Left Chest Pain: Symptoms, Causes, and Concerns - Pulmonology

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Left chest pain can be a concerning symptom, and understanding its potential causes is crucial for appropriate management. Based on your description, the pain you are experiencing is localized to various areas of the left chest, including beneath the collarbone, the middle of the chest, and near the armpit. The sensation of being "squeezed" or "gripped" in the chest, along with episodes of rapid or irregular heartbeat, adds complexity to your symptoms.

Given your medical history of hypothyroidism and mild mitral valve prolapse, it is essential to consider these factors when evaluating your symptoms. Hypothyroidism can lead to various cardiovascular issues, including changes in heart rate and rhythm. Mitral valve prolapse, while often benign, can sometimes cause palpitations and chest discomfort due to the abnormal movement of the valve leaflets during the heart's contraction.

The timing of your symptoms, occurring primarily in the evening, could suggest several possibilities. One potential cause is gastroesophageal reflux disease (GERD), which can lead to chest pain that mimics cardiac pain. Although you mentioned controlling your diet and avoiding caffeine, it is still possible for GERD to cause discomfort, especially if there are underlying factors such as delayed gastric emptying or esophageal motility issues.

Another consideration is anxiety or panic attacks, which can manifest as chest pain, palpitations, and a feeling of tightness in the chest. Stress and anxiety can exacerbate these symptoms, particularly in the evening when the body may be winding down from the day's activities.

Musculoskeletal issues should also be considered, especially if the pain is reproducible with palpation. Conditions such as costochondritis or muscle strain can cause localized pain in the chest area. These conditions are often exacerbated by certain movements or positions and can be mistaken for cardiac-related pain.

It is also important to rule out any cardiac-related issues, especially given the symptoms of palpitations and the history of mitral valve prolapse. While your pulse is normal, it would be prudent to undergo further evaluation, including an electrocardiogram (ECG) and possibly an echocardiogram, to assess the function of your heart and the mitral valve.

In summary, your left chest pain could be attributed to a variety of causes, including gastrointestinal issues, musculoskeletal problems, anxiety, or cardiac concerns. Given the complexity of your symptoms and your medical history, I recommend consulting a healthcare professional who can perform a thorough evaluation, including a physical examination and appropriate diagnostic tests. This will help to clarify the underlying cause of your symptoms and guide you toward the most effective treatment options. If symptoms worsen or you experience additional concerning signs, such as shortness of breath, severe pain, or changes in consciousness, seek immediate medical attention.