Chest Pain Help

[VDiego]

Hi there,

I am a relatively healthy 21 year old male (5'11, 135lb, non-smoking) who has no medical conditions or past major surgeries. Over the past 3-4 years I have been experiencing a regular dull chest pain. Sometimes it occurs a few times a day, sometimes once or twice, other times it won't happen for several days. The pain is generally focused on my left hand side, however it will occasionally (very rarely) occur on the right hand side. On a scale of 1-10, 10 being the worst pain possible, it would only be about a 3. It does not interfere with my day to day life in any manner--beyond being a source of concern. I find that the pain occurs most often in a non-active state and I rarely feet it when active. I am not an anxious person, neither do I have much stress in my day to day life. Very rarely (once every 1-2 months) I will also have a sharp pain which would register closer to a 6, however as I said, this sharp pain is rare.

I also have a problem when doing serious cardio-workouts. I am in good shape and can physically run several miles and used to do these workouts regularly. However, I do notice that my heart rate seems to be very fast when I finish. I also notice that my breathing is much more labored than that of others. I do not experience any of the chest pain while exercising, at least not any more than I would normally. I probably in fact experience it less, though this might be attributable to me just not noticing it while exercising

I recently went to an internalist and explained all this and she had me get an EKG, a stress test and some blood work (metabolic, thyroid function). All three came back normal. In regards to the pains, she expressed that she could not find any major cause, and did not think it was anything serious. She mentioned that anxiety might be a possibility. I do think that this is it partially, as I do notice the pains more when they are on my mind, however they also occur often when I have not thought of them in some time. I am also not a particularly anxious person or one who experiences much stress so I don't know if I can fully attribute the pains to this. Also, when I have been anxious or stressed I don't find that the pains happen any more frequently than otherwise. I also asked her if this could be a lung issue but she did not think that was a cause for concern. A friend of mine suggested a condition called anomalous origin of the coronary artery which she said had similar symptoms to mine and does not always show up on the standard tests. However, I could not find much information on this condition. The doctor also did not seem to be concerned with my exercise issue. She said the stress test indicated a normal heart rate but she did not have an explanation for my labored breathing.

What I need to know is whether you think I should go and get a second opinion. The doctor gave me relative peace of mind but now I have family and friends all urging me to get a second opinion. Do you think that my doctor's assessment was correct, that this is likely nothing major? Or could it be something more serious? I no longer have the insurance I used to, as I am a graduating student.  Even an office visit would be quite expensive, and though I know the right thing to do would be to just go get that second opinion, I want to know if it this is a serious matter for concern and I really should go get that second opinion.  


Thanks so much for your help

[Encephalomalcia]

The pain that you are experiencing and the rating that you give it, does not sound like a heart related condition.  Chest pains due to blocked arteries can be quite painful.  Sounds more like you have some ribs out of alignment, which a chiropractor can fix in no time at all. When ribs are out of alignment, the person can experience sharp sudden pains, dull pains, pains when breathing in and out.  Ribs can become out of alignment by physical activity or by coughing from a cold.  Also, the back is the foundation for the body.  If the back is in any way out of alignment, it can affect any part of the body.  See a chiropractor to see if that will help.  

[grendslori]

I agreee that this doesn't sound heart related. If they were, you wouldn't be running anywhere, let alone doing extensive running. The Chiropractor might help; the downside to them is that once you start going, usually you have to keep going, which is one reason I actually stopped going to them in the first place. If you are running in cold air, that can make the lungs hurt, keep that in mind. It would be highly unlikely, at your age, to be having chest pains related to heart disease; people your age that do, have serious forms of heart disease that would have been easy to notice, especially on the tests that you have already had done.