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What Causes Tightness Around Chest?

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Posted on Mon, 14 Jul 2014
Question: I am a 77 year old man with no history of heart problems. I am a non smoker. I exercise by walking 1.5 miles every few days (3x per week) and play golf (2-3x per week). I have been feeling a very light tighteness that is not persistent but seems to be in the upper part of my chest - actually near center. It also shows in my back but again, it is not persistent. The last time I practiced golf (90 degree weather and humid), I felt some light headiness and had to rest a couple of minutes between practices. I do not experience any breathing discomfort and no discomfort in walking.
doctor
Answered by Dr. Prakash H Muddegowda (3 hours later)
Brief Answer:
Looks like Angina pectoris

Detailed Answer:
Hi,
Welcome to HCM.
I am Dr. Prakash HM and I would like to answer your query.

The tightness around your chest could be due to two causes as not breathlessness is seen.:
1. Muscle pull
2. Cardiac cause

Other causes like lung involvement can be ruled out as you do no have any breathing discomfort.

1. Muscle pull or pain would be continuous and should have some history of lifting heavy objects or pull specific to the area. As it is not persistent I wouldnt think of it now.

2. Cardiac cause - angina pectoris, present usually of short duration (30 sec to 30 min). It usually presents with chest discomfort and chest pain like pressure or heaviness. It can also be associated with shortness of breath, nausea and sweating.
I would think of angina pectoris as chest tightness is one of the earliest presentation.
Routine ECG is not contributory. You need to get a Treadmill stress test or a Stress Echo to get evaluated for this cause.

Light headiness, was possibly due to the temperature. At your age, postural hypotension could be present due to baro receptors inability to adjust the volume of blood. As it is one time episode, I wouldn't worry about it. Take rest. If persistent when you get up from sleeping position to standing, then it needs to be worried about.

Do get yourself tested as it is one of the earliest signs of possible myocardial infarction in future.
Take care.
If you have any further queries, I would be happy to help you again.

Dr. Prakash HM

Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Prakash H Muddegowda (11 hours later)
The mild discomfort seemed to travel from the upper chest to the area on my back just inside my right shoulder blade. It was a very specific location - whereas the upper chest tightness was more difficult to target. That occurred last night for about an hour (on my back) and the chest discomfort was not present. This morning, I have neither symptom, although I sense an uneasiness in the area on my back that suggests maybe it would come back if I stressed it. Does that seem like my problem might be more associated with a strained muscle?
doctor
Answered by Dr. Prakash H Muddegowda (18 minutes later)
Brief Answer:
probably not strained muscle

Detailed Answer:
Hi XXXXX,
The tightness for one hour and its specificity to night and disappearing on its own could not be a muscle strain. Muscle strain would be continuous and of throbbing type as some amount of inflammation is going to be there.
Try to get an stress ECG or a stress echo done. I wouldn't think of anything else in present scenario other than angina pectoris.
If you have any further queries, I would be happy to help you. If you do not have any, you can close the question thread and rate it.
Take care. Do get tested.
Dr Prakash HM
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

Above answer was peer-reviewed by : Dr. Vaishalee Punj
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Answered by
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Dr. Prakash H Muddegowda

Geriatrics Specialist

Practicing since :2004

Answered : 2138 Questions

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What Causes Tightness Around Chest?

Brief Answer: Looks like Angina pectoris Detailed Answer: Hi, Welcome to HCM. I am Dr. Prakash HM and I would like to answer your query. The tightness around your chest could be due to two causes as not breathlessness is seen.: 1. Muscle pull 2. Cardiac cause Other causes like lung involvement can be ruled out as you do no have any breathing discomfort. 1. Muscle pull or pain would be continuous and should have some history of lifting heavy objects or pull specific to the area. As it is not persistent I wouldnt think of it now. 2. Cardiac cause - angina pectoris, present usually of short duration (30 sec to 30 min). It usually presents with chest discomfort and chest pain like pressure or heaviness. It can also be associated with shortness of breath, nausea and sweating. I would think of angina pectoris as chest tightness is one of the earliest presentation. Routine ECG is not contributory. You need to get a Treadmill stress test or a Stress Echo to get evaluated for this cause. Light headiness, was possibly due to the temperature. At your age, postural hypotension could be present due to baro receptors inability to adjust the volume of blood. As it is one time episode, I wouldn't worry about it. Take rest. If persistent when you get up from sleeping position to standing, then it needs to be worried about. Do get yourself tested as it is one of the earliest signs of possible myocardial infarction in future. Take care. If you have any further queries, I would be happy to help you again. Dr. Prakash HM