Chest Pain: Causes, Symptoms, and When to Seek Help

Chest pain?

Hello, let me describe my condition.
In the past few years, my health check-ups have shown slightly elevated triglyceride levels, which sometimes return to normal.
Around July or August of this year, I developed a cough that started after a cold.
Although the cold resolved, the cough persisted.
My doctor referred me to a pulmonologist for a chest X-ray and an upper endoscopy, and the doctor indicated that there were no significant issues.
I was prescribed medication for my stomach, which initially seemed effective, but after stopping the medication, I experienced some reflux symptoms again after a short period.
This has become somewhat recurrent, especially at night, although I generally feel fine in the mornings.
I do experience some chest tightness, and I rarely consume sweets, coffee, or tea.

Currently, I have been seeing a traditional Chinese medicine practitioner, and after a few weeks of treatment, my chest tightness has improved, and the reflux symptoms have diminished.
My cough has also improved significantly.
Previously, I experienced sudden sharp pain near the left side of my chest, but I am unsure if it was related to my heart or muscle pain; this has also decreased.
However, in the past two weeks, I have started to experience sudden sharp pain in the center of my chest, just below the sternum, and occasional coughing.
This sharp pain occurs about once a week, with the first instance being more painful than the second.
I am wondering if this is related to my mitral valve prolapse.

After several months of experiencing various symptoms, I am concerned if there are any signs of deterioration.
Which specialist should I consult? Additionally, I occasionally experience sudden sharp pain on both sides of the back of my head.
Recently, I have also felt sudden pain in my teeth when biting down or eating.
I visited a dentist, who said everything appeared normal.
I know I have sensitive teeth, but the painful areas are different from the sensitive ones.
I am unsure if this is related to the chest pain.
Thank you.

l, 30~39 year old female. Ask Date: 2016/11/28

Dr. He Dongjin reply Cardiology

Hello, the pain shifts from one area to another, which suggests a higher likelihood of neuropathic pain.
There may be a potential association with mitral valve prolapse.
It is recommended to increase your intake of B vitamins during this period and continue to monitor your condition.
The likelihood of reflux recurrence is high, so you should continue your medication.
If there is no improvement, it would be advisable to visit the outpatient clinic for further examination.
Changhua Hospital cares about your well-being.

Reply Date: 2016/11/28

More Info

Understanding chest pain can be complex, as it can stem from various causes, ranging from benign to serious conditions. Based on your description, it seems you have been experiencing a range of symptoms, including chest discomfort, cough, and occasional sharp pains. Let's break down your symptoms and explore potential causes, as well as when to seek medical help.

Potential Causes of Chest Pain
1. Gastroesophageal Reflux Disease (GERD): Given your history of cough following a cold and the sensation of acid reflux, GERD could be a significant contributor to your chest discomfort. This condition occurs when stomach acid flows back into the esophagus, leading to symptoms like heartburn, chest pain, and cough, particularly at night or after meals.

2. Musculoskeletal Pain: The sharp pain you described near the center of your chest could be related to muscle strain or inflammation. This is especially plausible if you have been engaging in activities that involve heavy lifting or poor posture, which can strain the muscles around the chest.

3. Cardiac Issues: Although your previous tests did not indicate significant problems, it is essential to consider cardiac causes, especially if you experience symptoms like sudden sharp pain, particularly on the left side, or if the pain radiates to your arm, neck, or jaw. Conditions like mitral valve prolapse (which you mentioned) can sometimes cause atypical chest pain, but they are usually not serious unless accompanied by other symptoms like shortness of breath or palpitations.

4. Anxiety and Stress: Psychological factors can also manifest as physical symptoms, including chest pain. Anxiety can lead to hyperventilation, which may cause chest tightness and discomfort.

5. Dental Issues: The sensitivity and pain in your teeth could be related to dental problems, which can sometimes refer pain to the chest area. If the pain is not consistent with your dental issues, it may be worth further investigation.

When to Seek Help
Given the variety of symptoms you have experienced over the past few months, it is crucial to monitor your condition closely. Here are some guidelines on when to seek medical attention:
- Persistent or Worsening Symptoms: If your chest pain becomes more frequent, severe, or is accompanied by other symptoms such as shortness of breath, sweating, nausea, or dizziness, seek immediate medical attention.

- New Symptoms: If you experience new symptoms, such as a significant change in your cough, increased frequency of chest pain, or if the pain starts radiating to other areas, consult a healthcare provider.

- Follow-Up on Previous Conditions: Since you have a history of elevated triglycerides and have experienced ongoing symptoms, it may be wise to follow up with a cardiologist to rule out any underlying heart conditions, especially if you have risk factors such as family history, smoking, or high blood pressure.

Recommended Actions
1. Consult a Specialist: Given your symptoms, it would be beneficial to see a cardiologist for a thorough evaluation, including possibly an echocardiogram to assess your heart's structure and function, especially in relation to your mitral valve prolapse.

2. Gastroenterology Referral: If GERD is suspected, a gastroenterologist can provide further evaluation and management options, including lifestyle modifications and medications to control acid reflux.

3. Pain Management: For musculoskeletal pain, consider physical therapy or pain management strategies, including exercises to strengthen the chest and back muscles.

4. Dental Evaluation: Since you have experienced dental pain, a follow-up with your dentist might be necessary to ensure there are no underlying issues that could be contributing to your symptoms.

In conclusion, while many causes of chest pain are benign, it is essential to take your symptoms seriously, especially given their persistence and variability. Regular follow-ups with healthcare providers and appropriate referrals can help ensure that any serious conditions are ruled out and that you receive the necessary care for your symptoms.

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