Chest pain with exercise?

[Emilym80]

Hi everyone,

I hope you're all well. I'd been doing quite well this week but unfortunately I've had something of a setback :mad: I was running for the train before and it was quite cold today. I just missed the train, it left while I was validating my ticket. I sat down to wait for the next one and noticed some chest discomfort in my left side. It felt like the chest muscle was being squeezed/tight from within or something, not being pressed on, but I still began thinking immediately of angina. It felt deep down in my chest. It was pretty minor, not even bad enough to call it "pain", but I definitely noticed it! It persisted for probably a few minutes and I had a tingling feeling in my left arm and heaviness/weakness in both. I didn't google, not because I was able to resist necessarily but because I know that all it would say was "angina, see a doctor urgently etc". I'm just feeling really scared right now because I'm going to be home alone for the next few nights and so I can't be with my parents, which would usually help me relax and feel calm.

In late Jan/early Feb I had a blood test for heart conditions, 3 ECGs (two at rest, one during/after exercise) and 2 echos (one before exercise, one after). I also have some postural issues which are giving me some grief atm, nerve irritation and the like, so I'm trying to convince myself that running somehow aggravated them and is giving me some nervy pain in my arm and chest (but obviously my anxious mind won't accept that). My arms still feel weak and my left arm is still a bit tingly. I'm in pretty good health otherwise, my BP as of a couple of weeks ago was 108/70 or something like that, I don't smoke and generally eat very healthily. I also walk briskly for 40 mins/1 hr 30 every day and am 18 years old. Healthy weight. But I can't stop freaking myself out about this! I'm not searching for a diagnosis, just reassurance/similar experiences.

So if anyone feels they can reassure me, I'd really appreciate it. I thought I'd overcome my heart worries so this is a real setback for me. Thanks, guys.

[Gary A]

A fit 18 year old who doesn't smoke is highly unlikely to have angina or any other degenerative heart issues. Chances are you've strained a muscle from running or something of that nature. Having had all these tests done, which I'm assuming were all negative, then surely it's safe to say your heart is absolutely fine. Angina is caused by build ups of fatty deposits etc, smoking, having an unhealthy diet, little exercise and age are all risk factors, of which you have precisely zero.

[Emilym80]

Thanks :) I guess I'm paranoid because I haven't been eating too well over the last few weeks and I wouldn't call myself super fit- my heart was pounding after the running and the pain was different from what I've had before. But I do moderate exercise every day and yeah, the tests were all negative.

[MyNameIsTerry]

Don't forget the cold weather you mentioned.

Exercising in cold weather is different and more challenging as your body responds differently to it.

If you do moderate exercise and this was a higher intensity, it could simply be the extra workload and then your anxious mind kicking in to examine all the sensations and finding they are close to those of anxiety.

I do that. I did running exercises in ERP to explore it with my CBT therapist.

Performing more strenuous exercise can also impact in other ways. The tingling and heaviness could be due to heavier breathing, for instance.

Its also easy to create a temporary weakness in someone who doesn't exercise certain muscles e.g. carry something heavy in the same position for several minutes which can result in weakness in that arm for hours and muscle shaking.

I would write it off as just a combination of cold weather and more intensity that your symptom focussed mind latched onto as anxiety symptoms.

Going forward, in a controlled manner, build up your resistance to it.

[Emilym80]

As always, thank you Terry :)

I tried stretching my left pec and it was extremely tight, so I'm going to try and convince myself it was a combination of that and sudden exertion, as well as carrying my bag on the opposite shoulder and all of my back/neck/shoulder issues.

I also read up on angina (naughty, I know) and it says that it's usually in the centre of the chest and a feeling of squeezing or tightness or pressure, which I didn't have. So hopefully I'll be able to relax a little...

Thanks again guys :shades:

[MyNameIsTerry]

Thats sounds like muscle strain to me, Emily. What do you think, Gary?

If you perform an exercise slowly (with very little resistance) that focusses on that area, you will feel it pretty deep e.g. pushing off from a walk with that side of your body. You would find your arm would be ok, as would your shoulders (front) but then the soreness would appear in the pec muscle.

Tightness is very common in strains.

Essentially, if its this, it just means too much intensity on a muscle that wasn't warmed up ready. It may take day or 2 to go and with it being chest, you may feel a little tight there but it will go.

Sometimes even twisting can do it.

Muscle grow by tearing processes called "micro tears" and its what we all do when we work out, especially with weights. For the first 3 weeks or so, you tend to get a lot of this until your body starts to cope with the demand and heals/rebuilds more effectively.

[Emilym80]

Hey Terry,

When I push off the wall, my arm hurts and so does my pec a bit and it feels tight though the area.

I think it's all linked to my shoulder issues and pinched nerves. My muscles are weak because of postural issues too.

Thanks again :)

---------- Post added at 12:29 ---------- Previous post was at 11:13 ----------

Wow- I was reading about costochondritis and gave my rib joints around the area that I got the chest sensation from a poke. They're VERY tender and not so on the other side. Maybe that's why? Even though the pain wasn't sharp, I suppose they're interrelated. Or perhaps there's an issue with my ribs causing pectoral pain.

I'm supposed to see my GP early next week so I guess I'll mention it to her just to be safe. Best not to self-diagnose with this kind of thing.

Thanks again :)

[Alice1]

Well I ran for a train the other day and couldn't breathe, had chest squeezing and heart palps like crazy and have no idea what it is either, it wasn't just a little pain though I had to stop and grasp my chest even though I was worried about missing the train cause I couldn't go on.
If you had tests you're fine seriously. You'd know if you have heart/lung problems. :)

[MyNameIsTerry]

I think costochondritis is unlikely, Emily. That would require physical trauma and a quick run is something that is very normal to us. If you were bench pressing your max or more and it happened, it would be a possibility or having some severe coughing fits.

It is very likely that you have pulled muscles in several places as a result of running with a shoulder bad and the awkward posture that can bring. Remember these muscles are all very close together and the abs are more than the 8 pack people think of as there are important core stabiliser muscles which are pretty small.

In terms of fitness, it is now widely accepted that cross-training is an excellent way to improve the ability of a marathon runner. Those people are super fit, aren't they? Well put them on a cycle and see just how unfit they are doing that. So, now cross-training is used for runners ro incorporate cycling and it has improved their running ability.

There is a similiar issue with encouraging marathon runners to do sprint training.

The reason is the muscles they don't use and the ability to build their oxygen intake levels to beyond that of their expected exercise. Sprinters have greater ability in this respect due to the intensity so by a marathon runner doing this too, they improve their cardiovascular to a level beyond what they would normally require making their performance improve.

So, if you do a lot of brisk walking (which is great) it doesn't mean you have the fitness to run or sprint. That requires training for the extra load on the body.

[Emilym80]

Hi Terry,

Thanks again. You're probably right, but a couple of the rib joints at the sternum are very sore and tender which is why I thought it could be costochondritis. It can apparently be idiopathic too and I've been having a lot of physio treatment in that area so maybe that could cause it. But I guess I won't know for sure without asking a doctor, although hopefully it'll be better by the time I see my gp this week.

All the best :)

[MyNameIsTerry]

My GF used to have a lot of pain like this from physiotherapy following an injury. She stopped going as it made it worse.

My mum once had some back problems after a medication change. Her GP referred her for deep tissue massage which made it far worse. It emerged later that it was statins and how some people are not suited to them...strange how that took until after licencing to make it out, eh?

So, it could easily be that or combination of the too. If there is some damage being healed following physio, strenuous exercise with muscles that haven't been warmed up could make it worse.

There are possibilities for it to be something that will heal on its own in a few days so I think you need to see how it goes.