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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Tightness And Pain In The Chest?

Hello. I have had chest pain for the last few days. It is right under the breast bone and feels like a painful tightness - not better after rest, worse when I cough or laugh. I am a 29 year old overweight female (215 lbs and 5'5") and my uncle had a heart attack at 50 but besides that no heart trouble in my immediate family. I had my blood drawn and blood pressure taken a few weeks ago and it was normal but I am apparently very low on vitamin B 12, and also low on vitamin D, Calcium, and Iron. I do not exercise very much and was in much better shape about three years ago but still walk on the treadmill at a mild pace a few times a week. The pain does not appear to be getting worse or radiating but I am getting scared. I have terrible medical coverage but if I need to go to the ER I will go. Please help?
Fri, 26 Sep 2014
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General & Family Physician,  's  Response
Greetings Madam.

I'm glad that i am able to guide you regarding discomfort felt as CHEST PAIN.

My opinion after reading your query is that since the chest pain felt like tightening,not getting better after rest,worse when cough/laugh(as per your details) along with risk factors of No exercise,Family History of heart problem, it could most possibly a CARDIAC(heart) related attack.

But i want to know:
1.Do you have throat pain with Fever attack in recent past/present ?
2.Was it associated with swollen joint pain ? Is the pain shifting from one joint to other?
3.Do you experience any uncontrolled movements of arms, legs, or facial muscles?

Why i am asking was that these questions help doctor to narrow down your diagnosis.

Though it may be of cardiac type pain, it's necessary to rule out other NON-CARDIAC causes also viz., Chest Muscle-Lung-GastroIntestinal problem etc.,

Well Usually the first part of the evaluation of chest pain includes obtaining an ECG/EKG & a review of the recent history of events prior to the onset of the chest pain.

The treatment proceeds differently for Cardiac&Non-Cardiac causes.

So my best advise for your betterment is that visit a doctor at the earliest, get examined & do necessary investigation to know exact reason behind your discomfort & avoid further complication.

Note:
Finally it's just a guidance. Not a definitive treatment as i haven't seen you personally. You've to realize that these are temporary remedies. We don't know what your exact condition is unless we see you personally.Consult your Doctor if you still feel uncomfortable in spite of knowing above possibility.

Hope i guided you right & it helped.
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General & Family Physician,  Dr. Amarnath's  Response
welcome to hcm,
chest pain not radiating and not associated with sweating is most probably because of costochondral pain (muscular pain)or gastritis and it is unlikely to be of heart disease
but i want you to be evaluated with an ecg or EKG to confirm.
NSAIDS will be enough if it a costochondral pain
evaluate with an ECG and review if necessary.
hope this finds useful
with regards
Dr.Amarnath
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What Causes Tightness And Pain In The Chest?

Greetings Madam. I m glad that i am able to guide you regarding discomfort felt as CHEST PAIN. My opinion after reading your query is that since the chest pain felt like tightening,not getting better after rest,worse when cough/laugh(as per your details) along with risk factors of No exercise,Family History of heart problem, it could most possibly a CARDIAC(heart) related attack. But i want to know: 1.Do you have throat pain with Fever attack in recent past/present ? 2.Was it associated with swollen joint pain ? Is the pain shifting from one joint to other? 3.Do you experience any uncontrolled movements of arms, legs, or facial muscles? Why i am asking was that these questions help doctor to narrow down your diagnosis. Though it may be of cardiac type pain, it s necessary to rule out other NON-CARDIAC causes also viz., Chest Muscle-Lung-GastroIntestinal problem etc., Well Usually the first part of the evaluation of chest pain includes obtaining an ECG/EKG & a review of the recent history of events prior to the onset of the chest pain. The treatment proceeds differently for Cardiac&Non-Cardiac causes. So my best advise for your betterment is that visit a doctor at the earliest, get examined & do necessary investigation to know exact reason behind your discomfort & avoid further complication. Note: Finally it s just a guidance. Not a definitive treatment as i haven t seen you personally. You ve to realize that these are temporary remedies. We don t know what your exact condition is unless we see you personally.Consult your Doctor if you still feel uncomfortable in spite of knowing above possibility. Hope i guided you right & it helped.