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Suggest treatment for intermittent chest pain with shortness of breath

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Posted on Mon, 14 Dec 2015
Question: I'm having what feels like a pulling feeling in my chest where my heart is every few mins for the last 4 or 5 hrs straight. It burns and has mild pain accompanied with the pulling feelin. No extreme chest tightness or extreme laxk of breath. But mild burning pain and lack of breath for the second I'm experiencing it. Should I go to the hospital? And do u know what could this be?
doctor
Answered by Dr. Ilir Sharka (51 minutes later)
Brief Answer:
I would explain as follows:

Detailed Answer:
Hello!

Welcome and thank you for asking on HCM!

Regarding your concern, I would explain that facing your actual complaints, your chest discomfort and lack of breathing, it is necessary to perform a differential diagnosis.

Though anxiety could be an option (taking into account your young age), first, several cardio-pulmonary disorders should be ruled out/in.

As chest pain is persisting intermittently for some hours, a careful physical exam coupled with a resting ECG, chest X ray study are necessary, for investigating about an episodic cardiac ischemia, an enlarged mediastinum, and pulmonary fields.

Some lab tests, like complete blood count, PCR, cardiac enzymes (CK-MB, Troponin), AST & ALT, CPK, etc. may be helpful in differential work up.

If suspicions are raised a cardiac ultrasound would be an option.

Also a musculoskeletal disorder (costochondritis, backbone degenerative disorders), as well as shingles (herpes zoster) should be sought.

For addressing these issues a careful chest inspection, and a spine X ray study could be helpful.

GERD (gastroesophageal reflux), hiatal hernia could produce similar symptoms.

For all the above reasons, it is necessary that you consult an ER doctor (for a careful medical history interview and having those differentiating tests).

I hope that, it's just anxiety and all the above result normal.

Nevertheless, we have to be cautions in drawing the right conclusions.

That's why you need to be closely evaluated by your doctor.

Hope to have been helpful.

In case of further uncertainties feel free to discuss with me!

You can also reach me directly through the following link:
http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=69765

Kind regards,

Dr.Iliri





Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Ilir Sharka (14 minutes later)
Can this be some sort of heart attack? What about a clot of some kind. Ive been out worl and been not avtive at all for about a yr and half Have felt some tightness in my left thigh on inside. Thought it could be a pulled muscle but.could it be a clot that has moved to the lung or artery.near the heart? Im still expieremcing the slight tugging and burning sensation in my heart going on 6 hrs now. Happening every few mins or so. It is a scary.feeling. Ive had anxiety. PTSD in the past but definitely.never felt anything like this. Should I.go to the emergency room?
doctor
Answered by Dr. Ilir Sharka (18 minutes later)
Brief Answer:
You should go to ER

Detailed Answer:
Hi again,

As I explained you above above, a careful medical physical exam and additional tests are necessary in properly addressing your actual complains.

Careful attention should be paid also to your lower limbs blood vessels. If necessary a Doppler ultrasound of limbs blood vessels could be performed.

Returning to your direct question, my answer is:
Yes! You should go to the emergency room for ruling out all the above mentioned potentially dangerous health conditions.

That repeated chest discomfort (for a few minutes) doesn't seem to be an expression of any important cardiac ischemia, but we can't speculate in drawing preliminary conclusions without the necessary tests.

Regards,

Dr.Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Ilir Sharka

Cardiologist

Practicing since :2001

Answered : 8601 Questions

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Suggest treatment for intermittent chest pain with shortness of breath

Brief Answer: I would explain as follows: Detailed Answer: Hello! Welcome and thank you for asking on HCM! Regarding your concern, I would explain that facing your actual complaints, your chest discomfort and lack of breathing, it is necessary to perform a differential diagnosis. Though anxiety could be an option (taking into account your young age), first, several cardio-pulmonary disorders should be ruled out/in. As chest pain is persisting intermittently for some hours, a careful physical exam coupled with a resting ECG, chest X ray study are necessary, for investigating about an episodic cardiac ischemia, an enlarged mediastinum, and pulmonary fields. Some lab tests, like complete blood count, PCR, cardiac enzymes (CK-MB, Troponin), AST & ALT, CPK, etc. may be helpful in differential work up. If suspicions are raised a cardiac ultrasound would be an option. Also a musculoskeletal disorder (costochondritis, backbone degenerative disorders), as well as shingles (herpes zoster) should be sought. For addressing these issues a careful chest inspection, and a spine X ray study could be helpful. GERD (gastroesophageal reflux), hiatal hernia could produce similar symptoms. For all the above reasons, it is necessary that you consult an ER doctor (for a careful medical history interview and having those differentiating tests). I hope that, it's just anxiety and all the above result normal. Nevertheless, we have to be cautions in drawing the right conclusions. That's why you need to be closely evaluated by your doctor. Hope to have been helpful. In case of further uncertainties feel free to discuss with me! You can also reach me directly through the following link: http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=69765 Kind regards, Dr.Iliri