Chest Discomfort: Muscle Pain or Heart Concerns?

Discomfort in the muscles near the chest?

Hello Doctor: In the past few days, I have occasionally felt pain in the area about 3-4 fingers wide above the left nipple or near the midpoint between the nipple and the armpit when I move my arm.
I'm not sure if it's muscle pain, bone pain, or heart-related pain.
Sometimes, taking a deep breath or puffing out my chest also triggers the discomfort.
I'm a bit worried that it might be a heart condition or myocarditis.
A few days ago, I saw a doctor who said it should just be a muscle issue nearby and advised me not to worry.
They mentioned that if it was due to my sleeping position, it would happen every day, so I should gradually adjust it.
However, it has been three to four days already.
How long does muscle pain typically take to resolve? Should I go back to the internal medicine department for a detailed examination, or should I wait for my follow-up appointment in two weeks with my family medicine doctor and ask them if the symptoms persist? Thank you.

Mik, 20~29 year old female. Ask Date: 2020/10/25

Dr. Hong Yuanbin reply Internal Medicine

Hello, the area you are referring to is likely where the cartilage or pleura is prone to inflammation.
The deep breathing or chest expansion you mentioned can trigger pain, suggesting it could be pleuritis or costochondritis.
It is possible that you previously experienced a cold, severe coughing, a strain, or a bruise that caused this.
Typically, resting for 1-2 weeks will lead to gradual improvement.
You may also consider using some topical anti-inflammatory medications.
If there is no improvement after two weeks, further examination may be necessary to rule out other lung issues.
Thank you for your question.

Reply Date: 2020/10/25

More Info

Chest discomfort can be a source of significant anxiety, especially when it involves the heart. Your description of pain in the left side of your chest, particularly around the nipple area and extending towards the armpit, raises important considerations regarding the potential causes of your symptoms.
Firstly, it is essential to differentiate between musculoskeletal pain and cardiac-related issues. Musculoskeletal pain is often characterized by tenderness in specific areas, exacerbated by movement, deep breathing, or certain positions. This type of pain can arise from muscle strain, inflammation of the cartilage (costochondritis), or even nerve irritation. Given that you mentioned the pain occurs during deep breaths or certain movements, it is plausible that your discomfort may be related to muscle or skeletal issues rather than the heart.

On the other hand, cardiac pain typically presents differently. It may feel like pressure, squeezing, or a heavy sensation rather than sharp pain. It can also be associated with other symptoms such as shortness of breath, sweating, nausea, or radiating pain to the arms, neck, or jaw. In your case, if the pain is isolated to the chest area and does not present with these additional symptoms, it is less likely to be heart-related.

You mentioned that a doctor previously assessed your condition and suggested it was likely a muscular issue, which is reassuring. However, if the pain persists beyond a few days or worsens, it is advisable to seek further evaluation. Muscular pain can take time to resolve, especially if it is related to posture or repetitive movements. Generally, muscle strains can take anywhere from a few days to several weeks to heal, depending on the severity.

If you are still experiencing discomfort after a couple of weeks, it would be prudent to follow up with your healthcare provider. They may recommend further diagnostic tests such as an electrocardiogram (EKG), chest X-ray, or even blood tests to rule out any underlying cardiac conditions.
In the meantime, consider some self-care strategies that may alleviate your symptoms. Gentle stretching exercises, applying heat to the affected area, and maintaining good posture can be beneficial. Additionally, if stress or anxiety is contributing to your discomfort, engaging in relaxation techniques such as deep breathing exercises, meditation, or yoga may help.

In summary, while your symptoms may likely stem from musculoskeletal issues, it is crucial to remain vigilant. If the pain persists or you develop new symptoms, do not hesitate to seek medical attention. Your health and peace of mind are paramount, and ensuring that you receive appropriate care is essential.

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