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What Causes Chest Pain And Breathing Difficulty?

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Posted on Wed, 29 Jun 2016
Question: My 18 year old son complaining of chest pain and hard time breathing. Feels like a panic attack to him. Non smoker non drug user no alcohol no asthma just left the local ER ekg shows normal sinus rhythm borderline right axis deviation was sent home after being told to see a mental health provider. Is scared to death should we be concerned no other test but chest X-ray never told us what they saw. Should he get more test?
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Answered by Dr. Michelle Gibson James (43 minutes later)
Brief Answer:
ecg would have shown if areas with decreased blood in the heart

Detailed Answer:
HI, thanks for using healthcare magic

Chest pain can originate from a structural causes or related to anxiety as suggested.

Structurally it can be related to any aspect of the chest from the skin inwards- skin, heart, lungs, esophagus, muscles , bones

Heart is the issue that persons causes the most worry. Heart related chest pain occurs because areas of the heart are not receiving enough blood. The lack of blood in these areas (ischemia), results in pain.
Ischemia would show specific changes on the ECG.

Based on what was written, these changes were not seen eg ST segment changes would be mentioned on report

This means that it is unlikely that the chest pain is related to the heart. Hearet related pain also tends to occur with activity (when heart needs even more blood) so if the pain is occurring sitting or in a resting position , then it is not likely the heart.

The chest x ray would take a look at the lungs and would also give a basic idea of the size of the heart.
If it was abnormal, it is likely that they would have indicated but if you are still concerned you can contact them for clarification.

He can see his GP who can also assess him and determine if it is related to anxiety or if there is another cause (not likely heart or lung if ecg or chest x ray normal)

If it is anxiety and it continues, then medication and/or counselling would help

If related to inflammation of the sternum, there would be tenderness on pressing it.

If related to muscles ,there would be pain on specific movements

If related to esophagus (eg reflux)- would have reflux symptoms

I hope this helps, feel free to ask any other questions
Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Michelle Gibson James

General & Family Physician

Practicing since :2001

Answered : 16808 Questions

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What Causes Chest Pain And Breathing Difficulty?

Brief Answer: ecg would have shown if areas with decreased blood in the heart Detailed Answer: HI, thanks for using healthcare magic Chest pain can originate from a structural causes or related to anxiety as suggested. Structurally it can be related to any aspect of the chest from the skin inwards- skin, heart, lungs, esophagus, muscles , bones Heart is the issue that persons causes the most worry. Heart related chest pain occurs because areas of the heart are not receiving enough blood. The lack of blood in these areas (ischemia), results in pain. Ischemia would show specific changes on the ECG. Based on what was written, these changes were not seen eg ST segment changes would be mentioned on report This means that it is unlikely that the chest pain is related to the heart. Hearet related pain also tends to occur with activity (when heart needs even more blood) so if the pain is occurring sitting or in a resting position , then it is not likely the heart. The chest x ray would take a look at the lungs and would also give a basic idea of the size of the heart. If it was abnormal, it is likely that they would have indicated but if you are still concerned you can contact them for clarification. He can see his GP who can also assess him and determine if it is related to anxiety or if there is another cause (not likely heart or lung if ecg or chest x ray normal) If it is anxiety and it continues, then medication and/or counselling would help If related to inflammation of the sternum, there would be tenderness on pressing it. If related to muscles ,there would be pain on specific movements If related to esophagus (eg reflux)- would have reflux symptoms I hope this helps, feel free to ask any other questions