Heart pain or just pain? How to tell the difference
Posted , 11 users are following.
So recently there have been a lot of cases in my practice where the patient has presented with chest pain, of course the right thing to do is visit a doctor for any pain in your chest. But just to narrow it down for those wondering.
When you feel cardiac related pain, you will feel a deep pressure in your chest, a squeezing sensation if you like, the pain feels "crushing" this is usually the onset of a heart attack and medical attention is required as soon as possible. If you have irregular unexplained chest pain and you are generally healthy but they feel as described above, you may have a heart condition. If the pain feels like a tearing, sharp, stabbing, or more like an ache then the cause is more likely muscular or gastric. Of course as mentioned if you have any kind of pain near where your heart is, see a doctor and get a diagnosis. Doctors would rather you see them instead of googling your symptoms, in some cases time is in short supply.
Muscular pain in some cases can last years, but usually presents after demanding activity, for example you have just started going to the gym or after a long time have started having intercourse again. Both can be incredibly demanding on muscles that have been left to normal daily activities for the past several months/years. This can include tightness is your chest, aches and pains in arms, neck, chest etc.
I hope this helped anyone experiencing sudden chest pain.
Remember to always see a doctor regardless of what type of chest pain you or Google thinks it is.
0 likes, 38 replies
stef17532 DoctorMark
Posted
Hi Dr. Mark,
I was wondering if I could get your opinion on my symptoms that I’ve been having in regards to chest pain. In general, I’m a pretty healthy 21 year old female. I’m a student in university so I’m usually pretty stressed out and anxious. The doctor mentioned she thinks I have Generalized Anxiety Disorder.
Approximately 5 weeks ago, I began to feel slight pressure on the left hand side of my chest but not pain in anyway. My "pressure" will last sometimes a full day to few days or even just a couple hours and then I'll be fine for a few days to a week with no symptoms. It has been off and on and is most of the time localized to one spot. Once it turned into a throbbing sensation and occasionally the pain does move to the right side or it will occur on both sides at the same time for a few seconds. Once before I got a stabbing feeling in my ribs that will lasted no more than seconds. I went to a walk in family physician, my blood pressure was a little high, my blood work was normal besides the fact that I had an infection in my blood stream (which made sense to the doc because I got the flu 3 days later) and i’m assuming my EKG was normal because nothing was said in regards to it. It has been about a week and a half since I’ve gotten sick, I still have a slight cough, i’m always typically sore in my chest area since this has been occurring. One time I moved too quickly, and I felt a sharp stretch in my chest.
The doctor did express concern with my heart rate beating too quickly during my EKG (my heart was beating at 120 bpm), but this is not abnormal for me as I do get stressed out before doctors appointments. This was something I also told the Dr., that my EKG may be inaccurate in terms of my heart rate because of my worry before appointments. The Dr. suggested going back and redoing my EKG and said I do not need a follow up appointment, but will call if seeing a specialist is necessary. They did not further investigate with another round of blood work, chest x ray, etc. I don't know if the doctor is concerned, or if she's just being pro-cautious by being so willing to give me a referral to a specialist! I'm hoping this is just my anxiety getting the best of me, but by how willing she was to give me a referral to a specialist has worried me.
Does this sound like a cardiac issue to you? I don’t know if I should be rushing back to the clinic asking for more tests or if I should just be patient and redo my EKG to wait and see if I get a phone call. If not and symptoms persist, when would you recommend going back to get checked out? Also, do you have any tips on how to remain calm during an EKG?
Thanks so much in advance, I hope you can settle some nerves I have about this whole thing!
DoctorMark stef17532
Posted
In regards to your particular case it does not sound cardiac related. I have seen many patients who are naturally worried when getting an ECG (EKG same thing) have wires attached to you and being told to relax obviously isn't a relaxing situation. The best thing to do if you have a ECG redone is to ask the doctor/nurse to wait till you feel calm after the leads are attached, lay back and close your eyes for a few minutes before doing the trace.
In regards to the type of pain you feel, it could easily be muscular, minor unnoticed stretches, tears and pressures can become a lot more noticeable during the body's healing process. Feeling pressure is fairly common, the chest is a cavity and elevated BP can cause swelling, plus the flu virus can decrease the efficiency of the lungs to a point where you may feel left and right side discomfort.
As you said you have had stabbing like pains I am honestly not too concerned but the doctor you saw (by the way thank you for getting checked for the chest pain) the doctor you saw did everything necessary to clear you of any issue. However you can never be too careful when chest pain is involved, hence her willingness to refer you to a specialist. The cardiologist will likely get an ultrasound of your heart (an echo) another ECG and likely some bloods too. If all is good then you have a musculoskeletal situation. This means anything involving, muscles, bones, ligaments and tendons.
In summary I honestly would not worry because sounds like a cardiac issue is extremely unlikely however as simple precaution take things as far as you need in order to get peace of mind, obviously I'm not there and can't physically see your results, so my opinion is just that.. opinion.
All the best and good luck in your studies.
Regards
Mark
stef17532 DoctorMark
Posted
Hi Dr. Mark,
You're right about it being possibly a musculoskeletal issue. I'm a server at a restaurant, so I'm constantly moving tables, running food, etc. So it is likely! However, I felt as though if I injured myself enough to cause chest pain that I would have some kind of memory of what I did. This has been occurring since the last week of August. I don't know how long muscular issues in the chest last (if I even have that) but hopefully it heals quick because it's getting very annoying. A couple more symptoms I forgot to mention is sometimes I will get short of breath (sometimes from coughing and being unable to catch my breath, or I can pretty much distinguish it from anxiety happening over this chest pain). Also I have been starting to get pain around my shoulders and upper back.
I just have a couple more questions: How long approximately does it take for a GP to receive the results from an EKG? I'm assuming no news is good news in the medical world, but at the same time I want her to call me to give me a peace of mind on where i'm at with the second EKG. I know the EKG's get sent to a cardiologist before since I get them done at a medical lab, but I'm wondering when she should have the results by? Overall, how long would you recommend playing the waiting game as far as chest pains go? I'm unsure if I should go back to the clinic and ask for that referral to a cardiologist and get a piece of mind or should I stick it out a few more weeks?
My anxiety was so horrible over this situation that I managed to lose 10 pounds in between EKG visits within a 2 week time frame. I’m about 5’5 and my weight is usually around 112-115. I checked my weight before my first EKG in case they asked (thankfully, I did) and I was at 107 lbs. Due to stress over the chest pains, I managed to lose 7 pounds (now at 100lbs), which she will see when she compares EKG’s (which i’m planning on getting done tomorrow). I’m unsure if height and weight are usually plastered on the top of a patient's graph as I’ve never seen one. But she did express concern at my first appointment about my weight saying i'm already thin. I’m just worried that she’ll see the significant drop when she compares EKGs. Sometimes I wonder if consistent anxiety/stress and weight loss also combines with all of this too…
Thanks once again for all your help! All the best!
DoctorMark stef17532
Posted
Muscular injury can either be totally obvious from the moment of injury for example blunt force trauma or can be unnoticed completely. Small injuries like stretching, crushing etc may only be noticed during or after healing. Scar tissue is very different from healthy tissue. Scarred muscle fibre can't stretch which effectively tightens the entirety of that particular muscle. Chest injuries involving scar tissue related chest pain are extremely common especially if you have a physical job.
Regarding your results, here in the UK we usually give results on the same day, but for less priority cases like precautionary measures ECG results are normally given on the next visit. If it is urgent we see a patient or tell them the results before their next scheduled appointment we contact them. So in this case it seems you're spot on in saying no news is good news. If it was serious you would know within 1 business day.
The pain is spreading... Yes this is most likely to be more a mental thing over physical symptoms, you feel something is wrong, been told if the pain is in your back, arm, jaw it's heart related.. and I personally put this down as phantom symptoms, the pain may be real but it's anxiety based. If you worry it will get worse, you'll feel worse, the human body is very annoying in that sense.
I would recommend not worrying too much about your weight loss, ECG stands for Electrocardiogram again EKG is the same thing... although I do wonder where the "k" came from, medical terminology aside... The fact you have lost 7ibs should cause no issue on getting an accurate reading or comparison.
Short of breath, yes could be phantom, but more likely to be idiopathic or viral, a URI is usually the cause, if it was heart related this would usually be accompanied with dizziness, the feeling of pressure on your chest and a squeezing sensation deep in your chest. But with your main symptoms of chest pain described as sharp/ache, localised back and arm pain and what you have described so far I honestly think most of this is musculoskeletal and perhaps a bit respiratory. Sorry you never mentioned if you smoke or use vapour? And are you currently using any recreational substances on a regular basis? Also are you currently taking any medication (including contraception) because in detail I can PM you a report on the case as a general overview.
If you ever feel uncomfortable mentioning anything personal on the public space please by all means send me a message or feel free to keep it to yourself, your personal life is yours and you need never feel obligated to say anything you don't want to.
Regards
Mark
stef17532 DoctorMark
Posted
I don’t think your health system is much different than mine (Canada). The doctor wasn’t “pushy” as far as me seeing a cardiologist goes but before the appointment ended, she said “I’m going to refer you to a cardiologist”. I was like yes of course I’ll go if that’s what you think is necessary, but if you’re only concerned about my heart rate I’d prefer to redo my ECG. I figured that I may be more clam since I know what to expect as last time was my first go and I was nervous. We scrapped the idea of seeing a cardiologist for now. To be honest, I think I’m still going to be nervous for my ECG tomorrow as medical stuff in general freaks me out. I don’t think she’ll get an accurate reading still when her main concern was my heart rate. However, I feel as if she saw a potential problem, she would have been more forceful about me seeing additional help. ECG’s usually show a lot of potential issues? Although, she made it very clear to return back as soon as possible if this continues.
This is all very reassuring- also sometimes when I breathe in all the way, my lungs are at max capacity with air. Pressure is there again when I try and breathe in. Sometimes it feels as though that there’s something in my lungs. Funny as it seems like I’m getting far worse instead of getting better when this whole thing started in August. I definitely noticed there are good days and bad days in terms of all of this.
In short, you’re basically saying this is more than likely a muscular issue (thankfully) and this could lasts months until my body can repair scared tissue? Sometimes this pain I’m having can be very overwhelming and quite painful as I do have a physical job. Would my doctor be able to prescribe anything for this or would just over the counter muscle Relaxants suffice? I’ve taken ibourphen before and nothing has seemed to be working. I’m unsure if I should take some time off work if it would be beneficial? I just want to heal as quickly as possible.
lyn1951 stef17532
Posted
Stef - something I never realized until I experienced it, I tore a muscle/cart ledge in and around my hip joint, and it took a very good sympathetic Dr to explain to me, if it is muscular it will be about 6 weeks, he said and if it is cart ledge it will be about 12 weeks, and then only as long as you are careful and don't do any more damage.
At 7 weeks of not being able to walk due to severity of pain in hip joint he decided it may be worth sending me to the orthopedic surgeon, who had replaced my previous hip joint, a few months previous to have a look at me, I had letters from previous x-rays and specialist told me, to say left hip not too bad, and should last about 2 years or more.
At 13 weeks one morning simply woke up, no pain, I was amazed that the pain could vanish just like that, I can tell you I was very careful moving about that morning as I thought it could not be for real.
I few days later finally got to see the orthopedic specialist, he did an x-ray, and compared to others I had done a few weeks before my first hip replacement and also previous x-ray from 2 years previous, and he said he could see the difference in gap between bones and wasn't going to leave me any longer for hip replacement for left side as well, rated as non-urgent so had a long wait, but finally about 6 months later hip replaced.
Moral of the story, muscular 6 weeks, cart ledge 12 weeks, or thereabouts.
msfether DoctorMark
Posted
Hi, I have been having constant chest/throat pressure for a month now, at rest and when active. It just won't let up. It is also difficult to breathe (hard to pull the air in and out) and worse on exertion. I take Bystolic for a rapid heartrate and Imitrex whenever I have a migraine. I've been to a cardiologist, pulmonologist, and ENT. Tests don't show what could be causing the problem. I can't function normally and never have relief. Breathing treatments, albuterol, etc., don't help either. Nothing has made a dent, and I am feeling desperate. Do you have any idea what might causing this? My chest just feels heavy and like I'm being smothered all the time. Oh, and I'm 32, female, vegetarian, normal weight, exercised regularly before this, and blood pressure, hormones, thyroid, and cholesterol are fine. It started a day before my period if that matters.
amanda951753 DoctorMark
Posted
I had a sudden onset stabbing pain that started at the upper back, spread to the right shoulder blade, then shot straight through to the sternum. It lasted for around 8 hours, neither ibuprofen or paracetamol helped.
When it happened again the next day, I tried rapidol, gaviscon and rennies (not all at once!) and again, nothing helped.
I have been to my GP on 8 occasions so far to be told:
1. "I don't know what that could be. Come back if it happens again"
2. "It's acid reflux" (prescribed omeprazole - made no difference)
3. "It's acid reflux and a stomach ulcer, continue omeprazole" (still no difference)
4. "Not sure what it could be" (requests ECG, blood tests, chest x-ray and abdominal ultrasound - all come back "normal"
5. "all tests back normal. at this point we wouldn't normally do more test. manage the pain with painkillers; the nausea is just residual anxiety"
6. "It's related to mood" (had another normal ECG, prescribed beta blockers - no difference)
7. "Could be a stomach bacteria" (test for H. pylori - negative)
8. "It's related to anxiety" (sent to psych well-being. filled in their questionnaire, had consultation with a lady who said I don't have anxiety)
This has been going on for almost 6 months now, and the pain is getting more constant and bringing a feeling of pressure on the chest and occasional nausea with it.
I've mentioned the HIDA scan to a couple of the doctors I've seen but keep getting dismissed because "they've never heard of it".
Do you think I'm right to question that? Do you have any other things I can suggest to my GP next time I go to see her?
Thanks
linkerror DoctorMark
Posted
I have been diagnossed with B12 deficiency and I am on injections since last 4 weeks (Twice a week). 3 weeks back, I had a burning sensation at a precise point near my heart and then pos injection it disappeared. Now since 2 weeks, I am having a dull ache/pain near my heart. This thing has raised my anxiety a lot. I had done ECG 3 weeks back which came normal and every time I visit my GP (Has 35 years of practice) for injection, he measures my BP and pulse. My BP has always been in the 118-125 over 65-73 range. Even when I had this mild pain, my BP came out as 125/68 with 78 as pulse.
My GP says, I do not have any heart issues whatsoever. My triglycerides and cholesterol readings are normal and I am non diabetic. I have never Smoked/Vaped/Drunk throughout my life (36 years) and he says this is all my anxiety. He also mentioned that B12 deficiency has impact on nerves and muscles and this pain might actually be a healing process.
Wanted to know your opinion on the same. The pain is very mild/dull but as its near my heart, my anxiety is through the roof.
katie03012 DoctorMark
Posted
I’m a 24 year old female that has been suffering with left sided chest pain for the last 4 years.
The pain is a sharp stabbing pain, that comes and goes. I seem to have episodes that last for around a couple of weeks. I am an anxiety sufferer so when I get these pains in makes me very anxious and it’s all I can think about and contentrate on.
I’ve had ECG and chest X-ray that both came back clear.
I’m now 18 weeks pregnant which is worrying me more as I’m getting these makes me making myself stressed.
I really don’t know where else to turn, I’ve seen numerous GP’s over the years and just don’t know where else to turn.
DoctorMark katie03012
Posted
Hello.
First of all congratulations and I hope you have a healthy baby
Secondly, I have seen many people who suffer from a mysterious chest pain that comes and goes. After the tests come back clear I usually rule it out as a muscular related pain. When you get heart pain it's usually heavy. You can feel it deep in the chest. Like your being sat on by a sofa... A simple way to test is to see if you can make it worse... move and press around the area that hurts. If you get a sudden increase in pain then it is definitely nothing to worry about. Pregnancy puts a great deal of stress on the body and anxiety will cause you to doubt and worry. Your midwife will take amazing care of you and baby and your body is more than capable of supporting both of you. Be strong and be fantastic.
amy30676 DoctorMark
Posted
I’m hoping maybe you can give me your opinion on my situation. A little over two years ago at the end of December of 2015 I started having a few spells where I just didn’t feel right nothing super specific but I just would get where I felt bad in general. Beginning of 2016 I woke up one morning and had chest pain. From that day on my life has changed. My chest hurt constantly from the time I got up until I went to bed and it was everyday. I would feel weakness and almost as if my heart was going to stop. I made a dr appt to be seen about the chest pain. They ran test ruled out blood clot, did an x-ray, gave me medicine for inflammation, and even sent me for a 24 hour holter monitor. Everything came back normal yet I still felt awful. It was about 3 months of constant chest pain fatigue and just general bad feeling. So I was referred to a cardiologist. During that time in waiting to see the cardiologist I made two trips to the er. First trip the dr just kind of wrote me off as chest wall pain the second time the dr ran a few more test. She tested for Lyme diseases which came back unequivocal and was given a weeks woth if medication and then she told me to have my dr do a follow up test to see what the results showed. For the first few days I felt slightly better but then continued to feel awful. By now I was still having the pains, tiredness, and having palpitations and shortness of breath. While still waiting to see he cardiologist I took a family members adviceand went to see a different dr to get a new opinion. He also basically wrote me off and put it down to anxiety which I have never had a problem with but I agreed to try some anxiety medication. Also when I told him about what the er dr said about the lynes test needing to be redone he pushed it off and said I didn’t have that. So I tried the medication but it did not help so I stopped seeing him because that’s all he kept pushing and also stopped the medication. I finally saw my cardiologist and had anothe halter monitor done because i told her my heart rate has been kicking up fast for no reason at all. So we did that and see saw where my heart rate would Increase for no reason. So I was put on. Beta blocker and am still on it today. She also did a stress test and did an ultrasound of my heart during it and everything came back normal. On my form I saw where she put I had inapproate sinus tachycardia but didn’t know what caused that or the pain. So basically here I am two years later and the symptoms kind of started to ease on their own. I don’t always have pain or shortness of breath like I used to before but other days I’ll get the aches, weird sensation feelings and palpitations. I’ve had other random medical things come about in these two years as well (headaches, swelling on the right side of my temple, fingernails yellowed) but everything always comes back as normal but I certainly don’t feel it. I want to make sure my heart is ok but everyone has run out of ideas. Sorry for this being so long! (Forgot to mention I’m 25 yr old non smoker female)
DoctorMark amy30676
Posted
Hello.
Inappropriate Sinus Tachycardia. Also know as idiopathic tachycardia.. means there is no reason or obvious cause for the condition. I will say that, unfortunately without actually being in front of you to listen to your Heart, run tests and look over medical history and lifestyle there isn't much I can suggest. Depending on where you live this may well be an environmental thing. Parasitic infections can sometimes effect the heart and circulatory system, may be an idea to look into that. If you can message me privately we can go into more detail. Please keep in mind all I can do on here is guess, I cannot make a solid diagnosis.
Mark
claudio74139 DoctorMark
Posted
as69686 DoctorMark
Posted
Hello doc
I'm 27 years old and mom of 10 months old baby.in last February I had chest pain I did ECG 2 times it came normal. afterwards around march or April I did ECG again 2 times after week gap it comes normal. Doctor said ECG normal may you have muscular pain. It go and come again after some days what should I do? I'm very tensed?