Expert: David Richardson - 6/24/2009

Question
hello dr,

for the last 15 months or so, i have been experiencing
on and off stabbing pains in the left side breast, usually all around the left breast and sometimes underneath. it feels like the pain originates deep deep i have no other symptoms that go along and sometimes they are affected by change of position etc..., in fact if the pains are mild i just continue what i am doing. they are not related to exercise, in fact yesterday i had a nasty episode while watching tv!!!it started with minor stabbing and later it hurt a lot. it went away and when i was in bed i turned to my right and there another one.sometimes afterwards my chest on that side feels bruised.

a week ago i visited my cardiologist for an annual check up , he said everything is o.k. he even did an ekg.

history : mild mvp with mitral insufficiency +1.
        hashimotos underactive for over 12 yrs both.

i am fem 33, have 3 children.
1.65, 60kgs.
bp 10.5/6.5 at my home 12/7 at cardiologists ekg

had a perfect echo of the heart 15 months ago
had a perfect stress test 2.5yrs ago
saw my cardiologist last weeek

i try not to get scared but sometimes i think it could be my heart.the odd thing is i took my bp when it happened and it was perfect and my heart rate too!! i do have some minor issues with my bowel but i doubt that's it.

pls take the time to answer as i don't know what to do.

is there a chance it is a heart problem or not?

Answer
Dear tonia,

The most likely cause of pain like yours 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.  With a normal echo and stress test, heart disease is ruled out.

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

David Richardson