Chest tightness - #9791

Hello , Clinical Summary: You experienced chest pain 2 months ago, for which ECG and chest X-ray were normal, and it responded well to a muscle relaxant, suggesting the cause was musculoskeletal rather than cardiac. Now, you're experiencing chest tightness and left arm discomfort again, accompanied by fear of a heart attack and physical symptoms that may be part of an anxiety or panic-related response — which is not uncommon, especially after a previous episode that left you worried. Possible Causes of Your Current Symptoms: Musculoskeletal Chest Pain (Costochondritis / Muscle strain): Often sharp, worsens with movement or deep breathing Can radiate to the arm or shoulder Responds to anti-inflammatories or muscle relaxants Anxiety/Panic-Related Chest Symptoms: Often present with tightness, palpitations, breathlessness May mimic heart attack symptoms Frequently linked to stress, fear of illness, or previous traumatic health experience Usually normal ECG and physical exams Cardiac Pain (Angina): Typically pressure-like, worsens with exertion, relieved by rest Associated with shortness of breath, sweating, nausea More likely in individuals with risk factors: diabetes, high cholesterol, smoking, high BP, family history What You Should Do Now: Don’t ignore the symptoms – While they might be anxiety-related or musculoskeletal, it’s safest to repeat an ECG and consult a physician or cardiologist for a proper evaluation. Get these checked: ECG (again) 2D Echo (to assess heart structure and function) TMT (Treadmill stress test) if recommended Blood tests: Troponin I (if current chest pain is active), lipid profile, thyroid function, vitamin D/B12 levels If anxiety is suspected: You may be experiencing a psychosomatic pattern, where anxiety causes physical symptoms. A short course of anti-anxiety treatment, relaxation techniques, and counseling can help tremendously. Meanwhile, things you can do: Avoid stimulants like excess caffeine Practice slow breathing or meditation during symptoms Keep a diary of symptoms – what triggers it, what relieves it Ensure good posture if working long hours or sleeping poorly Stay physically active (mild-moderate walking, yoga, etc.) Final Thought: Your fear is understandable, but your prior tests being normal and pain resolving with muscle relaxants points away from a cardiac cause. Still, get a cardiac evaluation for reassurance — and don’t hesitate to address anxiety, as it’s a very real condition that can mimic serious physical illness. This requires proper follow for treatment. You can consult me Dr Shayeque Reza MD 9800280276

Hi SD, Your previous chest pain was likely muscle-related since tests were normal and pain settled with relaxants. Now, the recurring fear of heart issues along with chest tightness and arm discomfort could be linked to anxiety. Anxiety often creates real physical symptoms that mimic heart problems. Still, it's important to rule out any fresh medical cause — I suggest a quick review with your physician first. If reports are clear, we can address the anxiety part and work on managing these fears. You can also book for online consultation. Dr Aman Shaba Consultant Psychiatrist 7992489808