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What Causes Pain And Tightness In Upper Chest And SOB?
Question: My husband has pain and tightness in his upper chest which only eases when lying flat on his back. He has no pain anywhere else and it doesnt hurt to breathe but he seems short of breath. He is 46.
Brief Answer:
Chest pain is an emergency
Detailed Answer:
Hello,
You haven't mentioned some useful details regarding his pain like when it started, how it started (what was he doing at that moment), if something makes it worse or not, if it's steady or fluctuating in intensity, if other symptoms accompany the pain (like nausea, vomiting, cold sweating etc).
Chest pain is feared because it is sometimes related to serious diagnosis like the acute coronary syndrome, the pulmonary embolism, pericarditis etc.
Some characteristics of the acute coronary syndrome include a chest pain (or tightness) that usually involves the center of the chest but may radiate to the upper abdomen, left shoulder and arm, jaw and neck and to the back. The pain gets worse with physical activity and is relieved or attenuated with rest. Common accompanying symptoms include cold sweating and nausea.
Patients with coronary syndromes usually have one or more risk factors like smoking, hypertension, diabetes, increased lipid levels, a close relative that had a heart attack in a young age (<55 years for men or <65 for women) etc.
No diagnosis can be safely reached with the provided information. An urgent electrocardiogram and chemistry tests are needed to exclude the most serious diagnoses. Please conduct a cardiologist as soon as possible.
If - on the other hand - his condition does not look at all like the one described above and you'd like to provide more information, I'd be happy to explain things in greater detail.
Kind Regards!
Chest pain is an emergency
Detailed Answer:
Hello,
You haven't mentioned some useful details regarding his pain like when it started, how it started (what was he doing at that moment), if something makes it worse or not, if it's steady or fluctuating in intensity, if other symptoms accompany the pain (like nausea, vomiting, cold sweating etc).
Chest pain is feared because it is sometimes related to serious diagnosis like the acute coronary syndrome, the pulmonary embolism, pericarditis etc.
Some characteristics of the acute coronary syndrome include a chest pain (or tightness) that usually involves the center of the chest but may radiate to the upper abdomen, left shoulder and arm, jaw and neck and to the back. The pain gets worse with physical activity and is relieved or attenuated with rest. Common accompanying symptoms include cold sweating and nausea.
Patients with coronary syndromes usually have one or more risk factors like smoking, hypertension, diabetes, increased lipid levels, a close relative that had a heart attack in a young age (<55 years for men or <65 for women) etc.
No diagnosis can be safely reached with the provided information. An urgent electrocardiogram and chemistry tests are needed to exclude the most serious diagnoses. Please conduct a cardiologist as soon as possible.
If - on the other hand - his condition does not look at all like the one described above and you'd like to provide more information, I'd be happy to explain things in greater detail.
Kind Regards!
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
He woke up from sleep (2am) with the pain which is accompanied with a dull ache down the left side of his back. The pain gets worse when he sits leaning forward and eases when he lies flat on his back to stretch his chest out. Otherwise the pain does not change and has not worsened since Thursday.
Thanks for your help.
Thanks for your help.
Brief Answer:
Please exclude serious diagnoses
Detailed Answer:
Hello,
thanks for providing more information.
Any pain that awakens the patient is considered serious although the rest of the details do not confirm it. Heart related pain usually does not last that long unless pericarditis is the cause but pericarditis causes more pain when lying down and is releaved by leaning forward!
Musculoskeletal problems cannot be excluded as the source of pain but these are not serious and only cause discomfort.
Since you mentioned the left side of the back there's a possibility for herpes zoster. Herpes zoster causes pain that spreads like a belt round the half of the body. The skin lesions may appear after several days have passed.
I would insist on a fast assessment for the heart related causes since they are much more serious than anything else.
An electrocardiogram and a troponin and d-dimers assay would exclude most major causes.
I wish that everything goes well for him!
And I hope I've helped!
If you have more questions on this subject, please ask.
Kind Regards!
Please exclude serious diagnoses
Detailed Answer:
Hello,
thanks for providing more information.
Any pain that awakens the patient is considered serious although the rest of the details do not confirm it. Heart related pain usually does not last that long unless pericarditis is the cause but pericarditis causes more pain when lying down and is releaved by leaning forward!
Musculoskeletal problems cannot be excluded as the source of pain but these are not serious and only cause discomfort.
Since you mentioned the left side of the back there's a possibility for herpes zoster. Herpes zoster causes pain that spreads like a belt round the half of the body. The skin lesions may appear after several days have passed.
I would insist on a fast assessment for the heart related causes since they are much more serious than anything else.
An electrocardiogram and a troponin and d-dimers assay would exclude most major causes.
I wish that everything goes well for him!
And I hope I've helped!
If you have more questions on this subject, please ask.
Kind Regards!
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
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