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Forum Name: Cardiology Symptoms

Question: burning - pain sensation in chest


 Andrea1960 - Thu Sep 25, 2008 7:31 pm

I have been having a pain in the center of my chest. It sometimes radiates to the left breast bone and it sometimes has a burning feeling to it, but not like heartburn. Most of the time the pain (almost a pressure feeling) is right in the middle of my chest, dead even in the middle of my breast bone. I am 48 years old and relatively healthy. I don't smoke and exercise regularly. I had an echocardiogram, ekg and stress test, all normal results. My heart rate is high most of the time and my resting heart rate appears to be around 78 - 80. I don't understand why I am having this constant pain in the middle of my chest. Any suggestions of what I should try next? I suffer from anxiety and have had anxiety for over 23 years. I know my anxiety symptoms inside and out and this is not them. When my chest tightens due to anxiety, it is different feeling, this is more of a pain, almost like a huge gas pain but I don't have any indigestion or burping.
Thank you,
Andrea
 John Kenyon, CNA - Wed Oct 01, 2008 10:06 pm

User avatar Hi Andrea -

All your cardiological tests are normal, so the problem is very likely not your heart, although I would be the last person to just wave it off as impossible. Still, it seems extremely unlikely due to the extensive workup. Because of that we need to consider what other problems can sometimes mimic heart pain. There are quite a few.

While you say this doesn't feel like heartburn, there are degrees and qualities of upper GI pain, depending on the origin of the problem. This sensation could be caused by a sliding hiatal hernia, in which a part of the stomach actually slides up into the chest through a herniation of the diaphragm. This can cause heartburn-like sensations, but can also cause varying degrees of pain and pressure not unlike that of angina, sometimes even worse. This is one thing that needs to be ruled out. Also, certain foods can trigger spasm of the esophagus that is not heartburn, but which feels almost identical to angina. There are also chest wall abnormalities and inflammations which can cause this sort of sensation. They are usually duplicable by manual pressure on the spaces between the ribs near the breastbone, and sometimes by certain movements of the upper body.

Chronic, generalized anxiety is also frequently marked by chest pain, usually sharp or stabbing in nature, and usually (but not always) confined to the area of the left breast. Faulty breathing patterns, caused by anxiety, can also cause the irritation of both chest muscles and the connective tissues between the ribs.

Finally, more and more we are seeing asthma present with chest tightness and sometimes pain as well as soreness, due to unconscious use of accessory muscles.

All that said, it should go without saying that if you should experience significant chest pain or pressure, especially if it radiates to either shoulder or arm, or to the throat, neck or jaw, and especially if accompanied by shortness of breath, nausea, faintness or weakness, one should report to the nearest emergency room anyway, as it is better to be safe than sorry. However, if the symptoms you're currently having are persistent over a long period of time, do not change, and aren't aggravated by exertion (this last is especially important), then the likelihood is great that this is either caused by anxiety or is a relatively benign problem.

I hope this helps somewhat. It's never possible to make a diagnosis from a distance, but given the negative test results and apparent stability of your symptoms all suggest this is something other than heart-related.

Best of luck to you. Please follow up with us here as needed.
 Andrea1960 - Thu Oct 02, 2008 3:31 pm

Thank you so much for your reply. It has made me feel better and helped me to the point tha I have actually began to not focus on it so much.
You do a wonderful service.
Sincerely,
Andrea

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