Chest Pains in my 20s

[tesspr]

So I am a 20 year old female in relatively good health. I am overweight, but I have normal blood pressure and heart rate(between low 70s to low 90s) without any underlying heath conditions. However, this past October while away at school I started to experience some chest pain. The next day at the gym after running for a short period of time, my chest pain returned and hurt much more. I decided to go to an urgent care where they took an x-ray and told me my heart was enlarged and boot shaped and it looked as if I'd had a heart attack in the past. (this was extremely strange to me considering I was only 20 and never had any chest issues before). They sent me straight to the hospital where they did an EKG that showed an incomplete RBBB, but sent me home because they were not concerned and that I was stable. I then went to my family doctor who had me get another x-ray and EKG done. My doctor confirmed that this x-ray was completely normal (not enlarged OR boot shaped) and that my EKG was fine as well. To be sure, he had me wear a heart monitor for four weeks, which came back completely fine. He believed my chest pain was due to anxiety (I was diagnosed with generalized anxiety at a very young age and have recently been diagnosed with mild depression). I decided to get a second opinion on my EKG and was told that the doctor did in fact see an incomplete RBBB, but he didn't think there was any reason to be worried about it. Now, I have been having more chest pain and recently experienced left arm numbness, shoulder blade pain, and dizziness, only at night and when I am at rest. The chest pain recently has been sharp in the middle of my chest and intermittent but this has only happened once. Should I get reevaluated with these new symptoms? Could these pains be heart related or anxiety related? I've had panic attacks before but only once or twice, so I'm not sure if that could be it as well. It's difficult because I feel like I've been told a hundred different things and I'm not sure who I can totally believe. I have also been trying to lose weight but I am so scared to start exercising again in fear I will have more chest pain. Any input is greatly appreciated!!!!

[2210485]

Your pain sounds much less cardiac and concerning in consideration of this new info; which is good.

I would still throw a holter on at least and see what comes up. But that’s just me. Im big on holters for pretty much everyone anyways. I’d probably also stress just to be safe.

I wouldn’t expect to see anything on the stress based on what you’re saying. However these are very Easy, safe and non-invasive tests. There’s not really much argument for NOT doing them apart from conserving resources.

Dizziness is always an interesting symptom here, perhaps Moreso than pain. You say all of this only happened once though which is reassuring but certainly if you have a problem with that dizziness coming back more than once or twice it would be of real interest to figure out what’s going on there.

Could it be anxiety? I mean sure, of course it can! That’s sort of a diagnosis of exclusion though in my opinion.

I would request a second opinion or get a referral for cardiology to screen for ectopy  and ischemia just for the sake of being thorough; if within your means.

[tesspr]

I wore a heart monitor for about 3-4 weeks back in November and it didn’t show any abnormalities in my heart rhythm or anything. I will definitely be getting a second opinion and looking into seeing a cardiologist. Thank you for your input!!

[2210485]

This sounds like a concerning bit of symptoms. Honestly you  may need a stress test and echo to be safe. You should absolutely get this re-evaluated.

This arm numbness, is it worse on the side of your arm with your thumb or the side with the pinky? Or is it perhaps the entire arm?

Can you also elaborate on what exactly you mean by “intermittent” chest pain in as much detail as possible?

Do you have any sudden death of heart problems in the family that you know of?

What sort of doctor looked at your ekg? A cardiologist? Do you happen to have a copy you can upload into a drive link?

What is your ethnic background? Try to be detailed as possible as it’s relevant for genetics.

And Lastly, describe this sensation of dizziness more.

[tesspr]

I only had the arm numbness once and it was pretty much the entire arm, but I haven't had that issue since then.

By intermittent I mean the chest pain is very short and very sharp, lasting less than ten seconds before going away. Sometimes I'll have another pain but they're a few minutes in between at least and always just in one spot when it happens, but I have felt this pain in many different spots, but not all at once if that makes sense.

I don't have any heart problems in my family besides my younger cousin who was born with a heart defect, a hole in her heart. Other than that, none of my family members have died due to heart issues.

My first EKG was done at an urgent care where the dr said there was a RBBB. Then, a doctor from the hospital also did one and it also showed a RBBB. I had my primary family doctor do an EKG which came back normal, and another family doctor from a different office who looked at the EKG from the hospital and said he also saw the RBBB. I have not seen a cardiologist because my primary care doctor firmly believes that the issue is not my heart, but anxiety. Unfortunately, I do not have a copy I can upload.

My ethnic background is just about 100% Caucasian.

The dizziness has only happened once, just like the arm pain. I was laying in bed when I started having chest pain and the dizziness came on suddenly. I was able to get a drink of water and go to the bathroom and once I laid down in the dark the dizziness went away.

[tesspr]

I should add that I don't have this pain while I exercise, it is almost always at night and if it is during the day, it happens when I am not active. I have recently done a workout and my chest didn't bother me at all even though it was giving me some issues about half an hour before hand.

[SassyLassie]

Hello~Chest pains, no matter what the cause, can indeed be scary. Sometimes they are muscular, but that type usually hurts when touch certain areas that are hurting, and also, are usually confined to just one spot and not spread over the entire area.  Have you been checked for costochondritis, it can mimic heart attack pain, but it is muscular, it means inflammation in the ribs and rib cage area. I would certainly ask about this. Here is a link to some info about, it is from a reputable site:  https://www.mayoclinic.org/diseases-conditions/costochondritis/symptoms-causes/syc-20371175

As to going to the ER, I believe that if these symptoms are new, and enough to bother you, then yes, I would certainly go, it is better to be safe than sorry. I am sorry you are getting so many conflicting diagnosis, I would imagine, the doctors are  not use to someone young like you having issues, but sadly, it can happen, although rarely.

I hope you feel better soon and that the physicians will be able to get to the root of the cause.

[tesspr]

I haven't asked about costochondritis, but after reading about it it seems pretty similar to what I'm experiencing. I'm also wondering about teitze syndrome since that affects more people around my age. Thank you for your response it was very helpful!