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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Tightness In Chest And Rapid Heart Rate While Playing Sports?

Hello, thank you for your time. My 16 year old son has complained of sharp pain and tightness in his heart when playing sports. It s like his heart feels squeezed and beats fast and is painful. When this happens he just has to stop as he is out of breath and can t continue. Please indicate what may be the cause of this. We ve ruled out ecg, heart scan which came back perfectly normal . Can something else be the cause of this?
Mon, 24 Aug 2015
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Cardiologist,  's  Response
Hello. Thank you for your question and welcome to HCM. I carefully read your query.

Well, if it was a heart problem happening in a 16-year old boy, then EKG would confirm it, because certain cardiac conditions that are transmitted via genetic pathway, have specific signs that can be seen on EKG. Since you did not mention it, I am assuming he did not have a fainting episode. Further, the scan of the heart that you are referring to, I am assuming it is CT scan. If other scan was performed, I would recommend a CT scan of the coronary arteries.

As for these episodes, it is perfectly normal that the heart rate goes up during physical activity or psychological stress. During physical activity, it can go up to 204 beats per minute, in your son's case, and it is perfectly normal (the formula being 220-age). The pain episode he senses, can come from vigorous activity which triggers heavy breathing during physical activity, which make the diaphragm span more in every respiration cycle and also include the intercostal (between-ribs) muscles. Just to be safe, I also recommend a plain chest X-ray, to have a view of the rib cage (thorax).

I hope I was helpful. Take care.

Regards,
Dr. Meriton
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What Causes Tightness In Chest And Rapid Heart Rate While Playing Sports?

Hello. Thank you for your question and welcome to HCM. I carefully read your query. Well, if it was a heart problem happening in a 16-year old boy, then EKG would confirm it, because certain cardiac conditions that are transmitted via genetic pathway, have specific signs that can be seen on EKG. Since you did not mention it, I am assuming he did not have a fainting episode. Further, the scan of the heart that you are referring to, I am assuming it is CT scan. If other scan was performed, I would recommend a CT scan of the coronary arteries. As for these episodes, it is perfectly normal that the heart rate goes up during physical activity or psychological stress. During physical activity, it can go up to 204 beats per minute, in your son s case, and it is perfectly normal (the formula being 220-age). The pain episode he senses, can come from vigorous activity which triggers heavy breathing during physical activity, which make the diaphragm span more in every respiration cycle and also include the intercostal (between-ribs) muscles. Just to be safe, I also recommend a plain chest X-ray, to have a view of the rib cage (thorax). I hope I was helpful. Take care. Regards, Dr. Meriton