Left Chest Pain When Breathing: When to Seek Further Heart Evaluation

Pain in the left chest when breathing or moving?

Hello Doctor: I underwent surgery for transposition of the great vessels at birth and have been returning for annual check-ups, including electrocardiograms and echocardiograms.
During my follow-up appointment at the end of August this year, my attending physician indicated that everything was normal and advised me to continue with regular check-ups.
However, at the end of November, after experiencing a cold and cough, I began to feel a pulling pain in my left chest whenever I breathe or move.
I would like to know if I need to go to the hospital for further detailed examinations, and which specialty I should consult.
Below is the electrocardiogram report from the end of August for your reference.
Thank you.
Vent.
rate 77 bpm, Sinus rhythm with sinus arrhythmia with short PR interval 108 ms, Voltage criteria for left ventricular hypertrophy, QRS duration 96 ms, QT/QTc 368/416 ms, P-R-T axes 71 83 72.

Szu, 20~29 year old female. Ask Date: 2019/12/14

Dr. He Dongjin reply Cardiology

Hello, the symptoms you described seem more like discomfort caused by neuromuscular issues.
The electrocardiogram report shows no significant abnormalities, so it is advisable to monitor the situation.
Changhua Hospital cares about your well-being.

Reply Date: 2019/12/14

More Info

When experiencing left chest pain, especially in the context of a history of congenital heart surgery such as the arterial switch operation for transposition of the great vessels, it is crucial to approach the situation with caution. Given your background and the recent onset of pain associated with breathing and movement, it is advisable to seek further evaluation from a healthcare professional.

When to Seek Further Evaluation
1. Persistent Symptoms: If the left chest pain persists or worsens, particularly if it is associated with difficulty breathing, it is essential to seek medical attention. Pain that is exacerbated by breathing or movement could indicate a variety of conditions, including musculoskeletal issues, pleuritis, or even cardiac concerns.

2. Associated Symptoms: Pay attention to any accompanying symptoms such as shortness of breath, dizziness, or palpitations. If you experience any of these, it is a sign that you should seek immediate medical evaluation.

3. History of Heart Conditions: Given your history of heart surgery, any new or unusual symptoms should be taken seriously. While your recent echocardiogram and ECG indicated no immediate concerns, changes in your condition warrant further investigation.

Recommended Steps
1. Visit a Healthcare Provider: It would be prudent to schedule an appointment with your cardiologist or a healthcare provider specializing in cardiology. They can perform a thorough evaluation, including a physical examination and a review of your symptoms.

2. Diagnostic Testing: Depending on your symptoms and the findings from the physical examination, your doctor may recommend additional tests. These could include:
- Chest X-ray: To rule out any lung-related issues such as pneumonia or pleural effusion.

- Electrocardiogram (ECG): To assess your heart's electrical activity and identify any abnormalities.

- Echocardiogram: To evaluate the structure and function of your heart, especially considering your surgical history.

- Stress Testing: If indicated, to assess how your heart performs under physical stress.

3. Consider Other Specialists: If your cardiologist rules out cardiac causes, you may be referred to a pulmonologist for respiratory evaluation or a musculoskeletal specialist if the pain is determined to be related to muscle strain or nerve irritation.

Understanding Your Symptoms
The left chest pain you are experiencing could stem from various causes:
- Musculoskeletal Pain: This is common and can result from muscle strain, especially if you have been coughing due to a cold. It often worsens with movement or deep breathing.

- Pleuritis: Inflammation of the pleura (the lining around the lungs) can cause sharp pain that worsens with breathing or coughing.

- Cardiac Issues: Although your recent evaluations showed no immediate concerns, it is essential to remain vigilant. Symptoms like chest pain in the context of previous heart surgery could indicate complications that need to be addressed.

- Anxiety: Sometimes, anxiety can manifest as chest pain and difficulty breathing, especially in the context of worrying about your health.

Conclusion
In summary, given your history and the new onset of left chest pain associated with breathing, it is advisable to seek further evaluation from a cardiologist. They can help determine the underlying cause of your symptoms and recommend appropriate management. Do not hesitate to reach out for help, as timely intervention can be crucial in addressing any potential issues.

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