Chest Pain: Is It Heart-Related or Something Else?

Occasional sharp pain near the heart?

Hello, over the past year, I have experienced occasional sharp pains near my heart, but I usually don't feel anything significant.
My blood pressure has been normal in the past, although it has been slightly elevated at times, possibly due to stress.
In recent years, my triglyceride levels have been slightly high, though they have been normal at times.
Before the Mid-Autumn Festival, I experienced gastroesophageal reflux, and in early October, I underwent an endoscopy.
Prior to that, I had an X-ray at a pulmonology clinic, but since I was coughing persistently, the pulmonologist only prescribed cough syrup, leading to a near certainty of gastroesophageal reflux.
During the endoscopy, the doctor mentioned that there were no major issues and prescribed me some stomach medication.
However, since then, I have felt increasing tightness in my chest.
I have tried exercising and taking traditional Chinese medicine, which has helped alleviate the tightness somewhat, but I still feel like my breathing is not quite smooth.

Recently, while showering, I noticed a patch of skin on my left chest, near the lower left shoulder, that is yellow-green in color, about the size of a ten-dollar coin.
It doesn't hurt when touched, nor is it hard, but it feels unusual.
There is no swelling, and I don't recall hitting anything.
Given the occasional sharp pain near my heart, I am concerned and would like to know what this situation might indicate.
Is there a problem with my heart or cardiovascular system? Should I see a dermatologist or a cardiologist regarding the yellow-green patch of skin? Is the tightness in my chest related to my heart?

r, 30~39 year old female. Ask Date: 2016/11/18

Dr. He Dongjin reply Cardiology

Hello, yellow-green skin? It is advisable to observe it first.
If you are still concerned, you should see a dermatologist.
Based on the symptoms, it does not appear to be psychogenic chest pain; it seems more like chest pain caused by muscular or neurological issues.
However, if you are still worried, it would be best to consult a cardiologist.
Changhua Hospital cares about you.

Reply Date: 2016/11/18

More Info

Understanding chest pain can be quite complex, especially when it involves a combination of symptoms and medical history. Based on your description, it seems that you are experiencing a range of symptoms that could potentially be linked to both gastrointestinal issues and musculoskeletal problems, rather than a direct heart issue.

Firstly, the occasional sharp pain near your heart area, especially if it is brief and resolves quickly, is often not indicative of a serious heart condition, particularly in younger individuals without significant risk factors. Given that you have had normal blood pressure readings and only slightly elevated triglycerides, your cardiovascular risk appears to be relatively low. However, it is crucial to consider that anxiety and stress can manifest physically, leading to symptoms such as chest pain or discomfort.

Your history of gastroesophageal reflux disease (GERD) is particularly relevant. GERD can cause chest pain that mimics heart-related pain, often described as a burning sensation or discomfort in the chest, especially after eating or when lying down. The fact that you have experienced GERD symptoms, along with the recent endoscopy showing no significant issues, suggests that your chest discomfort could be related to acid reflux rather than a cardiac issue.

The yellow-green discoloration on your skin near the left shoulder could be a separate issue altogether. It might indicate a bruise or a skin condition that warrants further investigation. Since it does not appear painful or hard, it may not be related to your heart or chest pain. However, it is advisable to consult a dermatologist or a primary care physician to assess this skin change.

As for the chest tightness and the feeling of breathlessness, these symptoms can also be attributed to anxiety, especially if they occur during stressful situations or after physical exertion. Engaging in regular exercise, as you mentioned you have started, can significantly help alleviate anxiety and improve overall cardiovascular health. Additionally, practicing relaxation techniques such as deep breathing, meditation, or yoga can be beneficial.

If you continue to experience chest pain, especially if it becomes more frequent, intense, or is accompanied by other symptoms such as shortness of breath, dizziness, or sweating, it is essential to seek medical attention promptly. While your previous tests have shown no significant heart issues, further evaluation may be warranted if your symptoms persist or worsen.

In summary, while your symptoms may be concerning, they are not necessarily indicative of a heart problem. The combination of GERD, potential anxiety, and musculoskeletal issues could explain your discomfort. However, do not hesitate to consult healthcare professionals for a thorough evaluation, especially regarding the skin discoloration and persistent chest symptoms. It is always better to err on the side of caution when it comes to health concerns.

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