Chest Pain: When to Seek Medical Attention

Q: Chest Pain: When to Seek Medical Attention

Hello： There are many causes of chest pain; please seek medical attention from a physician for evaluation.

Pain in the center of the chest?

Hello Doctor, on the night of May 26th, I suddenly experienced pain in the center of my chest (just below the collarbone).
It was the most painful that night, to the point where I couldn't tolerate it and took a Tylenol.
After waiting for a long time, the pain subsided somewhat.
In the following days, the pain gradually decreased, leaving only occasional mild discomfort.
However, today, June 11th, after lifting something slightly heavier, I felt the same area start to hurt again.
It is not as painful as on May 26th, but I have noticed that if I exert myself in that area, whether by puffing out my chest or bending, I will feel pain.
I do not have any chronic illnesses or other diseases, but I did see a doctor last year due to anxiety related to job searching, and I took medication for 1-2 months before stopping.
Recently, I have not experienced any other abnormalities in my body.
I am unsure if my anxiety has resurfaced due to being at home during the pandemic, or if it could be another condition.
However, I am hesitant to visit a hospital or clinic due to the pandemic, so I wanted to ask for your advice.
Should I focus on relaxing and resting, or should I seek medical attention? Alternatively, if it is just inflammation, could I take some over-the-counter anti-inflammatory medication and observe if there is any improvement? I have been feeling anxious due to these physical issues in recent days, so I appreciate your response.
Thank you.

Li, 20~29 year old female. Ask Date: 2021/06/12

Dr. Zhou Ziguang reply Pulmonology

Hello: There are many causes of chest pain; please seek medical attention from a physician for evaluation.

Reply Date: 2021/06/12

More Info

Chest pain can be a concerning symptom, and understanding when to seek medical attention is crucial for your health. Based on your description, it seems you experienced a significant episode of chest pain on May 26, which was severe enough to require medication. Following that, you noted a gradual decrease in pain, but you have since experienced a recurrence of discomfort after lifting something heavy.
Firstly, it’s important to recognize that chest pain can arise from various causes, some of which may be benign, while others can be serious. Common causes of chest pain include musculoskeletal issues, such as muscle strain or costochondritis, which is inflammation of the cartilage connecting the ribs to the sternum. Given that your pain seems to be triggered by physical activity, this could be a plausible explanation. However, other potential causes include gastrointestinal issues like acid reflux, anxiety-related chest pain, or even cardiac conditions, which should not be overlooked.

In your case, the fact that the pain is localized and associated with specific movements (like lifting or bending) suggests a musculoskeletal origin. However, the intensity of the pain you experienced on May 26 raises a red flag. Severe chest pain, especially if it feels different from your usual discomfort, warrants further investigation to rule out serious conditions such as angina or myocardial infarction (heart attack), even if you do not have a history of chronic illness.

Given your previous experience with anxiety and the current context of the pandemic, it is understandable that you might feel anxious about seeking medical care. However, it is essential to prioritize your health. If the pain persists, worsens, or is accompanied by other symptoms such as shortness of breath, dizziness, or radiating pain to the arm, jaw, or back, you should seek immediate medical attention. These could be signs of a more serious condition that requires prompt evaluation.

If the pain remains mild and does not significantly interfere with your daily activities, you might consider monitoring it for a short period. Over-the-counter anti-inflammatory medications, such as ibuprofen, can help alleviate discomfort if you suspect inflammation. However, self-medication should not replace professional medical advice, especially if symptoms change or escalate.

In summary, while it is possible that your symptoms are related to muscle strain or anxiety, it is crucial to remain vigilant. If you experience any significant changes in your symptoms or if the pain becomes severe again, do not hesitate to consult a healthcare professional. Your health and peace of mind are paramount, and it is always better to err on the side of caution when it comes to chest pain.

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