Chest Pain: When to Worry About Heart Issues

Chest pain?

Hello Doctor, over the past week or two, I have experienced occasional pain in my left chest with a distinct tender point, but it does not lead to shortness of breath.
The symptoms are not continuous, lasting only a few seconds, occurring at least once a day.
Yesterday, I also felt some soreness in my left shoulder, which occasionally radiates to my upper back, but again, these symptoms are not continuous.
The discomfort in my armpit is also intermittent.
Recently, due to the pandemic, I have been feeling anxious and having trouble sleeping.
Whenever I experience any discomfort, I worry about my health.
I'm starting to wonder if it could be autonomic nervous system dysfunction, as the pain tends to be less noticeable when I am relaxed and more frequent when I am tense.
In 2017, I was diagnosed with a hereditary predisposition to diabetes, as my mother is a diabetic.
A few days ago, I read that these symptoms could be a precursor to a heart attack, and I am concerned about my heart health.
However, due to the recent pandemic, I am hesitant to visit a hospital.
What do you think I should do?

C, 20~29 year old female. Ask Date: 2021/06/18

Dr. He Dongjin reply Cardiology

Hello, it seems that you are experiencing autonomic nervous system dysfunction along with some neuromuscular issues, rather than a heart condition.
It is not a precursor to a myocardial infarction.
Just observe your condition for now.
Changhua Hospital cares about you.

Reply Date: 2021/06/18

More Info

When it comes to chest pain, it is essential to understand the various potential causes and when to seek medical attention. Your symptoms of intermittent left chest pain, shoulder discomfort, and occasional pain extending to your upper back and armpit can be concerning, especially given your family history of diabetes and the current stressors in your life, such as anxiety and insomnia due to the pandemic.

Firstly, it's important to recognize that chest pain can arise from a variety of sources, including cardiac issues, musculoskeletal problems, gastrointestinal conditions, and anxiety-related disorders. Given that your pain is not continuous and lasts only a few seconds, it may suggest a non-cardiac origin, particularly if it is associated with stress and anxiety. Stress can lead to muscle tension, which may manifest as pain in the chest and shoulders. Additionally, anxiety can cause physical symptoms that mimic heart problems, such as palpitations and chest discomfort.

However, it is crucial to remain vigilant about your symptoms. While your pain may not be severe enough to cause breathing difficulties, any new or unusual chest pain should be evaluated, especially considering your family history of diabetes. Diabetes can increase the risk of cardiovascular diseases, including heart attacks. Therefore, it is wise to monitor your symptoms closely and consider the following factors:
1. Duration and Frequency: If your chest pain becomes more frequent, lasts longer, or is accompanied by other symptoms such as shortness of breath, sweating, nausea, or dizziness, you should seek immediate medical attention.

2. Triggers: Pay attention to what triggers your pain. If it occurs during physical activity or emotional stress, it may indicate a more serious issue that warrants further investigation.

3. Rest and Relaxation: You mentioned that the pain is less noticeable when you are relaxed. This could indicate that anxiety and stress are significant contributors to your symptoms. Engaging in relaxation techniques, such as deep breathing exercises, meditation, or yoga, may help alleviate some of your discomfort.

4. Lifestyle Factors: Consider your lifestyle habits, including diet, exercise, and sleep patterns. A balanced diet, regular physical activity, and adequate sleep are essential for overall health and can help manage anxiety and stress levels.

5. Medical Evaluation: Given your concerns about potential heart issues, it would be prudent to consult with a healthcare provider. They may recommend tests such as an electrocardiogram (EKG), echocardiogram, or stress test to assess your heart's health. Even if you are hesitant to visit a hospital due to the pandemic, many healthcare providers offer telemedicine consultations, which can be a safe way to discuss your symptoms and receive guidance.

In summary, while your symptoms may be related to anxiety and stress, it is essential to remain cautious, especially with your family history of diabetes. Monitoring your symptoms, making lifestyle adjustments, and seeking medical advice when necessary are crucial steps in ensuring your health and peace of mind. If your symptoms persist or worsen, do not hesitate to seek medical attention, as early intervention can be key in managing potential health issues.

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