Chest Pain and Discomfort After COVID-19 Vaccination

There are times when I experience sharp pain in my left chest, sometimes feeling like it is being heavily pressed or constricted, accompanied by chest tightness. Occasionally, there is also a sharp pain radiating to the upper left back?

Since receiving the second dose of the BNT vaccine, I have been experiencing intermittent sharp pain in the upper left back, which varies in intensity.
By the sixth day, I started to notice occasional sharp pain in the left chest, sometimes feeling like pressure or constriction, accompanied by a sensation of tightness in the chest.
At times, this pain radiates to the upper left back.
The discomfort lasts anywhere from half an hour to two to three hours.
During these episodes, I find myself unconsciously shortening my breath and breathing more rapidly, even when my breathing is otherwise normal.
Sometimes, while lying down, I also experience these symptoms.
On the eighth day, I had an episode at night where my breathing became labored, and an emergency evaluation showed my heart rate was 105.
Subsequent measurements returned to normal.
I underwent chest X-rays, an electrocardiogram, and blood tests, all of which indicated that my heart is normal and there is no myocarditis.
I also consulted a cardiologist who suggested that the issue might be related to tendonitis and prescribed pain relief and muscle relaxants.
As of now, on the fourteenth day, these symptoms continue to occur several times a day without improvement.

Xiao Lan, 40~49 year old female. Ask Date: 2021/11/20

Dr. Wu Xueming reply Cardiology

If these symptoms persist without improvement, it is recommended to visit a hospital for a thorough examination.

Reply Date: 2021/11/20

More Info

Experiencing chest pain and discomfort after receiving a COVID-19 vaccination, such as the BNT (BioNTech) vaccine, can be concerning. It's important to understand the potential causes and implications of these symptoms, especially in the context of recent vaccination.

Firstly, it is not uncommon for individuals to experience various side effects after vaccination. Common side effects include pain at the injection site, fatigue, headache, muscle pain, chills, fever, and nausea. However, some individuals may also report atypical symptoms such as chest pain or discomfort. In your case, the symptoms you describe—sharp pain in the left upper back, chest tightness, and feelings of pressure—are noteworthy and warrant careful consideration.

1. Possible Causes:
- Musculoskeletal Pain: Given that your symptoms began after the vaccination, one possibility is that they are related to musculoskeletal issues, such as muscle strain or inflammation (myalgia) in the chest or back area. This can occur due to physical activity or even from the positioning during the vaccination itself.

- Anxiety and Hyperventilation: The experience of chest pain can also be exacerbated by anxiety, which is common after receiving a vaccine, especially if there are concerns about potential side effects. Hyperventilation, or rapid breathing, can lead to feelings of chest tightness and discomfort.

- Vaccine-Related Myocarditis or Pericarditis: While rare, there have been reports of myocarditis and pericarditis following mRNA vaccinations, particularly in younger males. However, your tests (X-ray, ECG, and blood tests) have indicated that there is no evidence of heart inflammation, which is reassuring.

2. Duration and Monitoring:
- Since your symptoms have persisted for over two weeks, it is essential to continue monitoring them. If the pain worsens or if you experience additional symptoms such as shortness of breath, dizziness, or significant changes in heart rate, you should seek immediate medical attention.

- It is also advisable to follow up with your healthcare provider to discuss the ongoing nature of your symptoms. They may recommend further evaluation or referral to a specialist, such as a rheumatologist or a pain management specialist, if musculoskeletal pain is suspected.

3. Management Strategies:
- Pain Management: You mentioned being prescribed pain relievers and muscle relaxants. Continuing these medications as directed can help manage discomfort. Additionally, gentle stretching and physical therapy may be beneficial if musculoskeletal pain is confirmed.

- Breathing Techniques: Practicing relaxation and breathing techniques may help alleviate anxiety and improve your breathing pattern, which can reduce the sensation of chest tightness.

- Lifestyle Modifications: Engaging in light physical activity, staying hydrated, and ensuring adequate rest can support recovery and overall well-being.

4. When to Seek Help:
- If you experience any new or worsening symptoms, such as severe chest pain, difficulty breathing, or any signs of a heart attack (e.g., radiating pain to the arm, jaw, or back, sweating, nausea), it is crucial to seek emergency medical care immediately.

In conclusion, while chest pain and discomfort after vaccination can be alarming, they are often related to non-cardiac causes, particularly musculoskeletal issues or anxiety. Given that your initial cardiac evaluations were normal, it is important to continue monitoring your symptoms and maintain open communication with your healthcare provider for further assessment and management.

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