Occasional Right Chest Pain: Causes and Insights

Occasional sharp pain in the right chest?

Hello, doctor.
Recently, I have been experiencing sudden sharp pain in the area between my ribs, about three finger widths above my right nipple, which lasts for about 10 seconds before returning to normal.
A while ago, I visited the hospital and had four consultations: 1.
In the pulmonology department, I had an X-ray, and the doctor indicated there were no abnormalities and prescribed muscle relaxants.
2.
In the otolaryngology department, I underwent an endoscopic examination, and the doctor noted symptoms of gastroesophageal reflux disease.
The next day, I experienced chest pain and went to the emergency room, and then returned to the hospital for another consultation.
3.
In the cardiology department, I had an exercise electrocardiogram, and the report also indicated no abnormalities.
4.
In the hepatobiliary and gastroenterology department, the doctor diagnosed me with esophagitis and prescribed chewable antacids.
Currently, I do not have any significant pain in the center of my chest, but I still occasionally experience slight sharp pain in the area above my right nipple.
Compared to the previous week, my symptoms have improved.

Mr. Yang, 20~29 year old female. Ask Date: 2023/08/01

Dr. Guo Hongyi reply Pulmonology

Hello, the public.
Based on what you have described, you have seen various specialists but no abnormalities were found.
If the aforementioned specialties have ruled out any issues, intercostal pain is often related to muscular or neurological factors, typically caused by fatigue or poor posture.
It is recommended that you try resting and monitoring your condition, but if discomfort persists, you should seek medical attention at a hospital.
Thank you for your inquiry.

Reply Date: 2023/08/01

More Info

Understanding occasional right chest pain can be quite complex, as it can stem from various causes ranging from musculoskeletal issues to gastrointestinal problems. Based on your description, it seems you've already undergone a thorough evaluation with multiple specialists, which is a great first step in addressing your concerns.

The intermittent sharp pain you experience in the area above your right nipple, lasting about 10 seconds, could be attributed to several factors. Given that you have already consulted with a pulmonologist, ENT specialist, cardiologist, and gastroenterologist, it appears that serious conditions have been ruled out, which is reassuring.

1. Musculoskeletal Pain: One of the most common causes of localized chest pain, especially in younger individuals, is musculoskeletal pain. This can occur due to muscle strain, inflammation of the cartilage connecting the ribs to the breastbone (costochondritis), or even irritation of the intercostal nerves. The fact that your pain is sharp and lasts for a short duration aligns with this type of pain. Activities that involve repetitive movements or poor posture can exacerbate these symptoms.

2. Gastroesophageal Reflux Disease (GERD): Your ENT specialist noted symptoms of gastroesophageal reflux, which can also manifest as chest pain. GERD occurs when stomach acid flows back into the esophagus, leading to irritation and discomfort. This can sometimes be mistaken for heart-related pain. If you notice that your symptoms worsen after eating or when lying down, this could be a contributing factor.

3. Cardiac Issues: While your cardiac evaluations have returned normal, it’s important to remember that chest pain can sometimes be non-specific. If you experience any additional symptoms such as shortness of breath, dizziness, or radiating pain to the arm or jaw, it would be prudent to seek immediate medical attention.

4. Anxiety and Stress: Psychological factors can also play a significant role in the perception of pain. Anxiety can lead to muscle tension and hyperventilation, which may contribute to chest discomfort. If you find that your pain correlates with stressful situations or anxiety, addressing these underlying issues may help alleviate your symptoms.

5. Other Considerations: Conditions such as pleuritis (inflammation of the lining of the lungs), shingles (if you have had a recent viral infection), or even referred pain from the abdomen could also be potential causes.
Given that your symptoms have improved since your last visit, it may be beneficial to keep a symptom diary. Note when the pain occurs, its duration, any associated activities, and any other symptoms that accompany it. This information can be invaluable for your healthcare provider in determining the underlying cause.

In conclusion, while your symptoms may be concerning, the comprehensive evaluations you've undergone have largely ruled out serious conditions. Continuing to monitor your symptoms and maintaining open communication with your healthcare providers will be key in managing your health. If the pain persists or worsens, or if you develop new symptoms, do not hesitate to seek further medical advice.

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