Chest Pain: When to Seek Cardiac Care at 21

I feel strange in my chest?

Hello doctor, I am a 21-year-old female.
Recently, I have been experiencing pain in the center of my chest and below my left breast, as well as pain in my upper back near the shoulder blades.
My hands feel numb, and sometimes I notice my heart beating heavily and occasionally faster than usual.
I went to the hospital for evaluation, where I had a chest X-ray, an electrocardiogram (ECG), and blood tests.
After being observed overnight, the hospital reported no issues and suggested it might be premature contractions, advising me to follow up with a cardiologist in two months.
However, I have had to visit the emergency room twice due to discomfort in my chest, where I underwent ECG and X-ray again, and the doctors still found no problems.
They believe it may be inflammation of the chest muscles or ribs.
I took anti-inflammatory medication, but it seems to have little effect.
Recently, over the past two to three days, the sharp pain in my left breast area has decreased significantly, replaced by a strange sensation, almost like a small electric current flowing rapidly inside me.
This feeling occurs when I breathe, perform any activity, or even when I shower with hot water.
I also experience this sensation when startled, such as when an insect suddenly flies by.
It’s not sharp pain, nor is it pressure pain; it feels somewhat numb but not entirely.
I’m unsure how to describe it, but it occurs frequently, essentially all day long.
Sometimes, my heart will suddenly beat very loudly, and I can feel a heavy heartbeat in my abdomen.

Is this phenomenon dangerous? Is it truly just muscle soreness, or should I see a cardiologist immediately? I perform outdoor activities and have a high level of physical exertion daily, so I am quite concerned.
I hope you can help me determine whether I should seek immediate evaluation from a cardiologist.
Additionally, my hands and feet feel weak and numb, and my fingertips and toes are often cold.
I experience dizziness, and sometimes my left ankle feels weak, causing me to lose balance.
I feel very fatigued but have never fainted.
After eating, I sometimes experience chest pain, followed by frequent belching and flatulence, which seems somewhat gastrointestinal in nature.
My stool has been dark brown and yellow, both in a loose consistency.

In April, one night, I experienced pulling pain throughout my neck, left shoulder, and entire left chest and back, regardless of my position.
During the night, I felt a sudden ache in my left chest that made my whole body tremble, and I felt very cold.
The next day, while sitting against a cabinet, the pain suddenly subsided.
However, when I hurriedly stood up, I felt dizzy and had a sharp pain in my back, which I previously had diagnosed as nerve root compression from carrying heavy loads on one side.
The doctor mentioned that my left shoulder muscles were completely tight, and I appeared to have uneven shoulders.
I wonder if this could be affecting my sternum.
Additionally, I feel pain near my left hip close to the pelvis when I stretch.
Thank you, doctor.

Chan, 20~29 year old female. Ask Date: 2018/06/16

Dr. He Dongjin reply Cardiology

Hello, the overall symptoms indicate autonomic nervous system dysfunction, possibly due to recent stress and being overly busy.
There is pain in the left shoulder, numbness in the hand, and a slight stabbing pain near the left rib area.
The symptoms resemble mitral valve prolapse.
Additionally, there is pain in the left lower back near the pelvis that feels like tendonitis when stretching, rather than heart disease, angina, or myocardial infarction.
Please do not worry; Changhua Hospital is concerned about your well-being.

Reply Date: 2018/06/16

More Info

It sounds like you are experiencing a complex array of symptoms that can be quite concerning, especially at your young age. Chest pain, particularly when accompanied by other symptoms like shortness of breath, palpitations, and numbness, should always be taken seriously. Given your history of chest pain and the various tests you've undergone, it seems that your healthcare providers have been trying to rule out serious cardiac issues. However, your ongoing symptoms warrant further evaluation.

Understanding Your Symptoms
1. Chest Pain and Discomfort: The pain you describe, particularly in the left chest area and under the breast, could be related to several factors. While your doctors have suggested that it might be muscular or related to inflammation of the ribs, it’s essential to consider other potential causes, including anxiety, which can manifest physically in the form of chest pain and palpitations.

2. Palpitations and Heart Rate Variability: The sensation of your heart racing or beating heavily can be alarming. Palpitations can occur due to various reasons, including anxiety, caffeine intake, or even hormonal changes. Since you mentioned that these symptoms sometimes occur after eating, it could also be related to gastrointestinal issues, such as acid reflux, which can mimic cardiac symptoms.

3. Numbness and Weakness: The numbness in your hands and feet, along with feelings of weakness, could suggest a neurological component or even anxiety-related hyperventilation. It’s also possible that these symptoms are related to your posture or muscle tension, especially if you have a history of muscle strain or nerve compression.

4. Gastrointestinal Symptoms: Your description of gastrointestinal symptoms, such as belching and changes in bowel movements, could indicate that some of your discomfort is related to digestive issues. Stress and anxiety can exacerbate gastrointestinal symptoms, leading to a cycle of discomfort.

When to Seek Further Care
Given your ongoing symptoms and the fact that they have not fully resolved, it would be prudent to follow up with a cardiologist, especially since you have experienced episodes of significant discomfort. Here are some recommendations:
- Follow-Up with a Cardiologist: Since you have already been evaluated, it’s important to keep your follow-up appointment. If your symptoms worsen or if you experience new symptoms, such as severe chest pain, dizziness, or fainting, seek immediate medical attention.

- Consider a Holistic Approach: Given the complexity of your symptoms, consider discussing with your doctor the possibility of a multidisciplinary approach. This could include seeing a cardiologist, a neurologist for your numbness, and possibly a gastroenterologist for your digestive symptoms.

- Lifestyle Modifications: Engaging in regular physical activity, managing stress through techniques such as mindfulness or yoga, and maintaining a balanced diet can help alleviate some symptoms. Avoiding stimulants like caffeine and ensuring adequate hydration can also be beneficial.

- Monitor Your Symptoms: Keep a detailed log of your symptoms, noting when they occur, their intensity, and any potential triggers. This information can be invaluable to your healthcare provider in diagnosing and managing your condition.

Conclusion
While it’s reassuring that your initial tests have not indicated serious cardiac issues, your ongoing symptoms should not be ignored. It’s crucial to continue advocating for your health and seeking answers. If you feel that your symptoms are impacting your daily life or causing significant distress, do not hesitate to seek further evaluation. Your health and well-being are paramount, and it’s essential to ensure that all potential causes of your symptoms are thoroughly investigated.

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