Chest Pain: Is It Time to See a Doctor?

Sharp pain in the heart area?

Hello, doctor.
About six years ago, I experienced my first episodes of sharp chest pain and discomfort during my pregnancy.
At that time, due to stress, I sought medical attention, and the doctor diagnosed me with "mitral valve prolapse" after auscultation.
Over the past few years, I have frequently experienced sharp chest pain and discomfort.
(In the first three years, I also had autonomic nervous system dysregulation and fainting spells, for which I sought medical care.) Recently, due to stress, the sharp pain and discomfort have become more frequent.
I would like to know if I need to seek medical attention because the symptoms have persisted for a long time (intermittently over six years).
Is there treatment available for these pain symptoms? Thank you.

Xiao Lu, 30~39 year old female. Ask Date: 2020/11/11

Dr. Wu Xueming reply Cardiology

Due to your young age and lack of chronic diseases, your risk of developing heart disease is low.
Many factors in daily life can contribute to this situation, such as emotions, stress, irregular sleep patterns, or excessive intake of caffeinated beverages.
It is advisable to adjust your lifestyle and engage in regular exercise.
However, if symptoms persist, it is still recommended to visit a hospital for further evaluation.

Reply Date: 2020/11/11

More Info

Chest pain can be a concerning symptom, especially when it has been recurrent over several years. In your case, the history of experiencing sharp and dull pain in the heart area, coupled with a previous diagnosis of mitral valve prolapse, suggests that there may be underlying cardiac or non-cardiac issues that need to be addressed.
Mitral valve prolapse (MVP) is a condition where the valve between the heart's left atrium and left ventricle doesn't close properly, which can lead to various symptoms, including palpitations, chest pain, and anxiety. While MVP is often benign and many individuals live without significant issues, it can sometimes be associated with more serious complications, such as arrhythmias or mitral regurgitation. Given your history of autonomic nervous system dysfunction and fainting episodes, it is essential to approach your symptoms with caution.

The fact that your chest pain has persisted intermittently for six years, especially with increased frequency during stressful periods, warrants a thorough evaluation. Stress can exacerbate many conditions, including those related to the heart and the autonomic nervous system. It is crucial to differentiate whether your symptoms are primarily cardiac in nature or if they could be related to anxiety, panic attacks, or other non-cardiac causes.

Here are some steps you should consider:
1. Consult a Cardiologist: Given your history of MVP and recurrent chest pain, it would be prudent to see a cardiologist. They may recommend further diagnostic tests such as an echocardiogram to assess the structure and function of your heart, an electrocardiogram (ECG) to check for any irregular heart rhythms, or even a Holter monitor to track your heart's activity over 24 hours.

2. Evaluate for Anxiety or Panic Disorders: Since you mentioned that stress seems to exacerbate your symptoms, it might be beneficial to evaluate whether anxiety or panic attacks are contributing to your chest pain. A mental health professional can help you explore this aspect and provide coping strategies or treatment options.

3. Lifestyle Modifications: Incorporating stress management techniques such as mindfulness, yoga, or regular physical activity can be beneficial. These practices can help reduce overall stress levels and may alleviate some of the symptoms you are experiencing.

4. Monitor Symptoms: Keep a detailed log of your symptoms, including when they occur, their duration, and any associated factors (such as stress levels, physical activity, or dietary changes). This information can be invaluable for your healthcare provider in determining the cause of your symptoms.

5. Follow-Up: If you experience any new symptoms, such as shortness of breath, dizziness, or changes in your heart rate, seek medical attention promptly. These could indicate a more serious condition that requires immediate evaluation.

In summary, while your symptoms may be related to a benign condition like mitral valve prolapse, the persistence and frequency of your chest pain, especially in the context of stress, suggest that a comprehensive evaluation is warranted. It is essential to work closely with healthcare professionals to determine the underlying cause and to explore treatment options that can help manage your symptoms effectively. Remember, early intervention can often lead to better outcomes, so don’t hesitate to seek medical advice.

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