Sudden Heart Pain: When to Seek Further Evaluation

Sudden chest pain?

Hello Doctor, I would like to ask you about my condition.
I started experiencing intermittent chest pain about three to four years ago.
When measured by the school nurse, it was noted that when my heart rate was very fast (around 120 bpm), my blood oxygen levels were adequate.
When my heart rate was within the normal range, my blood oxygen levels were around 90%.
I later underwent numerous tests at the hospital, including an electrocardiogram, blood tests, X-rays, ultrasound, and a 24-hour Holter monitor (with a maximum heart rate of over 150 bpm and a minimum of 50 bpm, averaging around 80 bpm), all of which showed no issues.
The doctor later suspected that it might be due to high stress.
However, my condition has not improved and sometimes even affects my daily life.
Should I undergo further testing, or is this considered normal and not significantly impactful? If you have any recommendations, please let me know.
Thank you.

Gemma, 10~19 year old female. Ask Date: 2020/07/23

Dr. Wu Xueming reply Cardiology

Due to your young age and the absence of chronic diseases, your risk of developing heart disease is very low.
However, if symptoms persist, it is still advisable to visit a hospital for further evaluation.

Reply Date: 2020/07/23

More Info

Understanding sudden heart pain can be quite complex, especially when previous medical evaluations have not revealed any significant issues. Based on the information you've provided, it seems that you have experienced intermittent heart pain for several years, which has been associated with episodes of tachycardia (rapid heart rate) but has not been linked to any structural heart problems through various tests including ECG, echocardiograms, and blood tests.
Your symptoms, particularly the heart pain that occurs when your heart rate increases, may be indicative of several potential causes. One possibility is that your symptoms could be related to anxiety or stress, which can manifest physically in the form of palpitations, chest pain, and other discomforts. Stress and anxiety can lead to a heightened state of arousal in the autonomic nervous system, which can cause your heart to race and may lead to sensations of pain or discomfort in the chest area. This is often referred to as "psychophysiological" pain, where emotional factors contribute to physical symptoms.

Another consideration is the possibility of a condition known as "costochondritis," which is inflammation of the cartilage that connects a rib to the sternum. This can cause sharp chest pain that may mimic heart pain but is not related to heart function. Additionally, muscle strain or other musculoskeletal issues can also lead to chest discomfort, especially if you have been physically active or under stress.

Given that you have undergone extensive testing and the results have been normal, it may be beneficial to focus on managing stress and anxiety levels. Techniques such as mindfulness, cognitive behavioral therapy (CBT), or relaxation exercises can be very effective in reducing the physical manifestations of anxiety. Regular physical activity, a balanced diet, and adequate sleep are also crucial for overall heart health and can help mitigate symptoms.

However, if your symptoms persist or worsen, or if you experience new symptoms such as shortness of breath, dizziness, or changes in your heart rhythm, it is important to seek further evaluation. While your previous tests have been normal, the persistence of your symptoms warrants a thorough discussion with a healthcare provider, possibly a cardiologist or a specialist in psychosomatic medicine. They can help determine if there are any underlying issues that may not have been previously identified or if a different approach to managing your symptoms is needed.

In summary, while your symptoms may not indicate a serious heart condition based on past evaluations, ongoing discomfort that affects your quality of life should not be ignored. Engaging in stress management techniques and maintaining open communication with your healthcare provider will be key in addressing your concerns and improving your overall well-being. If you feel that your current management plan is not effective, do not hesitate to seek a second opinion or further evaluation. Your health and peace of mind are paramount.

Similar Q&A

Recognizing Heart Issues: When to Seek Medical Help for Chest Pain

I have a history of hypertension, asthma, and peptic ulcers, and I occasionally experience sudden chest tightness and mild pain. Each time, the chest tightness is followed by significant soreness in my jaw and back, but after a few minutes, I feel completely fine, as if nothing h...

Dr. He Dongjin reply Cardiology
Hello, it is recommended that you undergo a thorough examination at the hospital when you are feeling well to rule out issues such as angina and to investigate the possibility of coronary artery vasospasm. Changhua Hospital cares about your health.

Understanding Chest Pain: When to Seek Further Heart Evaluation

Hello Dr. Bu, I have been experiencing heart pain since middle school, which I believe is caused by academic pressure. My symptoms include irregular heartbeats, a stabbing pain in the heart area, and a tight sensation in the back where the heart is located. I often feel weakness ...

Dr. Bu Shiyun reply Cardiology
Chest pain is not uncommon in young people, but most of the time it is not caused by heart problems. Sometimes it can be due to neuromuscular pain, and stress can also have an impact. It is advisable to engage in more physical activity to relax, maintain a regular lifestyle, ensu...

Understanding Heart Discomfort: When to Seek Further Cardiac Evaluation

First, I would like to thank the doctor for taking the time to respond despite their busy schedule. About two years ago, I began to frequently experience chest tightness and episodes of my heart suddenly racing. After seeking medical attention, I underwent an electrocardiogram (E...

Dr. He Dongjin reply Cardiology
Hello, this sounds like typical autonomic nervous system dysfunction. You may simply need to consult a psychiatrist for a medication adjustment, and there should be no need for another cardiac examination. Pingan Changhua Hospital cares about you.

Understanding Sudden Chest Pain: Causes and When to Seek Help

Hello, Doctor. I would like to ask about a recent issue where I occasionally experience sudden sharp pain near my heart or chest (while at rest) that lasts for 2-3 seconds. It goes away and then returns after a few seconds. A few months ago, I had an X-ray and echocardiogram at t...

Dr. Yang Wenda reply Pulmonology
Hello: If recent heart and X-ray examinations are normal, and you experience sudden sharp pain that feels more like nerve pain, it is recommended to manage stress, ensure good sleep quality, and temporarily avoid cold foods, as this may lead to improvement!