What are the possible causes of chest pain?

Question

Hello doctor,

I am 29 years old and have no prior heart issues. I am a fan of exercise. At the beginning of this year, I started experiencing chest pain located near or right over my right side. Mostly, the pain comes in short, quick bursts at random intervals, but sometimes it lingers. A couple of weeks after the pain started, I had my first-ever panic attack. Although I thought I was having a heart attack, in the ER, I underwent an ECG, chest X-ray, and blood work. The tests showed nothing. The chest pain went away for a couple of months but then returned worse last month, and I am still dealing with it.

Since then, I have met with a cardiologist who performed a treadmill stress test, which yielded normal results. I am currently wearing an event monitor for a month. I am having trouble accepting that this might be anxiety causing the pain, and I am worried it could be angina. The pain did not hurt while I was working out earlier, but now it does. I do not know if that is because I am focusing on and worrying about it. I guess what I am looking for is reassurance that the tests I have undergone, along with my medical history, indicate that my heart is fine.

Answer 1

Hello,

Welcome to icliniq.com.

Historically, and based on investigations like the TMT (treadmill test), it does not appear to be cardiac pain (attachment removed to protect patient identity). I assume you do not smoke or drink. The usual cause for this type of pain is musculoskeletal discomfort arising from the muscles and bones, which may increase during exercise due to rapid and heavy breathing. You may be able to reproduce the pain by pressing on the area. Another possibility is gastroesophageal reflux, especially if you are also experiencing bloating, burping, nausea, epigastric pain, chest burning, or a sour water feeling in your throat. Your chest X-ray and lipid profile are also normal.

I hope this helps you.

Thank you.