Chest Pain: When to Worry and What It Could Mean - Pulmonology

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Chest pain?


About six months ago, while exercising, I suddenly felt a cool sensation in my chest that lasted for about two weeks, after which it disappeared.
Not long after, I experienced a sensation similar to a muscle strain when exerting myself, followed by chest tightness and difficulty breathing, along with pain when pressing on the left side of my chest.
This lasted for about a month before it resolved.
On January 7, I noticed slight swelling of the lymph nodes behind my left ear, which lasted for about three days.
On January 13, I felt a pulling sensation again during exertion, followed by difficulty breathing.
On January 15, I noticed slight swelling of the lymph nodes near my left clavicle, which disappeared by January 18.
However, I have since developed chest pain.
I have a history of autonomic nervous system dysfunction and a habit of lying down while using my phone.
Could this be a sign of a serious illness, or is it just a muscle strain?

ni hao ni hao, 10~19 year old female. Ask Date: 2017/01/12

Dr. Yang Wenda reply Pulmonology


Hello: The lymph nodes have diminished, which may be related to an upper respiratory infection.
As for the feelings of chest tightness, pressure, or mild pain, a chest X-ray is necessary to rule out any significant pulmonary pathology.
As you mentioned, if you have a habit of poor posture while using your phone, it is advisable to correct this habit and ensure it does not affect your normal sleep.

Reply Date: 2017/01/12

More Info


Chest pain can be a concerning symptom, and understanding its potential causes is crucial for determining when to seek medical attention. Given your description of symptoms, it’s important to consider both muscular and more serious underlying conditions.

Firstly, the sensation of "coolness" in the chest during exercise, followed by a feeling of tightness or strain, could suggest a few different things. If the discomfort is related to physical activity and is accompanied by shortness of breath, it may indicate a musculoskeletal issue, such as a muscle strain or a problem with the rib cage. This is especially plausible if you have a habit of leaning forward or lying down while using your phone, which can strain the muscles in your chest and back.

However, the presence of pain in the left chest, especially if it is reproducible by pressing on the area, often points to musculoskeletal pain rather than a cardiac issue. Musculoskeletal pain can arise from overuse, poor posture, or even anxiety, which can lead to muscle tension. Given your history of autonomic nervous system dysregulation, it’s possible that stress and anxiety could be contributing to your symptoms as well.

The swelling of the lymph nodes you mentioned, particularly in the left ear and left clavicle area, could indicate an infection or inflammation. Lymph nodes can swell in response to various conditions, including viral infections, bacterial infections, or even localized inflammation. If the swelling is persistent or accompanied by other symptoms such as fever, night sweats, or unexplained weight loss, it would be prudent to consult a healthcare professional for further evaluation.

While your symptoms could be benign, it’s essential to rule out any serious conditions. Chest pain can sometimes be a sign of cardiac issues, especially if it is associated with other symptoms like shortness of breath, sweating, nausea, or pain radiating to the arm, jaw, or back. Given your history of autonomic nervous system issues, it’s also important to consider that anxiety can manifest physically, leading to sensations that mimic more serious conditions.

In your case, it would be advisable to monitor your symptoms closely. If you experience any worsening of the pain, new symptoms, or if the pain persists, it would be wise to seek medical attention. A healthcare provider may recommend tests such as an electrocardiogram (ECG), echocardiogram, or imaging studies to assess your heart and lungs, as well as a physical examination to evaluate your lymph nodes and overall health.

In summary, while your symptoms may be related to muscle strain or posture, the presence of lymph node swelling and chest pain warrants careful consideration. It’s always better to err on the side of caution when it comes to chest pain. Regular follow-ups with your healthcare provider can help manage your symptoms and address any underlying issues effectively. Remember, your health is paramount, and seeking professional advice is a proactive step in ensuring your well-being.

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