Brief Answer:
Angina - special features

Detailed Answer:
Hello, sir! Thank you for your question and welcome to Health Care Magic. I am Dr. Meriton. I understand your concern.

Well, allow me to describe angina on detail, because it is different from all other forms of pain that can be originated in the chest or ribcage. Angina is called the pain that is generated by a narrowing or blockage within a coronary artery, reflecting the cardiac muscle suffering from low supply with oxygen and significant nutrients. It is the heart's way to "cry for help". This is a pain that starts on the mid-chest, related to various intensities of physical activity (depending on the percentage of the blockage causing it), radiates to both sides of the chest, throat, left shoulder and left arm. It is described more like a discomfort, heaviness or squeezing pain, rather than clear-cut pain. It usually goes away when you discontinue the physical activity you are engaging to. It is not related with inspiratory-expiratory cycle, nor it is with the touch of the area. On the other hand, pectoral muscle pain is generally clear-cut pain, can be related to the respiratory cycle or to the reflex of cough, and this muscles are tender to touch. Usually, a patient can tell that he/she has this kind of pain, because it is related to a recent physical activity that demands heavy breathing, where besides diaphragm, intercostal (between ribs) muscles are involved in breathing. Judging from your age of 64 years old and from your medication which I assume is for high blood pressure and (maybe) for high cholesterol levels, I, as a cardiologist, cannot just say that you have nothing to worry about, since these are all factors for cardiovascular disease. If this was angina, it would probably be triggered from your regular tennis practice. However, I would recommend some cardiac check-up tests:
- EKG: to assess the electrical and conduction systems of the heart, in resting state.
- echocardiogram: to evaluate the size, motility and function of heart valves and chambers.
- cardiac stress test: to assess the heart electrical system while engaging to physical activity, and confirm or exclude a possible blockage in your coronary arteries. If this tests results positive, a coronary angiogram would be in order, to further evaluate the blockage and decide the strategy of treating it, if present.

I hope I was helpful with my answer. Take care.
If you have follow-up questions, I would be happy to help.
If you do not, please close the discussion and rate the answer.

Best regards,
Dr. Meriton

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