Brief Answer:
Maybe X-ray of the chest

Detailed Answer:
Greetings, sir! Welcome to Health Care Magic and thank you for your question. I understand your concern.

Let us go through chest pain together. But first, I am assuming that you have performed some tests which made available that doctors told you that you have "a strong heart".

Chest pain can come from a lot of reasons that are related to the within chest organs and other structures. Two most important types of pain are:

- anginal pain - pain originated from a blockage within coronary arteries and is characterized as a severe heaviness or tenderness in the mid chest, which radiates to the jaw, left arm and left shoulder; elicited by physical activity and ceased when this activity is discontinued. It usually lasts 10-15 minutes, it is not related to the inspiration-expiration cycle nor to the positional changes. To confirm or exclude this kind of pain, an EKG (to evaluate the heart electrical and conduction systems in resting state) and a cardiac stress test (the same as the EKG, only on physical activity) would be in order.

- pleuritic pain - a sharp, stabbing-like pain which is caused by acute or chronic inflammation of pleura (lining of the lungs) and/or pericardium (the lining of the heart). This kind of pain is related to the respiratory cycle and also to position switches (pain is reduced when assuming sitting up position in pericarditis and when lying down on the opposite of the inflamed pleura in pleuritis). To confirm or exclude this kind of pain a plain chest X-ray should be carried out and, in case of suspected pericardial inflammation, an echocardiogram (echo of the heart).

- costochondritis (musculo-skeletal pain) - which is pain derived from a within rib muscle soreness or skeletal pain coming from the ribs. A short course of OTC NSAIDs would help in this case, maybe 5-7 days.

Also, yes, stress can produce various spasms and, therefore, mild to moderate pain, especially when exposed to psychological stress for a long time. My opinion is that this is not the case, and it may be more related to an airway obstruction problem, at times, although not always.

As I mentioned above, I am assuming that some tests are done, since the doctors you consulted were confident that everything is fine. My personal opinion is that this is not anginal pain, neither pleuritic pain. But, the tests I mentioned are more to be totally secure to say that "there is nothing to worry about".

I hope I was helpful with my answer. I am happy to help, if you have follow-up questions. Please rate the answer, if you do not.

Best regards,
Dr. Meriton

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Brief Answer:
Hello again.

Detailed Answer:
Welcome back.

Hello again, sir! I was trying to encompass all the possible causes, with excluding the main ones. And yes, stress can cause on and off episodes of pain, because psychological stress can be "interpreted" as clear-cut pain, by the brain to a certain organic system. For every problem, refer to the original answer. Stress can also be effectively fought with physical activity. A 60-minute activity a day has proven to be effective both in the physical fitness and psychological domains.

I am really glad I was helpful.

If you do not have further questions, please close the discussion and rate the answer.

Wish you a good health.

Best regards,
Dr. Meriton

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