Expert: David Richardson - 11/9/2009

Question
I am a 37 year old woman - I am not overweight, I don't smoke, and I exercise fairly regularly.  Lately, I have been having chest pains, sometimes just right of the center of my chest, and today, just in the center of my chest.  The pain is such that it is hard to take a deep breath.  When it begins to subside, there is only minor discomfort when I take a deep breath.  My husband thinks I've pulled a muscle in my chest, but it doesn't feel like that to me, as it doesn't seem to be aggravated by day-to-day activities like lifting/stretching.  Any thoughts as to what could be going on would be most appreciated.

Answer
Dear Holly,  

The most common cause of pain in a young person is cramping of the muscles in the chest wall.  If you can modify the pain, make it better or worse, by pressing on the area that hurts, then you have proven that the pain is coming from your chest wall.  Chest wall pain is a nuisance but no threat to life or health.  At age below 45, chest pain is very unlikely to come from clogging of the coronary arteries that supply blood to the heart. A few people get chest pain from congenital heart disease that causes trouble in mid-life, though this is unlikely in someone with good exercise ability.  If pressure on the painful area does not modify the pain, ask your doctor to consider an echocardiogram to be sure that your heart's structure and function are normal.

Please write back if this note doesn't answer all your questions.

David Richardson