Chest Pain: Causes and When to Seek Help

Chest pain in the center?

For the past 3.4 months, I have been experiencing sudden sharp pain in the center of my chest (the area where CPR compressions are performed).
Sometimes the pain radiates to the back at the same point.
During these episodes, I also feel a sensation of something being stuck in my throat.
Pressing on the painful area sometimes provides relief.
Occasionally, I suddenly have a metallic taste of blood in my mouth, and I'm unsure if this is related.

Li, 20~29 year old female. Ask Date: 2021/10/02

Dr. Hong Yuanbin reply Internal Medicine

Based on your description, there are two possible scenarios.
If pressing down causes pain in the bony area, it may indicate inflammation of the costal cartilage.
In this case, it is recommended to apply some anti-inflammatory ointment on the outer side of the pain, which may help improve the condition.

If pressing down causes pain beneath the bone, in the area of the internal organs, it could be related to gastritis or gastroesophageal reflux disease (GERD).
It is advisable to maintain a balanced diet, have a regular routine, and engage in moderate exercise, which may help alleviate the symptoms.
Regarding the bad taste in the mouth, theoretically, the aforementioned conditions should not cause bleeding from the mouth, and there should be no correlation.
However, if it is GERD, it is possible to detect a gastric acid taste in the mouth.
If symptoms do not improve, it is recommended to consult a family medicine clinic.
Thank you for your inquiry.

Reply Date: 2021/10/02

More Info

Understanding chest pain can be quite complex, as it can arise from a variety of causes, some of which may be serious. Given your symptoms of sudden chest pain located in the center of your chest (the area where CPR compressions are applied), along with pain radiating to your back and a sensation of something stuck in your throat, it is essential to approach this matter with caution.

Chest pain can be categorized into several types based on its origin:
1. Cardiac Causes: This includes conditions like angina (chest pain due to reduced blood flow to the heart) and myocardial infarction (heart attack). Symptoms may include pressure or squeezing in the chest, pain that radiates to the arms, neck, or jaw, and associated symptoms like shortness of breath, sweating, or nausea.

2. Gastrointestinal Causes: Conditions such as gastroesophageal reflux disease (GERD), esophageal spasms, or peptic ulcers can cause chest pain. These pains may be accompanied by heartburn, regurgitation, or a sour taste in the mouth.

3. Musculoskeletal Causes: Pain can also arise from muscle strain, rib injuries, or inflammation of the cartilage connecting the ribs to the sternum (costochondritis). This type of pain often worsens with movement or palpation of the affected area.

4. Pulmonary Causes: Conditions like pulmonary embolism (a blood clot in the lungs) or pneumonia can cause chest pain, often accompanied by difficulty breathing or coughing.

5. Psychogenic Causes: Anxiety and panic attacks can also manifest as chest pain, often accompanied by feelings of impending doom, rapid heartbeat, and hyperventilation.

Given that you have experienced this pain intermittently for the past 3 to 4 months, it is crucial to seek medical attention, especially since you mentioned the pain is sometimes severe and associated with a peculiar taste of blood in your mouth. This could indicate a more serious underlying condition that requires prompt evaluation.

When to Seek Help:
- Immediate Attention: If you experience severe chest pain, especially if it feels like pressure or squeezing, or if it radiates to your arms, neck, or jaw, you should seek emergency medical help immediately. This is particularly important if you also experience shortness of breath, sweating, or fainting.

- Persistent Symptoms: If your chest pain persists, worsens, or is accompanied by other concerning symptoms (like the blood taste you mentioned), it is advisable to consult a healthcare provider for a thorough evaluation.
- Routine Check-ups: Regular check-ups can help identify risk factors for heart disease or other conditions that could lead to chest pain. This is especially important if you have a family history of heart disease, high blood pressure, or diabetes.

Diagnostic Approach:
A healthcare provider may recommend several tests to determine the cause of your chest pain, including:
- Electrocardiogram (ECG): To check for heart-related issues.

- Chest X-ray: To visualize the lungs and heart.

- Echocardiogram: To assess heart function.

- Stress Testing: To evaluate how your heart performs under physical stress.

- Blood Tests: To check for markers of heart damage or other conditions.

In conclusion, while chest pain can arise from various benign causes, the potential for serious underlying conditions necessitates a careful and thorough evaluation. Do not hesitate to reach out to a healthcare professional to discuss your symptoms and receive appropriate care. Your health and well-being are paramount, and early intervention can make a significant difference.

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