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Can brief chest pain after exercise be non-cardiac?
Hi everyone,
I’m 28 and I’ve been struggling with health anxiety since I felt a very brief, sharp pain in the middle of my chest right after a short sprint a few weeks ago. The pain lasted about one second and never came back, even though I’ve repeated the same effort many times since then.
I went to the ER this morning and had:
• a normal ECG
• a normal echocardiogram
• normal blood tests and troponin
Doctors told me it was not cardiac, probably a muscle, cartilage or intercostal nerve reacting to the effort.
Even if I understand that medically everything is normal, my mind keeps telling me:
“Because it happened during effort, it must be the heart.”
My question is:
Are a normal ECG and a normal echo enough to rule out a heart problem?
Or do I still need a stress test or something more (like coronary imaging) to be fully reassured?
Thank you for your time. I really want to move forward and stop being stuck on this fear.
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It could be Gerd! Stomach acid splashing up into your esophagus.
Whoa! Take it easy. Normal tests are a good thing. Coulda' been a gas pocket. I had the intercostal thing (diagnosed after a whole day of urgent care and ER) Long time ago it was inflammation of the lung lining, pleurisy.
Don't work yourself up into an anxious fit. You can make yourself unwell that way, and your providers may get frustrated with you. Know it can happen again.
Heart attack is usually an Elephant On The Chest pain, left arm, collapsing.
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1 ReactionHello @adlin and welcome to Mayo Connect. I can understand your anxiety, and you are asking good questions! There could be many reasons for the type of pain that you experienced. I see that in the ER, they did a work-up to rule out any cardiac reasons for this pain.
Have you visited your PCP for a general physical to rule out other causes of this pain? If not, I would suggest this is a good next step for you. As @lenmayo mentioned, specific digestive tract issues (like GERD) can result in pain. In order for you to have some peace of mind, you need to explore other physical problems that may be the cause.
Do you have an appointment scheduled with your PCP for a follow-up in the near future?
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1 ReactionSpasm, gas moving along the transverse colon, intercostal muscle/ligamental pain, micro tear...who knows. The ECG is normal, so good, but if it every happens again, you can wear a Holter monitor or something similar for a week and try to replicate the circumstances each day, twice a day, to see if it happens.
No, those are only "point in time" tests. Better:
Zio test, which monitors your heart for 2 weeks. However, they do that only when something else makes them think there might be a problem, so it's used as a way to verify or confirm.
Also: hsC-Reactive protein, a blood test that predicts likelihood of heart problems. Unfortunately, doctors dismiss it, so I couldn't get anyone to take it seriously years ago when I had the first signs of heart problems (bradycardia and purple toes, even when my results went from 3 to 9 (max) over a year or so.
I understand your concern, but what you describe sounds like nothing to worry about to me. Free advice from a patient, not a clinician. 😉