Heart & Cardiology/chest pain

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Question
Yesterday, while laying on the couch I had a dull ache on the right side of my chest ( a few inches left of my nipple, pectoral area). This area was about the size of a quarter. This ache has continued for 48 hours, although is has lessoned in severity. The ache was fleeting, would feel it for 3-5 seconds and it would go away. The area was also very tender/sore to the touch. There is slight discomfort when breathing in deeply also. No other symtoms. Any ideas what this could be? IM otherwise healthy and active and just returned from a physical with an ekg

Answer
Hi,

Your chest pain is what we call atypical chest pain. This is different from the typical chest pain that we commonly associate with the heart. Typical chest pain is often central in the chest, not localized to a specific spot,  and associated with a feeling of pressure that some describe as an elephant sitting on the chest. There may also be some shortness of breath. In typical chest pain, the symptoms usually come on with exertion and are relieved by rest. In the case of a heart attack for example, the pain can come on at rest but is usually associated with the typical symptoms described above.

Your chest pain is atypical in that it came on at rest, was localized to a specific area, continued for 48 hours and was associated with tenderness on touch, and worsens with breathing. This does not sound to concerning for cardiac chest pain. It is worth noting that atypical pain can be from the heart however especially in some groups such as women, the elderly, and diabetics. Its reassuring you are healthy and active without regular symptoms. In your case the best thing to do is at some point see a Dr, and let them get more information, determine your risk factors for heart disease and your need for further testing to provide reassurance. If the symptoms worsen or recur and you are concerned you can always get a more urgent check up.

As for what is causing your pain, there are many possible causes. The most likely is some musculoskeletal chest pain. I've put a few links below to useful articles discussing the different types of chest pain and their causes.

http://blog.myheart.net/2013/06/18/angina-or-some-other-chest-pain/
http://blog.myheart.net/2013/06/20/what-kind-of-chest-pain-is-it/
http://blog.myheart.net/2013/06/20/still-more-types-of-chest-pain/

Hope this was helpful,

Mustafa Ahmed
http://blog.myheart.net

Heart & Cardiology

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Mustafa Ahmed MD

Expertise

Cardiology, Interventional Cardiology, Cardiac Surgery, Hypertension, Pulmonary Embolism, Structural and Valve Disease

Experience

Board Certification Internal Medicine and Cardiology Interventional and Structural Cardiology

Organizations
http://blog.myheart.net

Publications
Multiple Publications In High Quality Peer Reviewed Journals. Internationally Recognized.

Education/Credentials
MD from The Royal Victoria University of Manchester, England Medicine, Cardiology, Interventional Cardiology, Research Training - University of Alabama

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