Heart & Cardiology/Chest pain nearly 24hrs


I know it's likely not cardiac but want to check any ideas as my usual dr not working for another couple of days.
The short is I've had constant L sided chest pain for nearly 24hrs. It was sudden in onset and has at times radiated slightly down the left upper arm. It's tight and sharp. Nil apparent shortness of breath except with exertion (even just walking around). Lying down does not relieve it and pain increases with coughing, and mildly with deep breathing. My friend has noticed me wincing even when lying down. Slight tingly in r fingers.
Started 18hrs ago on mobic 7.5mg. Usual meds seroquel 12.5mg nocte, duloxetine 90mg mane, propranolol 10mg mane and midi. Have noticed usually pain increase/onset after mild tachy of 95-100bpm and hr decreases back to 60-65 after propranolol dose. Nil cardiac history. Prone to chest infections but nil fever or coughing, through mild intermittent runny nose. Only health probs have been acute pancreatitis 9yrs ago (resolved), bursitis in hip and shoulder, and tendinitis is wrist and toes, osteopenia. Do have history anorexia nervosa and PTSD, though in recovery from both. In addition to mobic and usual meds have taken panadeine max, still no relief. Any ideas or suggestions? Usually chest X-ray and ECG have been normal, though none for over 3mths. Nil obvious trauma to chest nor obvious deformity. I'm just sick of this constant pain. I'm 26yr old female.

Hello Kath,

One-sided chest pain worse with deep breath and cough is called pleurisy, which means inflammation of the outer lining of the lungs.  Pneumonia and clot drifting from leg veins to a pulmonary artery branch are the causes of pleurisy.  Since you have no fever or cough, pneumonia is unlikely.  A clot in a branch of the pulmonary artery will heal up okay, but the problem is whether other clots may drift from legs to lung, possibly quite serious if a big clot drifts.  I suggest you go to an emergency room, tell them your symptoms and that you're worried about pulmonary emboli (the word for clots drifting up to lungs).

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

David Richardson

Heart & Cardiology

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David Richardson


Adult heart function and disease. Not very good about children lesss than 12. Hypertension is o.k. Heart rhythm a special interest.


Certified in cardiology by the American Board of Internal Medicine. Was chairman of division of cardiology at the Medical College of Virginia. Am now mostly retired.

Fellow of American Heart Association and American College of Cardiology and member of American Physiological Society..

Circulation, American Heart Journal, Hypertension.

M.D. from Harvard Medical School. Residency training at Yale Uhniversity School of Medicine and Medical College of Virginia.

Awards and Honors
Gold Heartt Award from American Heart Association in 1995.

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