What Causes Constant Pain, Pressure And Tightness In The Sternum?

Posted on Mon, 23 Jan 2017

Question: I am a 73 year old active adult. I cycle regularly (60 - 100 miles weekly). I take no medication. Several weeks ago, while on a bike ride in very heavy wind, I noticed that each time we rode into the wind, I had a "feeling" (a pressure? on my sternum). It subsided when not going into the wind and I thought nothing of it. Had another ride within the week (25 miles) and did not notice ANY symptoms. Then, on the next ride (in very cold conditions) I had a recurrence of the sensation. No difficulty breathing; no heart irregularity (I wear a heart monitor)...just the sensation. Next ride, I again noticed the sensation, but after 30 minutes or so, it subsided - or at least reduced by 80% - and I finished the ride with no discomfort. However, I do notice that I have a mild sensation at the sternum almost constantly. It does not restrict my activity; my resting pulse is 66 YYYY@YYYY . The ONLY thing that I did differently within this time frame was I inhaled some "essential oils" daily for a few days. Could that have created an irritation in my lungs, and what must I do to deal with this problem? **If there is any fee for this consultation, please cancel my question...no offense.

Answered by Dr. Prabhakar C Koregol (3 hours later)

Brief Answer:
Hi Looks like angina

Detailed Answer:
The sensation you are describing looks typical of angina that's discomfort related to heart and most likely due to blockages. You need to have an immediate ECG and echocardiogram and consultant a cardiologist or Atleast a physician. They should be able to start you on medicines. Also based on the examination finding and ecg echo they should be suggesting whether you should under go Coronary angiogram or treadmill test. please note this should be done urgently

Above answer was peer-reviewed by : Dr. Veerisetty Shyamkumar

Follow up: Dr. Prabhakar C Koregol (2 hours later)

If it is heart related, why am I able to "work through it" and after a brief time continue my exercises with no ill effects? I am able to actually increase my physical stress level (increase my bike speed) after the initial symptoms. If there are potential blockages, how can that be? Would I not have any additional cardiac symptoms...ie: pain into left arm, etc? Could this not be simply stress related tightening of the chest muscles? I think you are being overly protective and I understand that. However, it seems excessive to me. Why does my pulse remain steady and strong?

Answered by Dr. Prabhakar C Koregol (26 hours later)

Brief Answer:
Warm up angina

Detailed Answer:
There is an entity called Warm up angina which fits your description of symptoms.Its not necessary that all should have all signs and symptoms in typical form. It's not any one of think are believe but when it's matter of heart it's about testing and being very certain. in any cardiac evaluation there is possibility about 10% chance that evaluation may come normal. but it can be assumed only after the tests.

Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Remy Koshy