What Causes Severe Pain In Sternum And Heart Palpitations?

Posted on Tue, 12 Apr 2016

Question: Hi! I have been continuing a very good physical exercise regime lately including strength training. Each time before i start i do five minutes of cardio on the rowing machine to warm up. During the rowing exercise you pull quite hard. When i was really pushing myself today I experience brief fleeting pain in my sternum which i can only describe as "lightning bolt" like. I stopped and the pain went away immediately but as soon as I resumed at full strength the pain back, for a second again like a lightning bolt. I reduced the intensity and was able to continue with no problems. I then had a full workout including bench press, arms, etc where my heart rate was very high and I did not experience any issue.

I figure this has got to be something to do with the movement and pulling of the rowig machine?

I know this pain is not what angina feels like. Could Arryrhmia make this sensation or most likely nerve or some other cause?

I should add I just had an Echo last week which was totally normal. Thanks

Answered by Dr. Dr. Meriton Siqeca (23 minutes later)

Brief Answer:
Regarding your age, nothing to worry about

Detailed Answer:
Hello. Thank you for your question and welcome to Health Care Magic. I understand your concern.

First of all, I am always glad that a patient is informed about medical symptoms. You are right, this is not what anginal pain feels like. Most probably, it is palpitation. This symptom refers to slight, short-timed pain in the chest and/or a sensation of "heart jumping out of the chest" and/or sudden shortness of breath. These are normal phenomena during or post-exercise, as they are produces by extrasystoles ("skipped heart beats") - normal, benign, physiological phenomena that can happen during exercising, to everyone. Therefore, my opinion is that there is nothing to be worried about. Yes, I understand, it may be a doscomforting feeling, but the rationale is as above mentioned.

It is always normal for the heart rate and the blood pressure to increase whenever an individual is exercising, as the organism is in increased need and heart is loaded to meet its demands. Actually, your personal heart rate is expected to go up to 188 beats per minute while exercising (the formula being 220-age), and it is considered normal.

In addition, your echo cardiogram revealed normal results last week. I would recommend and encourage you to continue with your exercising activity, as it has well-known benefits, both physical and psychological.

I hope this was of help. Feel free to ask follow-up questions, I would be happy to help. Wish you a good health.

Kind regards,
Dr. Meriton

Above answer was peer-reviewed by : Dr. Naveen Kumar

Follow up: Dr. Dr. Meriton Siqeca (20 minutes later)

Thanks for the reply. That is interesting as I have never thought palpitations could cause pain and really thought it was nerve pain or something. With heart palpitations are they likely to come back the way I described them?

I wonder if this is a warning-sign or precursor to possible Cardiac Arrest? I know the framingham heart study did in fact note that palpitations during exercise and/or exercise induced had a higher sudden death rate. These happen so infrequently that when I had a holter monitor previously.

Answered by Dr. Dr. Meriton Siqeca (5 minutes later)

Brief Answer:
Welcome back

Detailed Answer:
Hi again.

They are really benign phenomena, especially in a physically active, totally healthy, with normal echo cardiogram (which gives definitive proof that a heart is structurally fine) 32-year old. If this really concerns you, you can run a resting EKG, which I assume you already did, as this simple examination, in a young person, would depict the risk of severe arrhythmias. As I said in the original answer, I would recommend you to continue exercising. Another interesting fact is that this discomforting phenomenon goes away while exercising.

I hope this helps. Please rate the answer and close the discussion, if you do not have follow-up questions.

Best regards,
Dr. Meriton

Above answer was peer-reviewed by : Dr. Naveen Kumar

Follow up: Dr. Dr. Meriton Siqeca (59 minutes later)

One last questio, we had 4-leads on my chest during the Echo would this count as a EKG?

Answered by Dr. Dr. Meriton Siqeca (6 minutes later)

Brief Answer:
Hello again

Detailed Answer:
Hello again.

Well, it is not a conventional 12-lead EKG, but as far as I am concerned, a 4-lead suffices to exclude anything wrong. Therefore, now my opinion is firm that yoi have nothing to worry about.

Regards,
Dr. Meriton

Above answer was peer-reviewed by : Dr. Naveen Kumar

Follow up: Dr. Dr. Meriton Siqeca (42 hours later)

Thank you. This is helpful information. My last question and I am sorry for the repeated questions, but i have done all sorts of research on the prognosis of exercise induced arrythmia, Pvc and Pac and underdtand in the absense of any strcutural heart disease there is virtually no change in mortalty rates although understand there has been some data that shows the other but most says no problem. I experiences another palpitation last night. I had the sensation of flip flopping , so i took my pulse and felt four very fast beats in a row followed by a pause and then normal rhythm resumed. Could these four short beats be NSVT? I have had skipped beats for most of my life during rest and have learned to live with them, as they ate very infrequent, however i worry that these will turn into VFib. What could mimic or cause the rapid four heart beats then a pause. It dirs not sound ljke SVt to me. Could do holter but events only happen once a week or so very hard to catch. Maybe i will try again. Or mayne i should just stop worrying

Answered by Dr. Dr. Meriton Siqeca (18 hours later)

Brief Answer:
Hi again

Detailed Answer:
Hello. I carefully read your follow-up.

Well, I understand that you are really concerned about these events, and that they give you a substantial amount of stress. Data will always be as statistics, and based on them, we should all, any age, be practically concerned about anything. You have undergone some tests, and all came back normal. These "spikes" may happen to anyone. It is not SVT, this is my opinion. These benign phenomena also generate anxiety to one who is experiencing them and anxiety, in turn, further promotes them. My opinion remains that you have nothing to worry about. There is a solution to the monitor. Besides the 24 hour rhythm monitor, there is an alternative and it is event monitor - just like the 24-hour rhythm Holter, only it is turned on/off by the user in the moment that extrasystoles are experienced.

I hope this helps.

Kind regards,
Dr. Meriton

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

Above answer was peer-reviewed by : Dr. Deepak