Intermittent Heart Pain and Upper Back Discomfort: Should You See a Cardiologist?

Chest pain with accompanying back pain?

Hello, I had a cardiac ultrasound about a month ago, and the examining physician said that my heart's contraction was normal.
However, in the past few days, I have been experiencing intermittent sharp pain in my heart, and I also have pain in my upper left back.
The back pain lasts for about ten seconds each time, but it occurs quite frequently.
Should I return to the cardiology department for further evaluation?

Qing, 20~29 year old female. Ask Date: 2020/12/24

Dr. Wu Xueming reply Cardiology

Due to your young age and the absence of chronic diseases, your risk of developing heart disease is low.
Additionally, sharp pain is not a typical symptom of angina.
Many factors in daily life can contribute to this condition, such as emotions, stress, irregular sleep patterns, or excessive intake of caffeinated beverages.
It is recommended to adjust your lifestyle and engage in regular exercise.
However, if the symptoms persist, it is advisable to visit a hospital for an electrocardiogram (ECG) examination.

Reply Date: 2020/12/24

More Info

Based on your description of intermittent heart pain and upper back discomfort, it is important to consider several factors before determining whether you should see a cardiologist again. You mentioned that you had a heart ultrasound about a month ago, which indicated that your heart's contraction was normal. However, the new symptoms you are experiencing warrant further evaluation.

Intermittent heart pain can be caused by a variety of factors, including but not limited to musculoskeletal issues, gastrointestinal problems, or cardiac conditions. The fact that you are also experiencing pain in your upper back could suggest a musculoskeletal origin, such as muscle strain or tension, especially if the pain is sharp and lasts for only a short duration. However, it is crucial to rule out any cardiac causes, particularly if the pain is located near the heart or is accompanied by other symptoms such as shortness of breath, dizziness, or palpitations.

Given that your heart ultrasound was normal, it is less likely that your symptoms are due to a significant heart condition. However, conditions like angina or even anxiety-related chest pain can still occur even in individuals with normal heart function. Additionally, if you have risk factors for heart disease (such as a family history, smoking, high blood pressure, or high cholesterol), it would be prudent to consult a cardiologist.

Here are some considerations to help you decide whether to see a cardiologist again:
1. Frequency and Duration of Symptoms: If the heart pain is becoming more frequent or lasts longer than before, it is advisable to seek medical attention.

2. Associated Symptoms: If you experience any additional symptoms such as shortness of breath, lightheadedness, nausea, or sweating, you should seek immediate medical attention.

3. Response to Rest or Medication: If the pain improves with rest or over-the-counter pain relief, it may indicate a non-cardiac cause. However, persistent or worsening symptoms should not be ignored.

4. Impact on Daily Life: If the pain is affecting your daily activities or causing significant anxiety, it is worth discussing with a healthcare provider.

5. Previous Medical History: If you have a history of heart disease or other cardiovascular issues, it is advisable to be more vigilant and consult your cardiologist.

In summary, while your recent heart ultrasound was normal, the new symptoms you are experiencing could still be related to a variety of causes. It is always better to err on the side of caution when it comes to heart health. If your symptoms persist or worsen, or if you have any concerns about your heart health, it would be wise to schedule an appointment with a cardiologist for further evaluation. They may recommend additional tests such as an electrocardiogram (ECG), stress testing, or even a repeat echocardiogram to ensure that your heart is functioning properly and to rule out any potential issues. Remember, your health and peace of mind are paramount, and seeking professional advice is always a prudent choice.

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