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Avatar universal

Exercise over a two week period removes my pain and symptoms

Hi,

I have had heart problems for almost four years now. I didn't go to the doctor when it started, but went several times after, and they always just take an ekg that comes back normal. I am a thin and under 30 years old. The weird thing is that if I do cardio exercise 30 min every day for a few weeks, all the pain and symptoms goes away. If I keep working out daily, I have no pain. But when I stop exercising, the pain comes back in about 2 weeks.

I'm wondering if anyone else has seen pain and symptoms that predictably go away completely with a few weeks of cardio exercise, but then always comes back after a while if you stop exercising.



8 Responses
Avatar universal
Thank you for the larger description of your pain.  I've studied human anatomy and physiology, and your description allows me to be pretty sure that you are *not* experiencing heart pain.

The reason I say this is the way our nervous system is wired.  When it comes to pain, one branch detects what is called visceral pain, which is pain from the internal organs, including the heart.

The other branch detects somatic pain, which is pain coming from things outside the body cavity (you can google something like 'compare somatic and visceral pain' to read about this).

You report very precise and smallish areas of pain in specific areas of your chest.  That is not possible with heart pain, because of the 'wiring' that I mentioned earlier.  Heart pain is a very different animal.  It does not occur in specific spots here and there on the chest.  It is central and absolutely crushing in nature. I'm talking serious 'crushing' here:  Really bad stuff.

In addition, a heart attack will almost always cause many of the following symptoms: faintness, nausea or vomiting, shortness of breath, and an incredibly profuse *cold* sweat.  You'd be drenched in seconds.

Finally, a patient with a compromised heart simply cannot do the kind of aerobic exercise you describe without having some of the symptoms I listed.

I suspect you may be dealing with several other things.  One possibility is what is called 'non-cardiac chest pain.'  You can google it.  It is not well understood, but it may involve some type of deep muscle or tendon injury, for example, coupled with fear of the pain.  Eventually, sufferers of this condition can get caught up in a vicious circle of pain and fear that is emotionally crippling.  It can be helped with cognitive-behavioral therapy.

Another possibility is what is called Da Costa's Syndrome, which you can also google, and which can also be treated with cognitive-behavioral therapy.

By all means, discuss your symptoms with your next GP.  Be sure to ask your questions about old heart attacks and EKGs--but also mention those other possibilities I brought up.

I suspect that more tests will once again show that your heart is healthy--but that your fears about your heart could use some work.
Avatar universal
And will an ECG always show if I had a heart attack in the past? If I take an ECG two months after a mild heart attack, will it always diagnose it?
Avatar universal
What heart problems do you think you have, since your tests come back with normal results--AND you are in fact capable of cardio exercise 30 minutes per day, after which you feel better?

This is--by definition--the exact opposite experience of people who truly have cardiovacular disease.

Avatar universal
I have pain in the left side of the chest in addition to fluttering and some other things. It is not better straight after exercise. Straight after exercise it often is worse. Sometimes I have to stop the exercise. But if I exercise every day for a few weeks, all the pain completely disappears. If I continue exercising daily, the pain stays away, but if I stop exercising the pain comes back after a few weeks.

Personally I think I might have had a mild heart attack during a period I had with a lot of stress. I spent several days with very little sleep and that was topped of with one day when I was awake 24 hours straight. At the end of those 24 hours I suddenly got pain in the chest. Pulse was about 110 bpm. In hindsight i see that i should have gone to the doctor. That was the onset of the problems. Before that I had never experienced any heart pain, but now I have it every day if I don't keep very fit.

Previous heart attacks sometimes don't show up at ECGs, and considering my first ECG was two months after my incident, it is possible that i had an undiagnosed heart attack.

I have taken a lot of tests and have ruled out stomach problems and lung problems.

I will go to the doctor again soon and hope to get an electrocardiogram. I wonder if it is possible to diagnose a previous heart attack 100 % with tests. I really hope I did not have an heart attack, but i fear that I did.

Avatar universal
Thank you for your reply.
Avatar universal
Some questions:

(a) When you exercise, are you doing heavy aerobic activity that causes you to breathe hard, sweat, and get your heart rate up?  I refer to things like dance classes or running, or even serious exercycle work.

(b) Pain is a really subjective thing, and it is difficult for one person to understand what another means by 'pain.'

Could you describe your pain more completely?  Where in your left chest do you feel it?  Is it a sharp pain that comes on suddenly and goes away suddenly?  Is it a dull pain that just hangs around?  Is it worse when you inhale deeply?  What about when you exhale?  When you make certain movements?  Can you touch or press hard on your chest and make the pain appear?  Does it show up or go away when you change positions?
Avatar universal
Thanks again for replying. I really appreciate your help.

(a) I use an exercise bike. Each session is about 30 minutes long at a steady pace. I start sweating about 10 minutes into it. I'd say my heart rate varies between 130-160 bpm during the sessions.

(b) I have two different types of pain:

Pain type 1:
Location:
About 2-4 centimeters (0.8-1.6 inches) to the left from where the ribs meet in the middle. So to the left of the lower part of the sternum.
Type of pain:
It's a dull pain that hangs around.
"Is it worse when you inhale/exhale deeply?":
No.
"Is it worse when you make certain movements?":
No.
"Can you touch or press hard on your chest and make the pain appear?"
No.
"Does it show up or go away when you change positions?"
No.

Pain type 2:
Location:
This pain usually occurs further up than the other pain. It is not always at the same place, but the most frequent area is a little to the right of the left nipple.
Type of pain:
Sharp pain that suddenly comes and leaves straight away. So it doesn't even last a second.
"Is it worse when you inhale/exhale deeply?":
The pain has occurred when I've taken a large breath. But it doesn't happen every time I take a deep breath.
"Is it worse when you make certain movements?":
Sometimes in bed if I change positions the pain can come. But most of the time it just occurs randomly.
"Can you touch or press hard on your chest and make the pain appear?":
No.

I should add that I also have some pain on the right side of the chest. This pain came later than the other pains, and it is less frequent. It is located quite far up, around the nipple area. Apart from location, it is more or less exactly the same as pain type 1.

Something that bugs me is that I have not visited a cardiologist, because my GP think it is not heart related as I am young and not overweight and the ECG was normal. I have now changed to another GP to get a second opinion.
Avatar universal
Great reply! I can tell that you're very knowledgeable about this.

I have been reading about the differences between somatic and visceral pain now.

My description of pain type 1 was not really that good. I gave the impression that it is a smallish area. I have pain at that small area, but often it is spreads more. I feel the pain right now actually. It's location is mostly behind the nipple and to the right of the nipple and down. I'd say it is 5 cm wide and 5 cm long right now. The pain is not extreme though, I'd say about 2-3 out of 10.

I think perhaps what I'm experiencing is deep somatic pain. Something that I find strange is that if I get nervous, the pain type 1 will almost always come. Pain type 1 never comes when I exercise, but pain type 2 does sometimes.

I read about non-cardiac chest pain and Da Costa Syndrome. Both were interesting reads and I will bring them to my doctors visit.

I'm hoping this might be a deep muscle or tendon injury like you suggested and that it has become worse by my awareness of it.

I looked at your post history, and you are a great person for contributing so much to the forum. Thank you for your detailed reply to my post!











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