Heart & Cardiology/Chest Pain


Hello Sir,
Thank you for taking the time to answer my question. My name is Steve and I am a Paramedic student, and soon to be firefighter/Paramedic. I am here because the other night I noticed left sided chest pain, and it feels far more different then just muscle strain or costochrondritis. It is a very tight feeling, almost as if someone has a tight grip on my heart, squeezing it tightly in their fist. If I breath in and hold my breath the pain intensifies and I can almost feel the pulsation of my heart in my chest. I maintain an active lifestyle and regularly workout muscle training and alot of cardio (running 2-3 miles every view days and stairmaster.) Which is why I feel my heart should be healthy! I notice sometimes when I run my carotid arteries feel like they are bulging and its slightly painful. Being a Paramedic student makes me worry 10x more about things like this. I am 20 y/o 5'7, 135 lbs, Pulse usually mid 50s to 65. And a relatively low BP. No meds. Thanks for your time,


Hello Steven,

Chest pain in a young person is usually cramping of muscles in the chest wall.  If pushing on the painful area modifies the pain (makes it better or worse), or if the pain is relieved by bending the body away from the painful area, that proves the pain is from chest  wall.  Even if these maneuvers donít affect the pain, itís still probably chest wall.  Pain caused by narrowing of the coronary arteries that supply blood to the heart is extremely rare below age 40. Chest wall pain is no threat to life or health, just a big nuisance.  Safest management is just to ignore the pain, though Tylenol, aspirin or ibuprofren usually help.

Could you get an echocardiogram to be sure your heart's structure and funtion are normal?

Please write back if this note doesnít 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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