Chest Pain and Discomfort: Is It Exercise-Related or Heart Issues?

Pain upon palpation of the lower edge of the left chest?

Hello Doctor: Last night and today, I suddenly felt a bit of pressure and pain at the lower edge of my left chest.
It also hurts a little when I press on it.
Additionally, I have experienced some palpitations last night and this morning.
I have been exercising for the past two days, lifting weights and cycling on a stationary bike.
I had an abdominal ultrasound yesterday, which was normal (I have fatty liver), and my blood sugar and cholesterol levels are also normal.
Could this be an exercise-related injury from weightlifting, or could it indicate a heart problem? (I had a cardiac ultrasound a year and a half ago, which was normal.)

Ms. Chen, 30~39 year old female. Ask Date: 2017/08/01

Dr. Chen Taicheng reply Family Medicine

● Given your age, the likelihood of having heart problems is low; however, conditions such as arrhythmia, thyroid disease, anemia, and fluctuations in blood sugar levels can lead to palpitations.
● For the pain point under the left chest, it is advisable to observe it for 2-3 days; if it is induced by exercise, it should gradually improve.
● If palpitations or the pain point under the left chest persist, it is recommended to consult a family medicine physician or a cardiologist for further evaluation and treatment.
Wishing you good health, Dr.
Chen Tai-Cheng from Taoyuan Hospital Family Medicine Department cares about you~

Reply Date: 2017/08/01

More Info

When it comes to chest pain and discomfort, especially in the context of recent exercise, it is essential to approach the situation with caution. Your symptoms of left chest pain, tenderness upon palpation, and episodes of palpitations could be indicative of several underlying issues, ranging from musculoskeletal problems to potential cardiac concerns.

Potential Causes of Your Symptoms
1. Musculoskeletal Issues: Given that you have been engaging in weightlifting and cycling, it is possible that your chest pain is related to muscle strain or injury. The pectoral muscles, which are involved in lifting and pushing movements, can become strained, leading to localized pain that may worsen with pressure or certain movements. This type of pain is often sharp and can be reproduced by palpation.

2. Cardiac Concerns: While your previous echocardiogram was normal, it is important to remember that symptoms can evolve. Chest pain accompanied by palpitations can sometimes indicate cardiac issues, such as arrhythmias or even angina, particularly if the pain is exertional (worsening with activity). Although your blood tests and abdominal ultrasound were normal, cardiac symptoms should not be dismissed, especially if they are new or different from what you have experienced before.

3. Gastrointestinal Issues: Sometimes, discomfort in the chest can be referred pain from gastrointestinal problems, such as acid reflux or esophageal spasms. These conditions can mimic cardiac symptoms and may be exacerbated by physical activity.

Recommendations for Evaluation and Management
1. Rest and Monitor: If you are experiencing chest pain, it is advisable to rest and avoid strenuous activities until you can further evaluate your symptoms. Pay attention to any additional symptoms such as shortness of breath, dizziness, or radiating pain to the arm or jaw, which could indicate a more serious condition.

2. Consult a Healthcare Provider: Given your symptoms, it would be prudent to consult with a healthcare provider, preferably a cardiologist, to discuss your symptoms in detail. They may recommend further testing, such as a stress test or a repeat echocardiogram, to assess your heart's function under exertion.

3. Consider a Holter Monitor: If palpitations persist, a Holter monitor (24-hour ECG) can help identify any arrhythmias that may be contributing to your symptoms.

4. Lifestyle Modifications: While awaiting further evaluation, consider modifying your exercise routine. Focus on low-impact activities that do not exacerbate your symptoms, and ensure you are warming up properly before engaging in more strenuous exercises.

5. Keep a Symptom Diary: Documenting when your symptoms occur, their duration, and any associated activities can provide valuable information to your healthcare provider.

Conclusion
In summary, while your symptoms could be related to exercise-induced musculoskeletal strain, they could also indicate a more serious cardiac issue. Given the complexity of your symptoms and the potential for serious underlying conditions, it is crucial to seek medical advice promptly. Early evaluation and intervention can help ensure that any significant issues are addressed before they lead to more serious complications. Remember, it is always better to err on the side of caution when it comes to chest pain and discomfort.

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