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Tightness in chest. Is this something I should follow up on? Is this a pulmonary of abdominal issue?

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General & Family Physician
Practicing since : 1992
Answered : 47 Questions
I have something that has been bothering me for many years now that once in the past it was said to be musculo-skeletal pain I believe. My bottom of my chest area which I am pretty sure is the Xiphoid Process area has an unusual tightness that comes and goes through the years. It is not my upper chest it is specifically in that hole location bottom of the sternum. The odd thing that happens though is I if I push a little in that hole area not even too much I get a more tight feeling and seem to get out of breathe when I do it. It almost scares me when I do that and I don't even push in that much and it comes on pretty sharp the out of breathe and further tightness. The thing is I also get these sort of sinus headaches once in a while that I almost feel has something to do with it as crazy as that sounds. The reason being is if I do that push in I also feel that below top of eyes pain or towards the upper sinus areas. Is this something that I should follow-up on again with someone or a specialist and any idea what this could be such as a pulmonary or abdominal issue etc? If it is musculo-skeletal pain could these symptoms be associated?
Posted Thu, 12 Apr 2012 in Lung and Chest disorders
Answered by Dr. James M. Schwartz 29 minutes later

I am happy to help with your question.

While I normally try to avoid making a diagnosis, I am quite confident by your description that this is not a serious problem. Aches and pains of the rib cage are common. Your entire description of your xyphoid discomfort and what triggers it is very understandable. No specific treatment is either needed or even available, other than aspirin-like medications or acetaminophen (Tylenol). Your sinus issue is interesting, but again, I strongly suspect is benign. You probably do not need a specialist. There is no direct relationship between the breast bone xyphoid and the sinus. Some asthma is triggered by sinus infections, but that is the closest relationship there is between the two areas of the body. So, if your family doctor has evaluated it (always necessary) and cleared you, then I would accept it as your own variation on normal and not worry.

Dr. J Schwartz
Above answer was peer-reviewed by
Follow-up: Tightness in chest. Is this something I should follow up on? Is this a pulmonary of abdominal issue? 3 hours later
One last follow-up on this. Any possible way it could pancreas pain related based on the location and if that is behind that middle area? The reason I ask is I have in the past had elevated pancreas counts however they have come back fine in my last physical. I have had many stomach issues through life and diagnosed with IBS. So I was also wondering if it was anything stomach related that could irritate that area but again I can make it worse by pressing in that area so that seemed again more musculo-skeletal related as well. Thanks just wanted to get some second thoughts on this as it was years ago that I brought this up to my primary care but will again on my next visit just to touch base again.
Answered by Dr. James M. Schwartz 7 hours later

The description that you had provided earlier does not fit with a disease in the pancreas, as this organ sits behind the stomach (a little lower) and typically give severe pain that is also felt in the back. However, if you have had pancreatitis in the past, then this is an especially good reason to seek an office consultation with a qualified healthcare provider.

All the best.
Dr. J. Schwartz
Above answer was peer-reviewed by
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