Chest discomfort in mornings and at rest

[r.a.j.]

Thanks for taking time for this.I'm not sure if I should be concerned.My question is about pain I experience in my chest usually in the early morning(4-7am).It's like squeezing/twinges of localized pain on mostly the left side of my chest.It typically lasts just a few minutes to 30 minutes(not continuous pain, but twinges in a 30 minute period).It doesn’t happen every morning and I can go weeks/months without it happening at all before it starts again.It had stopped happening at the end of June and didn’t start again until the first of October.It stopped a few weeks later and has only started again in the past week.Recently,it happened from 6:00am-10:30am and then infrequently throughout the afternoon and into the evening (which it hasn’t done before).It never happens when I’m doing any physical activity or exercise.There are also no other symptoms with it and I have not noticed any predictable patterns(other than it tending to be early morning hours).  
I can recall it happening as far back as 4-5 years,though I can't recall specifics.I have trouble imagining that it’s too serious(which is why I haven't mentioned it to a doc. when I've been in for other things)I am 25,female, 5’5 and 115-120lbs. I exercise pretty regularly(mostly run), have a healthy diet,manage stress well, and don’t tend to get sick.I don’t have a history of heart disease in my family.I’ve assumed that it’s just my body waking up or working out its kinks, but with this last time, I’ve been wondering about it much more. Any thoughts on this? Is it necessary to go in just for this? Thanks again~

[CCF-M.D.-MJM]

Hi RAJ,

Your symptoms sound pretty benign, but the safest thing to do is talk to your doctor about it.  You age, lack of family history or other risk factors, and the fact that is not progressive make this unlikely that it is obstructive coronary artery disease.  My guess is that it is most likely not cardiac in origin.

For someone your age the most likely cause is anxiety.  People with anxiety tend to have an increase in their symptoms in their mid twenties, particularly males.  You don't have to be an axious person to have anxiety spells or attacks.  They come and go at their own discretion and very in symptoms and intensity.

It could also be coronary vasospasm or a bunch of other rare cardiac problems -- these are the reason why you should mention it to your doctor, but again, I doubt it is any of these.
They are particularly less likely if you don't have a family history of sudden death, personal history of syncope (passing out) or near syncope (almost passing out), exertional chest pains or light headedness or reduction in exercise tolerance.

To prevent you from worrying about this long term, mentioning it to your doctor now will allow him to work it up and exclude bad things so you can go with your life and not worry about this.  The worrying is the hardest part.

Hope this helps and thanks for the post.

[madgeOwens]

Isn't that strange, I have all those symptoms, chest pain ....short of breath on any exertion....almost passing out...........and yet I am told its nothing. I should just give up......this is enough to cause anx!

[cgeckler]

A related discussion, chest pain at nightime only was started.