Intermittent Chest Pain: Causes and Concerns for Young Adults

Mild pain in the center of the chest?

Hello, doctor.
I apologize for the lengthy message.
About 4 to 5 days ago, I experienced occasional mild pain in the center of my chest that lasted only 1 to 2 seconds.
After a few days, it seemed to go away, but last night and today, the pain returned, again only briefly.
I researched online and found that poor posture, stress, and heart issues could all be contributing factors, but I'm unsure of the cause in my case.
I'm not someone who exercises regularly and often sit or lie in bed.
I considered whether this might be the reason, but it seems that whether I am sitting, lying down, standing, or moving around, it doesn't affect the occurrence of the pain.
Deep breathing or slow breathing also doesn't seem to influence it; it just comes and goes.
I'm uncertain if emotional stress is a factor, as I don't feel particularly unhappy or under any specific pressure.
To add some context: about 3 to 4 months ago, I had pain when pressing on the right side of my chest, so I went to the chest medicine department at Mackay Memorial Hospital for an examination.
They performed an ECG, blood tests, and X-rays, all of which came back normal.
After pressing on my chest, the doctor referred me to the breast department, where they found some cysts and advised me to return in three months.
Since then, I only experience some pain right before my menstrual period, which is more noticeable on the left and right sides of my chest, unlike this time, where the pain is in the center.
Although this intermittent mild pain doesn't significantly affect my daily life—I'm still able to eat, breathe, and walk normally—even when in pain, I have no discomfort in other parts of my body.
Pressing on the center of my chest doesn't cause pain either.
I could ignore it if I wanted to, but not knowing the cause makes me anxious.
Sometimes, even a brief pain causes me to worry and feel scared, leading me to frequently take deep breaths, slow breaths, or even hiccup, and I occasionally feel a bit of tightness in my chest (I'm unsure if this is psychological).
I'm not sure if I'm overly worried, which causes these sensations, or if there is an actual issue with my chest.
Since I had an examination just 3 to 4 months ago, I keep telling myself that everything is fine and not to worry too much.
I have considered cardiovascular issues, but after researching, it seems unlikely at my age (22).
However, every time I feel pain, it still makes me feel exhausted, and my mind races with various thoughts, leading to anxiety and fear.
I don't know if I genuinely have a chest pain issue that causes these feelings or if these feelings are causing my chest pain.
Could you please help clarify this for me? Thank you!

Xin Xin, 20~29 year old female. Ask Date: 2021/02/08

Dr. Ye Qianyu reply Family Medicine

Hello, based on your description, the chest pain can resolve on its own.
It is recommended that you engage in chest-expanding exercises, starting with small ranges and short durations, and gradually increasing both the range and duration.
If you are concerned, you may choose to have regular follow-ups with a trusted physician.

Reply Date: 2021/02/08

More Info

Understanding intermittent chest pain, especially in young adults, can be a complex issue that often leads to anxiety and concern. Your description of experiencing brief episodes of chest pain, lasting only a second or two, is not uncommon, and there are several potential causes to consider.

Firstly, it’s important to note that chest pain can arise from various sources, including musculoskeletal issues, gastrointestinal problems, and cardiac conditions. Given your age (22 years), the likelihood of serious cardiac issues is relatively low, but it is not entirely impossible. However, since you have previously undergone tests such as an electrocardiogram (ECG), blood tests, and chest X-rays, and these results were normal, it is reassuring that there are no immediate concerns regarding your heart health.

Musculoskeletal pain is one of the most common causes of chest pain in young adults. This type of pain can result from poor posture, muscle strain, or even anxiety, which can lead to muscle tension in the chest area. Since you mentioned that you often sit or lie down and do not engage in regular physical activity, it’s possible that your posture or muscle tension could be contributing to your symptoms. Additionally, if you have been experiencing stress or anxiety, this can exacerbate muscle tension and lead to episodes of pain.

Gastrointestinal issues, such as acid reflux or esophageal spasms, can also cause chest pain that may mimic cardiac pain. These conditions can lead to discomfort in the chest area, especially after eating or when lying down. If you notice that your symptoms correlate with meals or specific activities, it might be worth discussing with a healthcare provider.

You mentioned that you sometimes feel a sense of chest tightness or discomfort, which could be related to anxiety. It’s not uncommon for individuals to experience physical symptoms as a result of psychological stress. This can create a cycle where anxiety about the pain leads to more tension and discomfort, which in turn increases anxiety. Practicing relaxation techniques, such as deep breathing exercises or mindfulness, may help alleviate some of this anxiety and reduce the frequency of your symptoms.

Given that your symptoms are intermittent and do not significantly impact your daily life, it may be beneficial to monitor them while continuing to engage in healthy lifestyle practices. Regular physical activity, maintaining good posture, and managing stress through relaxation techniques can all contribute to reducing the frequency and intensity of chest pain episodes.

However, if your symptoms persist, worsen, or if you experience additional concerning symptoms such as shortness of breath, dizziness, or radiating pain to the arms or jaw, it is crucial to seek medical attention promptly. These could be signs of a more serious condition that requires immediate evaluation.

In summary, while your intermittent chest pain is likely not indicative of a serious health issue given your age and previous normal test results, it is essential to consider factors such as musculoskeletal strain, gastrointestinal issues, and anxiety. Maintaining a healthy lifestyle and managing stress can be beneficial, but do not hesitate to consult a healthcare professional if your symptoms change or if you have further concerns.

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