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Pain in the chest after physical activity, also have breathing problems. What is causing this?

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my father is a 65-year-old man and he has occurred several times over the past few weeks. He describes his chest pain as “a heavy pressure, like something sitting on my chest.” He states that it first occurred while he was mowing the grass. He later felt the same heavy sensation while raking leaves. The pain was located in the substernal area and resolved after about 5 minutes of rest. He experienced chest pain again today while carrying some boxes that was more severe and was not relieved by resting. He attributed the chest pain to indigestion after eating, and has tried Mylanta (an antacid) with no relief.

He appears to be in no acute distress. He is alert and cooperative. His vital signs are T 37.4°C, HR 94, RR 22, BP 154/90, SpO2 99% on 3L/min O2 via NP. His skin is pink, warm and dry, with capillary refill <2 seconds in all extremities. He has a patent IVC in his left hand. His neck veins are flat at 45 degrees and no carotid bruits noted. Apical pulse rate is also 94 and regular. Heart sounds: S1 and S2, without murmur or added sounds. Lungs are clear to auscultation. Abdomen centrally obese, without tenderness or masses. Bowel sounds active in all quadrants. Full and equal strength noted in all extremities. Pedal pulses are strong. No ankle oedema.

what is causing my father's chest pain and his breathing pattern so abnormal ?
Posted Sat, 14 Apr 2012 in Lung and Chest disorders
Answered by Dr. Robert Galamaga 5 hours later
Thank you for posting your question.

I have to say that I am very concerned that your father may be suffering some degree of limitation of blood flow to the muscle of his heart.

In the list of symptoms which you have reported, there are several classic findings and features which worry me. The main feature which I am concerned about is the fact that he is suffering this chest pressure with exertion. I realize that his vital signs are stable but I am extremely concerned that he may have some narrowing of his coronary arteries.

I cannot emphasize the following enough: please take your father to the nearest emergency room or hospital for immediate evaluation. He has signs and symptoms which are suggestive of acute coronary syndrome. This can be addressed and treated successfully by a cardiologist. There is simply no reason to wait and I would suggest that you take him to his response and recommendations to be helpful and informative. Please accept my response if you have no additional follow-ups.


Dr. Robert
Above answer was peer-reviewed by
Follow-up: Pain in the chest after physical activity, also have breathing problems. What is causing this? 2 hours later

i want to know the pathophysiology of chest paina and abnormal breathing pattern that my father is suffering.

coz i am a first yr student nurse so i want to understand more.
Answered by Dr. Robert Galamaga 21 hours later
Thanks for the followup.

I understand that you are a student. I again need to emphasize that it may be a life-threatening issue that your father is dealing with so again please do not delay in taking him to the emergency room or to his doctors office for evaluation. Right now my impression that the pathophysiology of his pain is impaired blood flow to his heart due to narrowing of his coronary arteries.

Other considerations in this case would be musculoskeletal such as inflammation of the chest wall muscles or cartilage. This is referred to as costochondritis. I consider this to be less likely in his case.

Another consideratio would be impaired blood flow to his lungs due to narrowing of a pulmonary artery. This typically happens due to a clot or embolus. This is referred to as a pulmonary embolism. This can cause shortness of breath as well.

Finally and again less likely would be esophageal reflux causing chest pain. This is referreed to as a viscerosomatic pain due to the fact that his XXXXXXX organs may be contributing to the pain he is dealing with in his chest.

Again I am concerned about the well-being of your father. Please take him for evaluation as soon as possible. Evaluation will include EKG, chest x-ray, laboratory studies and possibly a stress test.

Thanks again for the query and followup. I hope you found this to be informative and please accept my answer if you have no additional followups.


Dr. Galamaga

Above answer was peer-reviewed by
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