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Dr. Andrew Rynne

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What causes pain and discomfort near chest and shoulder?

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Dr. Praveen

General & Family Physician

Practicing since :2008

Answered : 1055 Questions

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Posted on Tue, 19 Aug 2014 in Accident and Emergency
Question: ECG and TMT is normal. Still have symptoms sometimes.

Hi Doctor,
I am 28 year old. I had mild pain and discomfort near chest and also had shoulder pain a month ago. I was informed to take ECG and consulted a cardiologist. I was informed that it is normal and this pain is not related to cardio. But was advised to take Lipid profile test and TMT. Again, the TMT was normal -Stage 1 BP 136/84. Stage 2 140/90. Stage 3 144/90. The resting heart rate of 196 bpm XXXXXXX to a maximum of 196 bpm. Also, test negative for Inducible Ischaemia. The doctor informed that my problem is not related to heart at all. Then, advised to meet a Orthopedician. As per Orthopedician, I did physio therapy for 10 days, but still I have pain near chest, pin point pricks and left shoulder pain. At times, it even comes to right side of the chest. So I went to cardiologist again. Doctor told that there is no further investigation required since my TMT was normal a month ago. I have fatigue, dizziness(sometimes) and fear a lot about heart attack. I become panic sometimes. I feel like something wrong is there.
I have attached TMT and Lipid profile report pics.

Is there any concern?
doctor
Answered by Dr. Praveen 3 hours later
Brief Answer:
Reports normal.Advise stress relaxation techniques

Detailed Answer:
Hi dear.Its my pleasure to take this opportunity to answer your query.

I have completely read your query and deeply understand your concern.I have gone through your reports and they are absolutely normal.Your lipids, TMT are within normal limits and there is no reason to worry.This means that this pain in non-cardiac origin and I were to attribute the above complaints to excessive stress and irrational fear which manifest as chest pain due to muscle strain/ache, & fatigue.

Heart attack is very uncommon when you have your lipids, blood pressure and glucose under control.I were to advise stress relaxation techniques like yoga, meditation, breathing exercises and regular exercise(brisk walking for 30 to 40 minutes).These reduce your stress & anxiety levels and bring peace of mind.

Hope this helps.Get well soon.

You may ask me if you have any further queries.
Above answer was peer-reviewed by : Dr. Prasad
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Follow up: Dr. Praveen 1 hour later
Thanks doctor for valuable suggestions.
Do I need to take further tests? Or is this TMT test enough. Coming to family history, my father had Heart attack. But he was continuous smoker. I am not a smoker nor I have drinking habit. I had told about family history to cardiologist. So he told me take tmt test. But I went twice to cardiologist. He told nothing to worry and told me to check with orthopedician. There I went through physio therapy because he thought I hav pain originating from cervical spine. Since physio therapy was not useful I went to other orthopedician who thinks that it could be shoulder frozen problem. But did not confirm that since I don't hav all the symptoms of frozen shoulder according to him. I do have stress. Right now orthopedician has given few tablets. Let's see. Can you suggest if I am going through right direction?
doctor
Answered by Dr. Praveen 3 hours later
Brief Answer:
This is the right direction.Nothing to worry.

Detailed Answer:
Hi dear.Thanks for writing me back.

Indeed that was a detailed history and I appreciate for the entire story that was narrated in a systematic fashion.You may continue the treatment for frozen shoulder(provisional diagnosis) as advised by your orthopedician and at the same time incorporate these stress relaxation techniques.Hope this brings down your pain and anxiety.

Feel free to post me about your health.
Get well soon.

Regards
Dr.Praveen
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Praveen 18 days later
Hi Doctor,

I have joined the Yoga classes as I felt that it may clear the breathing problems I had sometimes. I had shortness of breath/difficulty sometimes. So I joined Yoga therapy where a Yoga expert will guide you through Yoga. I have attended three classes as of now. He informed that this is due to lack of sleep and rotational shifts. I feel I have Insomnia as I am able to sleep less. I still get strange feelings like I am not breathing properly and I my mind concentrates only on how I breath. Sometimes the left side of chest(below) and shoulder keeps shaking. This doesnt happen when I am active and concentrating on other things. He has suggested to continue for one month and these problems are only temporary. The pain has reduced after three classes, but it is still there sometimes.

Do you suggest me to undergo any other tests as I have these strange problems which I never had before(prior 2 months).
Or these symptoms of Anxiety? Do I need to see anybody else?
doctor
Answered by Dr. Praveen 9 hours later
Brief Answer:
Symptoms due to inadequate sleep.Nothing to worry

Detailed Answer:
Hi dear.Thanks for writing me once again.

I am glad that you have joined yoga and have been noticing a considerable change thereafter.I would suggest you to continue the same.My choice of therapy for breathing problems along with yoga would be pranayama (breathing exercises).

Thanks for Yoga master for rightly pointing out the reason for your insomnia which is probably due to excess of stress due to shifts.Inadequate sleep results in anxiety, fatigue, irritability and chest symptoms.I would sincerely suggest to practice yoga regularly for few more weeks & observe the change within.I strongly feel that your sleep shall be restored gradually since these techniques not only relieve excess stress but also normalize your sleep hormone levels.

There is no reason to panic since your reports are perfectly healthy.No further tests are required.

Hope this answers your query.
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
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