Unexplained Chest Pain: Causes and When to Seek Help

Q: Unexplained Chest Pain: Causes and When to Seek Help

Hello： Your symptoms are more indicative of neuropathic pain. <br>Relaxing and relieving stress should help improve your condition. <br>It would also be advisable to visit a pulmonologist for a chest X-ray to ensure there are no abnormalities in your heart and lungs, which would

Unexplained chest pain?

Hello Doctor: On the evening of March 22, I noticed a sharp pain in the upper left chest (about 7 cm below the clavicle, where I can feel the bone).
The pain occurs intermittently, lasting about one second each time.
A few times, I experienced pain when I intentionally took a deep breath and exhaled, but most of the time, it was just the intermittent sharp pain.
This condition lasted for about an hour, and I felt no discomfort that night.

In the days since, I have not felt the same intermittent sharp pain as that night, but I have noticed that it reappears in certain positions, such as when bending over to stand up or during chest expansion exercises, although it disappears when I change positions.
Overall, I do not feel any significant discomfort at the moment.
I have not engaged in any vigorous exercise recently, I have mild acid reflux, and my sleep quality is not very good.

Although I currently do not feel any obvious discomfort, I am a bit worried about the intermittent pain and whether it could be pneumothorax or another uncommon condition.
Which specialty would you recommend I see for an examination? Thank you, Doctor.

Niming, 20~29 year old female. Ask Date: 2020/03/25

Dr. Yang Wenda reply Pulmonology

Hello: Your symptoms are more indicative of neuropathic pain.
Relaxing and relieving stress should help improve your condition.
It would also be advisable to visit a pulmonologist for a chest X-ray to ensure there are no abnormalities in your heart and lungs, which would provide you with more peace of mind.

Reply Date: 2020/03/25

More Info

Understanding unexplained chest pain can be a complex issue, as it can stem from various causes ranging from benign to serious conditions. Your description of intermittent sharp pain in the left upper chest area, particularly under the collarbone, raises several considerations.

Firstly, it's important to note that chest pain can originate from different systems in the body, including the musculoskeletal, gastrointestinal, and cardiovascular systems. Given that your pain is triggered by specific movements and positions, it may suggest a musculoskeletal origin, such as a muscle strain or costochondritis (inflammation of the cartilage connecting the ribs to the sternum). These conditions can cause localized pain that may feel sharp or stabbing, especially with certain movements or deep breathing.

The fact that you mentioned experiencing gastroesophageal reflux (GERD) could also be relevant. Acid reflux can sometimes cause chest discomfort that mimics heart-related pain. This discomfort often worsens with certain positions or after eating, and it can be mistaken for cardiac issues.
While your symptoms have subsided and you are not currently experiencing significant discomfort, it is essential to remain vigilant. Chest pain should always be taken seriously, especially if it is accompanied by other symptoms such as shortness of breath, dizziness, or radiating pain to the arms or jaw, which could indicate a heart-related issue.

Regarding your concerns about conditions like pneumothorax (collapsed lung), it is less likely given your symptom pattern. Pneumothorax typically presents with sudden, sharp chest pain and difficulty breathing, and it usually does not resolve quickly or only occur with specific movements. However, if you experience any sudden changes in your breathing or if the pain worsens, it would be prudent to seek immediate medical attention.

Given your symptoms and their nature, I recommend consulting with a primary care physician or a specialist in internal medicine. They can perform a thorough evaluation, which may include a physical examination and possibly imaging studies like a chest X-ray or ultrasound to rule out any serious conditions. If musculoskeletal issues are suspected, a referral to a physical therapist or a specialist in sports medicine may be beneficial for further assessment and management.

In summary, while your symptoms may not currently indicate a serious condition, it is wise to monitor them closely. If the pain recurs or worsens, or if you develop new symptoms, do not hesitate to seek medical advice. Early intervention can help address any underlying issues and provide peace of mind.

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