Is there anything 'normal' about chest pain?

[Eunoia]

ok, I know I should go to a GP for medical advice and I'm not asking for a 'medical' opinion... but I'm kind of confused. is there anything normal to having chest pains once in a while (like a sharp pain) if you're in your 20's??? it comes once in a while and then it just hurts a lot and is a really sharp pain where it hurts even more if I breathe.. but it goes away pretty quickly and does not happen a lot at all. I looked up a bunch of things and it looks like in general there's a whole bunch of reasons why someone could have chest pain, cardian and non-cardiac ones (ie. stress)... but from personal expeience or just from your gut feeling, is this normal? not normal? okay if it isn't chronic?

 

[David Baxter PhD]

Certainly.

Add to your list muscle strain and viruses, etc., not to mention heartburn or other digestive system upset.

If it's localized (e.g., no radiating pains down your arms, etc.) and doesn't persist, it's probably benign. It's never a bad idea to see your doctor and have a quick EKG, though.

 

[Daniel E.]

More info regarding possible causes from Cleveland Clinic's "Ask at Doctor":

Dear Doctor:
I had a disturbing experience while working out (which I did regularly) While my heart rate was at its' exercise max I felt a very sharp pain in the left side of my chest..I have also been experiencing left sided chest pain in the form of a sharp stabbing pain, as well as a general dull ache in my chest (sometimes on the left side, sometimes on the right), randomized shortness of breath, random aches in right/left arms and armpits....Could anxiety over the whole thing manifest itself in the physical symptoms I am having?

Answer: 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. Congratulations on quitting smoking as this is the single biggest thing you can do to improve your health.

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. If necessary he/she can refer you to a cardiologist.

Miller Family Heart, Vascular & Thoracic Institute | Cleveland Clinic

BTW, if the problem is stress/anxiety, treatment of chronic stress/anxiety may help reduce the risk of cardiovascular disease later in life. As you may know:

Chronic anxiety may be associated with increased risk for cardiovascular morbidity and mortality.
E-Medicine: Anxiety Disorders

For example, there is at least an association between PTSD and cardiovascular disease later in life:

The study revealed that Vietnam veterans who suffered from post-traumatic stress disorder (PTSD) as a result of combat service were six times more likely to have a heart attack than those without PTSD.

Medical Advice: Don't Stress Out - CBS News

 

[ThatLady]

Chest pain is always a reason to consult your physician. However, chest pain that increases when you take a deep breath is rarely cardiac in nature.

 

[Eunoia]

I don't know, maybe it is all in my head... maybe I'm at fault for having chest pain ie. b/c I constantly stress myself out too much... I guess I'll just live with it when it comes up, I'm pretty sure a doctor wouldn't be able to say anything else.... sigh. thanks anyways.

 

[Retired]

Most people do not have the diagnostic skills to rule out many of the underlying causes of chest pain. I have known physicians who were having heart attacks and have stayed home denying to themselves they were sick and convinced themselves it was heartburn.

If one experiences chest pain, no matter at what age, the incident should be reported to their family physician.

If the pain happens not to be debilitating and you chose not to go to Emergency, then a phone call should be made to your family physician who knows your medical history to advise you of your next step.

Chest pain needs to be followed up and the benign factors need to be ruled out. If the condition happens to be caused by cardiovascular disorder, the repeated events can cause irreversible damage.

Fortunately there are many diagnostic tests available to rule out benign conditions and to determine the cause of the chest pain.

maybe I'm at fault for having chest pain

IMO this is faulty logic, because you could be doing harm by ignoring what your body is telling you. If it happens to be caused by anxiety, your physician can offer treatments .

Listen to your body and if you feel something abnormal...see a doctor.

You must take charge of your own medical care.

 

[Daniel E.]

IMO this is faulty logic, because you could be doing harm by ignoring what your body is telling you. If it happens to be caused by anxiety, your physician can offer treatments .

This is a great point. Visiting the doctor is a no-lose situation, at least from the perspective of preventive health.

 

[Cat Dancer]

I hope that you will get this checked out for your peace of mind.

 

[Eunoia]

thanks... well, as irresponsible as this may seem, I don't think I'll end up going to a doctor. it's okay. it doesn't happen a lot and it passes quickly. and it makes sense how this could be due to stress, anxiety, or other reasons I'd rather not think about... partly why I don't want to go. I'm bad at taking care of myself & listening to my body (I don't think I ever listen to my body) and yes I have already seen that in the end I may end up paying a price for that and I already have. ( I don't like my GP anyways, don't particularly trust him, and am sick of going into walk-in-clinics. yes, I could just change GP's, I know. the ironic thing is I always get on my family's back for not going to the doctor (I guess I have that attitude from them?!), but I mean they have actual health problems that need to be taken care of, they know there are problems and they chose to ignore them. in theory, I know you're all right but I guess like always, fear takes over... and downplaying the actual problem. I hate being like that.

 

[Retired]

I don't like my GP anyways, don't particularly trust him, and am sick of going into walk-in-clinics

The mindset I suggest is to consider your physician as your paid consultant, who provides you with his/her opinion based on his/her training and experience. Then its up to you the patient to take charge of your health care and decide on what to do.

One's relationship with a physician should be that of a consultant, and while it's preferable to have an amicable relationship, the fact is you are using that person's professional expertise.

If you don;t like walk in clinics and have difficulty locating a family physician, try another approach.

Medical teaching hospitals usually have raining programs for Family Practice physicians. These clinics are staffed by young physicians to be under the constant supervison of skilled staff physicians.

You will usually have the same young physician looking after you for a two year period, and when that one goes out into private practice you can either follow them is they stay in town or be assigned a new Family Medicine resident.

Patients in these clinics usually get above average care often with preferential access to specialists and diagnostic tests.

No one has to deal with a physician they don't like, but I would submit that distrust ought not be confused with personal dislike.

Good luck and please don't ignore the signals your body sends you.