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What Causes Left-sided Chest Pain, Tightness And Blockage In Heart?

Posted on Tue, 26 May 2015

Question: I am a young boy aged 25 years. During the last six months I am having a pain in my cheast left side just below the heart. A feeling of heavy tightness and blockage. At the same time I feel pain in my left hand. A feeling like needle pins in the left hand palm. The pain increases if I travel by bus / car during jerking. I have done ECG, Cheast X-Ray, Echo cardiagram and TMT. But all the tests are OK. Kindly give me proper advise regarding my problem and how can it be cured.

Answered by Dr. Anantharamakrishnan (1 hour later)

Brief Answer:
Normal Heart / Muscle pain only

Detailed Answer:
Hi friend
Welcome to Health Care Magic

     Pain from the heart is oppressing, in central chest (and left), worse on effort, relieved by rest, may radiate to shoulders and arms, associated with sweating and so on. Your description of pain has nothing to do with heart
     TMT (Treadmill Exercise ECG) is the ideal non-invasive way to evaluate ischemia / to assess the PHYSIOLOGY (function) – to see whether the blood arriving at the heart muscle. Normal TMT has ruled out functional problem..
     Chest X-ray is non-invasive study ANAOMY (structure) – not only of heart, but also the lungs, bony cage etc. Normal X-ray along with ECHO have ruled out any structural heart problem
Your symptoms do not suggest Coronary Artery Disease (CAD).

     This is pain from chest wall muscles / spasm from stress, posture and so on – called Psycho-somatic. Over The Counter (OTC) Non-Steroidal Anti Inflammatory Drug (NSAID) like Ibuprofen will help / Muscle relaxants help. Relaxation helps. If necessary psychological assessment and assistance will help

Good luck
God bless you

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Anantharamakrishnan (16 hours later)

Doctor, the sensation i feel under the chest is not actually pain, I feel like a blockage or tightness like a narrow pipe tied with rope. When I feel this tightness just below the heart around the ribs , my left arm starts to pain and the pain gradually increases if i travel by bus. also i feel like needle pins on my left hand palm.This is happening to me since last 2 months. Just below the chest under the heart I feel this tightness like a pipe tied with rope and it is very discomfort like something blocked in there. When this tightness is not there and the muscle gets relaxed my left arm does not pain. Due to this problem I am facing great difficulty in work and journey.My TMT test have come normal and have given XXXXXXX Work Load Attained 9.6. Will an ultrasound of the whole abdomen help in detecting the cause? Or do I need to do some other tests ?

Answered by Dr. Anantharamakrishnan (1 hour later)

Brief Answer:
US may not help - yet useful to exclude & reassure

Detailed Answer:
Hi

There are no clues to suggest further investigations…
They are term pain equivalents / and need the same approach

Ultrasound not likely to give any direct diagnostic clue. Generally, it is done to exclude problems of gall bladder and liver (on the right side). It can rule out problems of pancreas, spleen and kidneys. It is useful for reassurance – to exclude, not entertain several such issues.
Endoscopy from above can evaluate the food pipe and the stomach / from below – the colon
Again, the purpose is to exclude - if your symptoms continue to persist in spite of treatment - for 2 or 3 months

Relaxation exercises and biofeedback / follow up with your general practioner will all go a long way to help

Regards

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

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar