Chest Pain Near the Heart: Causes and Concerns

Sharp pain and tightness near the left chest, close to the heart?

Recently, I have been experiencing a dull, sharp pain under my left collarbone, which is concerning since it's near the heart.
This has caused me a lot of anxiety and has affected my work, leading me to take multiple sick leaves.
I feel exhausted from worrying.
I have undergone several examinations, and this time the sensation feels the same.
I visited a traditional Chinese medicine practitioner the day before yesterday, who suggested it could be neuralgia or blood deficiency, but I still feel uneasy.
Therefore, I went to see a cardiologist again, who had me undergo another electrocardiogram (ECG).
The ECG results from April and May appeared the same, so the doctor concluded it was neuralgia.

I am wondering if the ECG would show normal results when I am not in pain.
I have a history of hypertension, with a height of 177 cm and a weight of 117 kg, and I also have left ventricular hypertrophy.
Additionally, I would like to ask the doctor if the following tests—blood tests, X-rays, ECG, and echocardiogram—can indicate whether I have heart disease.
I am very afraid of coronary artery disease, myocardial infarction, and other symptoms, and I have been worried since April until now in May.

Xiao Jie, 30~39 year old female. Ask Date: 2021/05/25

Dr. He Dongjin reply Cardiology

Hello, the sharp pain below the clavicle may be related to nerve pain.
The heart is not located there; it is situated in the so-called epigastric region, which is much more centrally located and lower.
What you are experiencing is likely due to poor posture, leading to shoulder and neck issues, which can cause associated symptoms that are different from those of common heart diseases such as coronary artery disease or myocardial infarction.
Please don't worry.
Changhua Hospital cares about you.

Reply Date: 2021/05/25

More Info

Understanding chest pain, especially when it is localized near the heart, can be a source of significant anxiety and concern. Your symptoms of left chest discomfort and sharp pain, particularly given your medical history of hypertension and left ventricular hypertrophy, warrant careful consideration. However, it is essential to understand that not all chest pain is indicative of a serious heart condition.
Based on the information you provided, it seems that you have undergone a comprehensive evaluation, including blood tests, X-rays, electrocardiograms (ECGs), and echocardiograms, all of which have returned normal results. These tests are critical in assessing heart health and can help rule out serious conditions such as coronary artery disease or myocardial infarction (heart attack).
1. Understanding Your Symptoms: The sharp, stabbing pain you experience could be related to several factors. Given that your heart tests have come back normal, it is plausible that your symptoms may be linked to musculoskeletal issues, nerve pain, or even anxiety. Conditions such as costochondritis (inflammation of the cartilage connecting the ribs to the sternum) or intercostal neuralgia (nerve pain between the ribs) can cause similar symptoms and are often exacerbated by stress or physical activity.

2. Role of Stress and Anxiety: Psychological factors such as stress and anxiety can manifest physically, leading to sensations of pain or discomfort in the chest area. The mind-body connection is powerful, and emotional distress can lead to muscle tension, which may contribute to your symptoms. It is not uncommon for individuals under stress to experience chest pain that mimics cardiac issues, leading to further anxiety and a cycle of worry.

3. Hypertension and Heart Health: You mentioned having high blood pressure and left ventricular hypertrophy. While these conditions do increase the risk for heart disease, they do not automatically mean you will develop serious heart problems. It is crucial to manage your blood pressure through lifestyle changes, including a balanced diet, regular exercise, and possibly medication as prescribed by your healthcare provider.

4. When to Seek Further Evaluation: Since you have already undergone extensive testing, it may be beneficial to focus on managing your anxiety and stress levels. However, if your symptoms persist, worsen, or if you experience additional symptoms such as shortness of breath, dizziness, or significant changes in your health, it would be wise to consult your healthcare provider again. They may recommend further evaluation or refer you to a specialist, such as a cardiologist or a psychologist, for a comprehensive approach to your health.

5. Lifestyle Modifications: Incorporating regular physical activity, practicing relaxation techniques (such as yoga or meditation), and ensuring a balanced diet rich in fruits, vegetables, and whole grains can significantly improve both physical and mental health. Reducing caffeine and alcohol intake may also help alleviate anxiety and improve overall well-being.

In conclusion, while your symptoms are understandably concerning, the normal results from your recent tests are reassuring. It is essential to continue monitoring your health, manage stress effectively, and maintain open communication with your healthcare providers. If you have ongoing concerns, do not hesitate to seek further evaluation to ensure your peace of mind and health.

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