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What could cause chest pain and shortness of breath?

This Premium Q&A, reviewed and published, features a real conversation between an iCliniq user and a physician.

Patient's Query

Hello doctor,

I have left chest pain above my breast and pain in my left arm. I also have shortness of breath and fast heartbeat. This does not happen all the time. It comes and goes. I have it for about three years I guess. I am not on medications currently.
Answered by Dr. Ahmed Mohamed Mahmoud Goha

Education:

MBBS

Professional Bio:

Dr.Ahmed Mohamed Mahmoud Goha is a Cardiologist with 28 years of clinical experience. He completed his Cardiology and Cardiac Imaging Consultant in September 2019 Egypt-Air Hospital, Cairo, Egypt. He has worked in the following places- Clinical Cardiac Imaging Fellow (July 2014 to June 2019); In the Nuclear Medicine Division of the Medical Imaging Department, Western University, London, Ontario, Canada; As a Tele-Cardiologist (June 2010 – Present) in Caribbean Heart Institute, Jamaica; As a Senior Cardiology Specialist or Consultant Director of Cardiac CT unit (2003- 2014) in Aero- Medical council and Egypt air hospital; As a Cardiology specialist or Consultant (2002 –2014) in Saint Rita hospital, Cairo, Egypt; As a Cardiology specialist (July 2000 – July 2002) in Cardiology department of Defense industry medical Centre (DIMC), Cairo, Egypt; As a Cardiology Resident or Registrar (March 1996 – June 2000) in Cardiology Department of Kobry Elkobba Military Hospital, Cairo, Egypt. In addition, he did a Rotating Internship (Feb 1995 – Feb 1996) in the Faculty Of Medicine at Ain Shams University Hospitals, Cairo, Egypt.

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Hi,

Welcome to icliniq.com.

Most common cause for this is costochondritis which is an inflammation of the cartilage in the rib cage or anxiety. However other causes need to be excluded. More information about chest pain is needed like character, duration, radiation, what brings it and how does it go, relation to mood, exercise or food?

The Probable causes

The probable cause is costochondritis or anxiety.

Investigations to be done

Do ECG (electrocardiography), X-ray chest and Echocardiography. 24-hour ambulatory ECG (Holter) may be considered. CBC (complete blood count) and Thyroid function test has to be done.

Differential diagnosis

The differential diagnosis are cardiac causes: mitral valve prolapse, pericarditis, coronary artery disease (unlikely in your case), lung causes: bronchial asthma, pleurisy. Musculoskeletal: injured rib, costochondritis, gasterointestinal causes: Gastroesophageal reflux disease, peptic ulcer, hiatus hernia and sychological causes: anxiety, panic attacks, psychosomatic disorder and others: hormonal disturbance.

Regarding follow up

Please reconsult after doing the requested tests.
Medically reviewed by Dr. Vinodhini J.
Published At July 10, 2020
Reviewed At August 10, 2024

Education:

MBBS

Professional Bio:

Dr.Ahmed Mohamed Mahmoud Goha is a Cardiologist with 28 years of clinical experience. He completed his Cardiology and Cardiac Imaging Consultant in September 2019 Egypt-Air Hospital, Cairo, Egypt. He has worked in the following places- Clinical Cardiac Imaging Fellow (July 2014 to June 2019); In the Nuclear Medicine Division of the Medical Imaging Department, Western University, London, Ontario, Canada; As a Tele-Cardiologist (June 2010 – Present) in Caribbean Heart Institute, Jamaica; As a Senior Cardiology Specialist or Consultant Director of Cardiac CT unit (2003- 2014) in Aero- Medical council and Egypt air hospital; As a Cardiology specialist or Consultant (2002 –2014) in Saint Rita hospital, Cairo, Egypt; As a Cardiology specialist (July 2000 – July 2002) in Cardiology department of Defense industry medical Centre (DIMC), Cairo, Egypt; As a Cardiology Resident or Registrar (March 1996 – June 2000) in Cardiology Department of Kobry Elkobba Military Hospital, Cairo, Egypt. In addition, he did a Rotating Internship (Feb 1995 – Feb 1996) in the Faculty Of Medicine at Ain Shams University Hospitals, Cairo, Egypt.

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Education:

BDS

Professional Bio:

Dr. Vinodhini J. is a Dental Surgeon with extensive years of clinical experience. She specializes in the diagnosis, prevention, and treatment of dental and oral health issues, including restorative, surgical, and cosmetic procedures. With a patient-centered approach, she focuses on maintaining oral health, alleviating discomfort, and enhancing smiles. Her expertise ensures comprehensive care tailored to each patient’s dental needs and overall wellbeing.

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Dr. Ahmed Mohamed Mahmoud Goha

Cardiology

Education:

MBBS

Professional Bio:

Dr.Ahmed Mohamed Mahmoud Goha is a Cardiologist with 28 years of clinical experience. He completed his Cardiology and Cardiac Imaging Consultant in September 2019 Egypt-Air Hospital, Cairo, Egypt. He has worked in the following places- Clinical Cardiac Imaging Fellow (July 2014 to June 2019); In the Nuclear Medicine Division of the Medical Imaging Department, Western University, London, Ontario, Canada; As a Tele-Cardiologist (June 2010 – Present) in Caribbean Heart Institute, Jamaica; As a Senior Cardiology Specialist or Consultant Director of Cardiac CT unit (2003- 2014) in Aero- Medical council and Egypt air hospital; As a Cardiology specialist or Consultant (2002 –2014) in Saint Rita hospital, Cairo, Egypt; As a Cardiology specialist (July 2000 – July 2002) in Cardiology department of Defense industry medical Centre (DIMC), Cairo, Egypt; As a Cardiology Resident or Registrar (March 1996 – June 2000) in Cardiology Department of Kobry Elkobba Military Hospital, Cairo, Egypt. In addition, he did a Rotating Internship (Feb 1995 – Feb 1996) in the Faculty Of Medicine at Ain Shams University Hospitals, Cairo, Egypt.

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