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What Causes Chest Pain When I Inhale?
Question: Hi. I am a 31 y/o male. I exercise 5-6 days a week, training for summer triathlons. I run 5-10 miles at a moderate pace, swim about 2000m, and bike 1-1.5 hours indoors when I train. Weights as well. Just did my second outdoor bike ride of 30 miles. Both times in very hilly areas. Afterwards my lungs/chest hurt on each inhale. Lasts all day and into the next. Never have this problem when doing any other exercise. My lungs do burn/get pushed on long/steep uphills. I'm wondering if I'm pushing too hard too soon, if this will cause this, or allergens/pollen as this is beginning of spring? Just want to better understand the cause, and if it is bad for me in the long run.
Brief Answer:
Kindly view the details
Detailed Answer:
Hello XXXXX,
Thanks for your query.
In your post, you have not mentioned about any past or family history of Diabetes, Hypertension, Asthma or any other recent illness.
Under such circumstances, the symptoms as mentioned in your post are most commonly attributed to:
1. Cardiovascular pathology- Investigations like ECG & Echo will be helpful in detection of the same, and a TMT (Treadmill test)/ Exercise stress test can be done to rule out Poor exercise effort tolerance.
2. Respiratory pathology- Given the medical history that you are prone to seasonal allergy, there is a risk factor for this.
And as you are having aggravation of symptoms on climbing uphill, the possibility of High Altitude pulmonary edema (caused due to non-acclimatization at high altitude) needs to be ruled out.
Investigations like X ray of chest & PFT (Pulmonary Function Test) will be helpful to rule out any basic Respiratory pathology.
3. Anemia- can also be the cause, if Cardiovascular & Respiratory investigations are within normal limits.
This can be detected with the help of a complete blood count & a peripheral blood smear study.
So, get a fresh investigation done.
I will also advice you to visit your General Physician once & get a complete clinical examination done, especially to look for any abnormal sounds in the heart or lungs.
The investigation findings need to be co-related clinically, based on which further plan of management will be decided.
Wishing you a good health.
Let me know if I need to clarify further.
Take care.
Kindly view the details
Detailed Answer:
Hello XXXXX,
Thanks for your query.
In your post, you have not mentioned about any past or family history of Diabetes, Hypertension, Asthma or any other recent illness.
Under such circumstances, the symptoms as mentioned in your post are most commonly attributed to:
1. Cardiovascular pathology- Investigations like ECG & Echo will be helpful in detection of the same, and a TMT (Treadmill test)/ Exercise stress test can be done to rule out Poor exercise effort tolerance.
2. Respiratory pathology- Given the medical history that you are prone to seasonal allergy, there is a risk factor for this.
And as you are having aggravation of symptoms on climbing uphill, the possibility of High Altitude pulmonary edema (caused due to non-acclimatization at high altitude) needs to be ruled out.
Investigations like X ray of chest & PFT (Pulmonary Function Test) will be helpful to rule out any basic Respiratory pathology.
3. Anemia- can also be the cause, if Cardiovascular & Respiratory investigations are within normal limits.
This can be detected with the help of a complete blood count & a peripheral blood smear study.
So, get a fresh investigation done.
I will also advice you to visit your General Physician once & get a complete clinical examination done, especially to look for any abnormal sounds in the heart or lungs.
The investigation findings need to be co-related clinically, based on which further plan of management will be decided.
Wishing you a good health.
Let me know if I need to clarify further.
Take care.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you very much for your detailed response. My father's side is prone to diabetes, my mother's heart disease. However both sides most live to 80's with little complications.
I have had Echos, Stress tests, etc done in the past and my results as would be expected for an athlete. I get blood and checkups regularly, or at least once a year. As I've mentioned I run up to 10 miles, swim and bike indoors regularly with no issues. I am in a close to sea level town, so the hills, although long and steep, are relatively low compared to sea level so altitude is not a factor. I travel with work most days so it is hard to see a doctor, although I will follow-up in a few weeks when I'm home.
At times yesterday evening the discomfort caused me to have to lay down. This morning I woke up and felt more of the same, a little milder. It has all of a sudden gone away in the past hour.I think there may be two things going on which is why the symptoms sometimes are intense. Please let me know what you may think of my hypothesis and offer any insight.
1. Not being acclimated to long bike rides, hills, or pollen in this region, there may have been irritation to the lungs, possibly the muscles sore from expanding going up the hills (although I am good at controlling my breathing and wasn't gasping). This could have caused some baseline irritiation.
2. When I was in high school sleeping on my desk during study hall, I would wake up with a little chest discomfort and what could only be described as air buildup in my chest. I would burp over the next 15 minutes to relieve the pressure and be fine.
At times last night and this morning that is what the discomfort felt like: air trapped in my chest, causing pressure. I did burp a little last night (i never burp), and this morning the discomfort felt more like trapped air. It also was uncomfortable (slight pain) swallowing last night (water), when I took big gulps.
Biking I am still relatively new too and I haven't perfected my form like running and swimming. Could my "hunched" position be causing this trapped air, and possibly limiting my lung capacity which is causing all this? If so, what is it that is causing this "trapped air" sensation? Solutions for if it happens again? Other hypothesis?
Thank you very much for your time.
I have had Echos, Stress tests, etc done in the past and my results as would be expected for an athlete. I get blood and checkups regularly, or at least once a year. As I've mentioned I run up to 10 miles, swim and bike indoors regularly with no issues. I am in a close to sea level town, so the hills, although long and steep, are relatively low compared to sea level so altitude is not a factor. I travel with work most days so it is hard to see a doctor, although I will follow-up in a few weeks when I'm home.
At times yesterday evening the discomfort caused me to have to lay down. This morning I woke up and felt more of the same, a little milder. It has all of a sudden gone away in the past hour.I think there may be two things going on which is why the symptoms sometimes are intense. Please let me know what you may think of my hypothesis and offer any insight.
1. Not being acclimated to long bike rides, hills, or pollen in this region, there may have been irritation to the lungs, possibly the muscles sore from expanding going up the hills (although I am good at controlling my breathing and wasn't gasping). This could have caused some baseline irritiation.
2. When I was in high school sleeping on my desk during study hall, I would wake up with a little chest discomfort and what could only be described as air buildup in my chest. I would burp over the next 15 minutes to relieve the pressure and be fine.
At times last night and this morning that is what the discomfort felt like: air trapped in my chest, causing pressure. I did burp a little last night (i never burp), and this morning the discomfort felt more like trapped air. It also was uncomfortable (slight pain) swallowing last night (water), when I took big gulps.
Biking I am still relatively new too and I haven't perfected my form like running and swimming. Could my "hunched" position be causing this trapped air, and possibly limiting my lung capacity which is causing all this? If so, what is it that is causing this "trapped air" sensation? Solutions for if it happens again? Other hypothesis?
Thank you very much for your time.
Brief Answer:
Kindly view the details
Detailed Answer:
Hello XXXXX,
Thanks for your follow up query and detailed history.
Your hypothesis can be attributed to your present symptoms.
The role of allergy cannot be ruled out, which might have caused the basic lung irritation. Symptomatic relief can be obtained with intake of antihistamine preparations like Allegra + Montelukast preparation (for maintenance therapy).
Regarding the problem of “air trapping sensation”, it can be explained on the basis of increased production of gas in the stomach secondary to increased acid production. Symptomatic relief can be obtained with intake of Pantoprazole preparations (to be taken twice a day, 30 min before meals).
So, kindly consult your Doctor for a prescription to these medications & get the basic investigations done.
It is also needed that you take certain precautions regarding your diet & lifestyle, such as:
1. Take soft, plain, non-spicy foods
2. Drink lots of water to maintain adequate hydration
3. Avoid consuming irritating substances such as acidic & rich foods, caffeine, nicotine, and alcohol.
4. Have your meals regularly and at appropriate time of the day. Do not skip breakfast & never stay hungry.
5. Keep away stress, think positive & practice meditation.
6. Avoid medicines like Ibuprofen, Diclofenac, etc for pain relief. They may further aggravate the condition.
7. Avoid staying awake late at nights. Get sufficient sleep.
There is no need to worry, you will be fine.
Please let me know if I can clarify further.
Wishing a good health.
Take care.
Kindly view the details
Detailed Answer:
Hello XXXXX,
Thanks for your follow up query and detailed history.
Your hypothesis can be attributed to your present symptoms.
The role of allergy cannot be ruled out, which might have caused the basic lung irritation. Symptomatic relief can be obtained with intake of antihistamine preparations like Allegra + Montelukast preparation (for maintenance therapy).
Regarding the problem of “air trapping sensation”, it can be explained on the basis of increased production of gas in the stomach secondary to increased acid production. Symptomatic relief can be obtained with intake of Pantoprazole preparations (to be taken twice a day, 30 min before meals).
So, kindly consult your Doctor for a prescription to these medications & get the basic investigations done.
It is also needed that you take certain precautions regarding your diet & lifestyle, such as:
1. Take soft, plain, non-spicy foods
2. Drink lots of water to maintain adequate hydration
3. Avoid consuming irritating substances such as acidic & rich foods, caffeine, nicotine, and alcohol.
4. Have your meals regularly and at appropriate time of the day. Do not skip breakfast & never stay hungry.
5. Keep away stress, think positive & practice meditation.
6. Avoid medicines like Ibuprofen, Diclofenac, etc for pain relief. They may further aggravate the condition.
7. Avoid staying awake late at nights. Get sufficient sleep.
There is no need to worry, you will be fine.
Please let me know if I can clarify further.
Wishing a good health.
Take care.
Note: For further follow up on related General & Family Physician Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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