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What Causes Sharp Stabbing Chest Pains While Doing Cardio?

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Posted on Wed, 14 Jan 2015
Question: I have asked this before, but am still stuck wondering what is causing this. I exercise every-day and have very good tolerance to cardio and weight lifting.

Today when I was doing cardio (HR of 151 for 25 minutes) I experience sharp stabbing fleeting chest pain that felt very specific in origin at about 8-minutes. It was shocking/surprising so I stopped biking immediately, and the pain was gone. I was experience no shortness of breath, or dizziness etc. I continued my exercise for 12 more minutes symptom free.

I know based on extensive conversations with doctors that this is most likely not heart related, at least not CAD.

Would this be a warning sign of an exercise induced arrhythmia that could be life threatening? I am going to go for a full cardio-work-up at my annual physical but I am sure, like all times before, nothing will be found. I find it annoying that such a worriesome sharp pain could exist during cardio but can not be diagnosed.

What possible causes could there be? Should I ask for additional tests? I am worried it could turn into V-FIB.

doctor
Answered by Dr. Muhammad Ahmad (1 hour later)
Brief Answer:
It doesn't seem to be a cardiac issue

Detailed Answer:
Hello

Welcome to Health Care Magic.
My name is Dr Muhammad Ahmad & i will look into your problem.

I have gone through your query and would try to help you in the best possible way.

I understand your concern and being a Cardiology resident myself, i will hereby try to talk about differentials for your better understanding and alleviating the anxiety you must be in.

Cardiac pain:
1- They are NEVER sharp pain they are dull pains like soar muscles or a compression.
2-They start with work out and go away as you are at rest.
3- When its paining they in most case get relieved by a nitroglycerin tab under tongue.
4- Regular "work out cardiac pains" (angina) usually show up in stress testing.
5- They are very rarely present in men below 40.

Few things about V-fib:
1- It doesn't usually come with pain it come with syncope.Light headedness,cold hands and feet.
2- Rarely happen below 40 years of age.
3- Usually a patient has a history of atrial tachycardia then after 10-15 years he starts having ventricular issues.
4- They are not exercise related if one never had anything in stress testing.

SUGGESTIONS:
This seems to be a neuromuscular pain and may be there is some bad nerve in your chest which starts paining as you work out

1- See a physiotherapist who would tell you targeted exercises to make nerves and muscles of the area strong.
2- You can have a stress test done if you are anxious.
3- Angiography is the best test to see CAD
4- Holters monitoring is best to see arrhythmia.


But I don't think you are in need of point 3 and 4.You can have a complete heart work-up if it is normal, stop worrying think of your muscles at that place and take help from a PT.



Hope I have answered your query. If you have any further questions I will be happy to help if not then don't forget to close the discussion and rate it.
Wishing you good health !!

Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Muhammad Ahmad (35 minutes later)
thanks very much for the reassuring news. it seems very confusing to me that this is triggered only during cardio exercise, which is always a stationary bike in my case. its also very infrequent. I understand that ischemia relates pain follows a pretty standard pattern.

is there any exercise induced arrhythmia that cou
ld cause such an experience or sharp stabbing pain that is fleeting?

it is very troubling as since its is related to exercise it makes me afraid that something ominous will happen. the pain is not in my head.
doctor
Answered by Dr. Muhammad Ahmad (10 minutes later)
Brief Answer:
Only cardiac pain which is sharp is a pericarditis.

Detailed Answer:
Hi,
Thanks for writing back to me,
It's my pleasure that I could make you feel better, I tried to be detailed so that you could know how to differentiate between there pains.

Pericarditis:
The only sharp pain due to heart issues is a pericarditis, which is infection or inflammation of upper covering of heart, but it is so irritating a pain and it has nothing to do with exercise neither is it occasional.

CAN A MUSCLE OR NERVE PAIN OCCUR WITH EXERCISE?


YES!! if you notice you breathing like anything during exercise , normally one breaths 12 times a minute but during exercise one can go to 30-35 min which is almost double plus chest starts going deeper and there are some muscles which are not even used during normal breathing they are only used in laboured breathing, these muscles are usually responsible for exercise related pains.
And unluckily in right handed people right side of chest is stronger as you would lift every thing like your luggage bags and stuff with right side so usually left side is weaker and when put to labour left side starts paining and patient get anxious that why on earth only left side pains. These are few facts which i wanted to let to know why i ruled out your cardiac pain and why you should feel anxious.


I will just suggest you to meet a physiotherapist and discuss this issue with him they can tell you exercises which only focus that area ... and make the muscles and nerves better.

Hope I have answered your query. If you have any further questions I will be happy to help if not then don't forget to close the discussion and rate it.
Wishing you good health !!



Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Muhammad Ahmad (19 hours later)
thanks for taking the time to write such a detailed reply. I had a work-out again today and no problem as I don't 95% of the time, but when it happens it is freaky. I guess my last and final question, is there any sort of exercise induced arrythmia that would cause these symptoms? I personally did not find any nor did my doctor in person say that any existed.
doctor
Answered by Dr. Muhammad Ahmad (6 minutes later)
Brief Answer:
No there is no arrhythmia causing pain.

Detailed Answer:
Hi,
Thanks for writing back,

There are very rare incidents when arrhythmia causes pain and there are NO incidents when arrhythmia causes excruciating ,piercing pain , cardiac pain is NEVER sharp it's always like a soar muscle cramp or compression

so i would like you not to freak out when this happens it's a simple issue with muscles and nerves which can be dealt with a month of targeted physiotherapy so stay calm and take it easy.

When ever you want to ask any question in future you can go to my profile and directly ask me there, thanks for your trust, if you have more question it's my pleasure to answer

Don't forget to rate my answers and giving your feedback.

Have a great new year

Dr.Muhammad Ahmad
Resident M.D (Cardiology).


Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Muhammad Ahmad (17 minutes later)
Thank you!
doctor
Answered by Dr. Muhammad Ahmad (1 minute later)
Brief Answer:
my pleasure :)

Detailed Answer:
it's perfectly all right.
thanks for being kinds.

stay blessed :)
Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
Answered by
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Dr. Muhammad Ahmad

General & Family Physician

Practicing since :2012

Answered : 1308 Questions

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What Causes Sharp Stabbing Chest Pains While Doing Cardio?

Brief Answer: It doesn't seem to be a cardiac issue Detailed Answer: Hello Welcome to Health Care Magic. My name is Dr Muhammad Ahmad & i will look into your problem. I have gone through your query and would try to help you in the best possible way. I understand your concern and being a Cardiology resident myself, i will hereby try to talk about differentials for your better understanding and alleviating the anxiety you must be in. Cardiac pain: 1- They are NEVER sharp pain they are dull pains like soar muscles or a compression. 2-They start with work out and go away as you are at rest. 3- When its paining they in most case get relieved by a nitroglycerin tab under tongue. 4- Regular "work out cardiac pains" (angina) usually show up in stress testing. 5- They are very rarely present in men below 40. Few things about V-fib: 1- It doesn't usually come with pain it come with syncope.Light headedness,cold hands and feet. 2- Rarely happen below 40 years of age. 3- Usually a patient has a history of atrial tachycardia then after 10-15 years he starts having ventricular issues. 4- They are not exercise related if one never had anything in stress testing. SUGGESTIONS: This seems to be a neuromuscular pain and may be there is some bad nerve in your chest which starts paining as you work out 1- See a physiotherapist who would tell you targeted exercises to make nerves and muscles of the area strong. 2- You can have a stress test done if you are anxious. 3- Angiography is the best test to see CAD 4- Holters monitoring is best to see arrhythmia. But I don't think you are in need of point 3 and 4.You can have a complete heart work-up if it is normal, stop worrying think of your muscles at that place and take help from a PT. Hope I have answered your query. If you have any further questions I will be happy to help if not then don't forget to close the discussion and rate it. Wishing you good health !!