feels like a hand inside my chest

Hi, I often get the feeling that a hand inside my chest squeezes
everything together. So I get an extreem pressure, it feels like
my heart has difficulties beating, and I can't breath. Often then, I get PVC's (hard beat feeling or a STOP feeling). I find
it very hard to breath, although my heart keeps on beating, a bit faster and harder then normal. Are there people who get the same feeling? And also I woke up last night because my heart had a pauze, you know beat extrabeat pauze beat beat ... . And because it's in the middle of the night, it's very frightening.
Also this may happen when I feel a sudden rush of adrenaline comming from below my chest. I'm only 18, and I just don't know what is happening. I have had tests, but when the doctors say to me : you're OK, your heart is OK, I am not satisfied, because I still experience the feelings. I don't smoke, don't drink any
caffeine drinks or much chocolate and stuff. Panic attacks are
in the family.

[Cleveland Clinic, MD]

Dear Mark,

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.