On going chest pains

[owen]

Hello, I am a 36 year old male, I have been having dull chest pains on the left side of my chest, I have had no problems with breathing, and I have not been dizzy, most of the pain seems to be above the rib cage, but I have had quick sharp pains below the rib cage. it seems to help if I lie down on my left side. I have had ekg's echo's and cardiolite stress done in the past few months. does this sound like it is stess related, what should be my next step. everything I ready sounds like it could be heart related.  I do not smoke, and I am not over weight.  Please can anyone help!     Owen

[Cleveland Clinic, MD]

There are many causes of chest pain.  The one that doctors worry about the most is cardiac because it has the potential to be life-threatening.  Once this is ruled out the work-up can proceed at a more leisurely pace.

Amongst the cardiac causes of chest pain are: ischemia (due to blockages - including both stable and unstable angina and acute heart attack and coronary artery spasm), pericarditis (inflammation of the sack around the heart), myocarditis (inflammation of the heart), cardiomyopathy (heart failure) and rarer causes such as coronary artery dissection, acute rupture of the heart and valves and infections of the pericardium.

Gastrointestinal causes of chest pain include reflux (acid from the stomach washing back into the esophagus), gallstones, esophageal spasm, esophageal rupture, varicose veins of the esophagus, strictures of the esophagus, tumors of the esophagus and other less common GI problems.

Pulmonary (lung) causes include pneumonia, pulmonary embolus, pneumothorax, pleuritis and bleb rupture.

Other potential causes are aortic dissection, back and spine problems and musculoskeletal (muscle strain, rib fracture, etc.).

Psychological causes of chest pain are common and include panic attacks, anxiety, stress and mental duress.

As you can see the list of potential causes in long and may take a little bit of time to determine the precise cause.  A good Internal Medicine doctor should be able to work through the potential causes of your symptoms.

[Cathy Lewis]

I have been having severe chest pains. I am 43, do not smoke or drink. Read my note below under enlatged heart. I am on alot of medication and was told I have an enlarged heart and I have Angina. I was not given a reason for this. I am going back to the Dr. this week because the chest pains have gotten so severe again. I will let you know what they say.  My suggestion is to get a second opinion. I am very worried that these pains will lead up to a heart attack so please get to a Dr. and be checked out. Go to several Dr.s until you get some relief.

[Cleveland Clinic, MD]

Thanks for your comments.

[DELORES RABUSE]

Hi, I am a 52 yr. old female and have chest pains.  I've every test done, even an agio gram for my pains.  Everything is normal, however, I do have an ulcer.  Would this cause chest pains, neck pains, tightness in the chest?  I'm confused.  I can dance all night and excerise and I don't ever get any chest pains.  I have taken Xanix for anixity.  What is my problem caused from?

[Mike Ryan]

Hi,

Greetings From Chicago!

I am a healthy 5'10, 155 lb white 22-year-old-male with the follwing symptoms:

If I ever get lses than, say, 6 hours of sleep, every few minutes my heart skips a beat, or, more disturbingly, it beats in a pattern, stops for a brief moment, then kicks in one incredibly strong beat.

If I ever pull an all-nighter, as I used to frequently in college, it is now unbearable; my heart has these fits I described constantly.

I also experience mild chest pains when I go out dancing, something I never used to experience.

Recently, around 5PM after work, I get stabbing pains in my left bicep. This is usually accompanied by a general numb rfeeling in the two left (pinky and ring) fingers on my left hand. and occasionaly numbness in my left foot, as well.

Lastly, often at night there seems to be no pattern to my heart beat; it's speeds up and slows uncontrollably.

Does anyone have any idea what might be causing all of this?

Best regards,
Mike Ryan

[Linda Kerschner]

Hi, I am a 42 year old very active female. I have had problems with arrythmia in the past and was treated for it in my late twenties early thirties. The attending physcian passed on and I decided to handle my situation with rest diet and excersise. Since this time I ahve had two stress tests due to related symtoms and was told that I didn't even have the originally diagnosed arrythmia....so I have just dealt with it. Beginning this past october I noticed my heart beating very hard, my energy level cut severely and a very tight uncomfotable feeling in my chest that occasional led to pain in the shoulders and under the shoulder blade of the right side of my back. These symtoms become more intense if I don't get adequate sleep and during activity. I had an echo....normal ; a 24 hour monitor that showed a resting heart rate sometimes in excess of 175 beats per minute. All bloos work including thyroid came back well within the normal ranges. I have been referred on to a specialist who did a 2 and a half week monitor system....results where normal sinus rythms and  what the specailist referred to as "a not so high rate" of 140 beats per minute. He is suggesting a electrical study with possable abualtion. He tried verapamil and I experienced severe swelling of the hands face and lower legs. He feels my condition is not life threatening...since I haven't died yet and it has been a few months I guess I have to trust his word. I am however having increasing problems with this discomfort. It is definetly worse during a very active day and I noticed taking deep breaths causes pain that almost feels like a lung infection of some kind but they have ruled that completely out. I go for the ectrical study in two weeks and I am scared to death (no pun intended ha). I know my body and it is definetly warning me!!!!!! I do not go to the doctor for anything except physicals and I am in perfect health. My last visit to the specialist he started to sound like he was more leaning towards there not bieng anything wrong. I do not want to have anything wrong but quality of life is very important to me and this situation is cramping my style and has slowed me to a fraction of my normal capcity. I might also mention my aunt and my uncle died three years ago within 7 months of each other from coronary heart disease. It is the opinion of this dcotor that I am too young and healthy for that to be a likelyhood. I would like to know what other conditions could be caused by the symtoms I am experiencing. I appreciate any input anyone out there has to offer. I am ususaly a very strong fearless individual but I don't feel right about this one....Help!!!!!!!

[Cleveland Clinic, MD]

The original answer gives a differential of causes of chest pain.  An electorphysiology (EP) study is used to rule out electrical causes.  Good luck.

[vincent wall ([e-mail])]

tenderness in the base of the stomach
discomfort in the middle of the stomach
extending to the right side of the chest
sometimes the entire chest feels like a
rock grating up and down in the stomach
sometimes locking or tightening of the chest

[Carmen Gathe]

I am a 45 year old female with ongoing chest pains.  Whenever I get these pains, they are so severe that I can't move.  The first time that I had these chest pains was over a year and half ago.  I went to the emergency room because I could not move without hurting and was told that I had Irritable Bowel Syndrome.  The pain would come and go throughout the year.  About 3 months ago the pain started getting severe once again.  I thought it was stress and took 2 weeks vacation.  I just recently went to the doctor who did not listen to my lungs, never took my blood pressure and simply sent me for a chest x-ray.  I'm waiting to get the results of this.  

I have also been suffering with bad acid reflux and the first time I went to the doctor I was told to take Mylanta.  This too has become increasingly worst.

Any ideas?

[Carmen Gathe]

I am a 45 year old female with ongoing chest pains.  The pains are from the front of my middle chest to the center of my back.  Whenever I get these pains, they are so severe that I can't move.  The first time that I had these chest pains was over a year and half ago.  I went to the emergency room because I could not move without hurting and was told that I had Irritable Bowel Syndrome.  The pain would come and go throughout the year.  About 3 months ago the pain started getting severe once again.  I thought it was stress and took 2 weeks vacation.  I just recently went to the doctor who did not listen to my lungs, never took my blood pressure and simply sent me for a chest x-ray.  I'm waiting to get the results of this.  

I have also been suffering with bad acid reflux and the first time I went to the doctor I was told to take Mylanta.  This too has become increasingly worst.

Any ideas?

[cj]

I've been having a "pain" in my chest, for the last 12 hours or so. It doesnt seem to be letting up any at all, and I have eaten MANY antacids. It intinsifies when I stand up, or move around. What could it be, and what can I do to stop it?

[Louise Vippond ([e-mail])]

Recently I have been experiencing sporadic chest pains across the top of my left breast/shoulder. I am a 29 year-old female smoker who has never had any particular health problems and am therefore rather concerned about the possible causes of the pain. It is not especially intense, but very uncomfortable...almost like a 'pulled muscle' feeling but worse. The pain increases with movement/stretching and is particularly bad when I am tired. My doctor could not find anything wrong when he listened to my heart with a stethoscope and my blood pressure is normal.He did however suggest I am suffering from stress. Surely stress cannot cause such obvious and consistent pains?

Any suggestions?

[MARY ANN]

To Louise,
My suggestion is to quit smoking first!  Then have a doctor
check for pericarditis, an inflammation of the sac lining the heart.  The pain can come on suddenly and be very intense.  When I got it I thought I had pulled a muscle.  Good luck!