (parents/grandparents). My diet is fairly healthy and I don't smoke. I'm not as active as I should be, but lately I've started walking about a mile a day. I do suffer from generalized and social anxiety, occasional mild depression and, more rarely, panic attacks. I take 40mg of generic Paxil a day. When my blood pressure is taken, the systolic (top number) is typically pre-hypertensive (120-139) and sometimes higher. Diastolic is almost always normal. My doctor suspects a bit of the white-coat hypertension effect due to my anxiety. I now home monitor my BP, and the systolic is usually between 120-130.
Of course my worst fears always get the best of me. I instinctively think that it's either heart-related (clogged artery, inflamed heart, etc.) or lung cancer. If anything, these fears seem to make it worse (more frequent). Compounding my worries, I don't have health insurance.
Any feedback would be greatly appreciated.
Thanks,
Mike

[John Kenyon, CNA]

Hello -

First, let's eliminate your concerns about a heart problem. Now heart pain, contrary to popular belief, can be felt, sometimes, to the right of the sternum, although it is unusual. However, heart pain is not intermittent, highly localized, nor fleeting. It's not heart pain you're feeling.

So what is it? Well, being an anxious person you do have some useful insight into the insidious ways anxiety can play tricks on us. These types of chest pains, while usually felt on the left side most often in anxious patients (no idea why this should be, but most often it is) are often caused by minor muscle spasms or irritation, and that, in turn, is quite often caused by faulty breathing practices, usually not consciously performed, but more like nervous tics in response to the pervading, almost claustrophobic sensations anxiety can sometimes cause. Usually the result is irritation of one or more small groups of accessory muscles.

This is the kind of thing that begs the advice "Try to ignore it." I realize that's like asking someone to not think about something: it rarely works. However, knowing it's nothing serious sometimes allows the sufferer to let is slip out of the sphere of awareness. As I'm sure you know, many anxious people are more tuned into their bodies and somatic sensations, so it's not as easy for everyone to "lose" track of a basically useless message from the body such as your pain. Still, this is, or should be, the goal for you. Know it's OK, it's nothing, and hopefully your attention will shift to something else, preferably something more positive. It can be done, but it's not so much a conscious "not thinking about it" as it is thinking about other things more, so that this issue is lost in the shuffle. Trust me, if you ever have truly significant chest pains you won't be able to ignore them or "forget" they're happening. It's a whole different animal.

I hope this is helpful to you. Please follow up with us as needed.

[D68Money]

I'm having the exact same issue...I am also 26...6'1" weigh about 240 but I don't have anxiety or depression. I am having a child in about 3 months and moving at the end of the month. Could it just be related to the stress of that and of course worrying that it might be something more serious?

[John Kenyon, CNA]

For D68Money -

If you were to go back and read your own post now, you might see that what you've described is a rather stressful, potentially anxiety-producing situation you're currently in the midst of. Then you close by saying you don't have anxiety (or depression). Anxiety is, by definition, an overwhelming feeling of dread, and if you (or perhaps your wife, since you have yourself classified as male) are having a baby soon, that alone is enough to produce enough anxiety for both of you. You're also moving shortly, one of the more stressful events on the stress scale (and there is a very real stress scale that assigns a point value to various life events). You then ask if all this might not be causing you to worry that your symptoms might represent something more serious, which is a working definition of anxiety. If you didn't have it to begin with, you are certainly anxious now. I hope you will go back and look at my response to the previous poster, since everything I said to her would apply to you as well, given that your symptoms are, as you say, "exactly the same."

I hope this is helpful. Please follow up with us as needed. Good luck to you.