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You are here: Experts > Health/Fitness > Medical Specialists > Heart & Cardiology > Weirdness
Expert: David Richardson - 11/7/2009
Question
What I am feeling for the past few weeks is a tightness in
my upper chest on the left side towards my shoulder. When I twist and turn the areas are more painful.The pain feels more like surface pain than deep down into my chest.
Sometimes the tightness travels to the right side and
at times I feel it in both areas right and left at the same time. Sometimes I get a heavy feeling in the underside of my left arm immediately touching the armpit like the muscle on the underside. When I press on the areas it causes the pain to become more pronounced. This pain can last for days on end. I do not get nausea nor do I sweat or have a rapid heart beat when this occurs and have never lost my appetite while going through it.
Being anxious as I am, and having two risk factors for heart disease
(cholesterol and diabetes - cholesterol 258 and H1C 7.2
I started looking up angina symptoms. I have adopted a low fat/very low carb diet and trying to get my numbers better.
As you know when one reads the internet it seems as if they have whatever they’re looking up.
So my question is.....if I have this chest tightness that could last for an entire day on occasion or 4 hours a day, go away and come back the next day and it occurs at times other than when I am exerting myself - (I walk stairs, no problem, I walk for exercise outdoors, no problem)
does this sound cardiac to you? My internist told me it’s anxiety - but again like I said, reading about angina frightens me that it could be that... I’ve had an EKG with no significant problem and a ECHO 1 ½ years ago showing no problems.
I thank you so much for reading this If it doesnt sound cardiac to you, what would you think it could be? Possibly anxiety related?
Excuse me..... I forget to mention blood pressure. For the most part my blood pressure is normal - i.e. this morning it was 123/74 with 73 pulse. There are times my pressure does get elevated but when it does it's usually because I feel anxious or worried about how I feel.
Again, you're most kind to assist. Thank you for your input.
Answer
Dear Laura,
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.
Your tightness seems to be chest wall, since you can increase the pain by pressing on the painful area. It doesn't sound at all cardiac. Anxiety may accentuate or prolong pain, but chest wall discomfort is not induced by anxiety so far as is known. No one knows why some people get chest wall discomfort.
Please keep close watch on your blood pressure to be sure it doesn't get elevated even if you're not stressed.
Please write back if this note doesn't answer all your questions.
David Richardson
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