Can running cause chest tightness?

Question

Hello doctor,

Five years ago, I quit smoking. I am a 34-year-old male weighing 220 pounds. I had health anxiety and underwent tests for asthma, ECG, EKG, and chest X-rays. I drank fairly often for four years, but over the last three months, the frequency increased, and I was getting really drunk. Over the past four years since my tests, I have smoked roughly one pack of cigarettes in total. Last year, I completed three marathons in three months. My son was born two months ago, and my running has slowed down to almost a halt (3 to 10 miles a week max).

Now, I am working on getting back into shape and attempting a 365-day running streak, while also quitting alcohol for that duration. Last week, I ran 16 miles, and this week I have done 20. I had a tight chest last week and went to urgent care, where my EKG results were normal. After running now, I seem to have a sore back and a slightly tight chest. I do not feel like I am gasping for air, but it seems like my breathing is a bit labored. When I take a deep breath, my chest and back feel sore. Additionally, I have OCD. Could this just be part of getting back into shape?

Please advise.

Answer 1

Hello,

Welcome to icliniq.com.

Please answer a few questions so I can assess this better. Does this occur only during exercise and is it relieved with rest? Do you still smoke? Do you have any other symptoms of gastritis or reflux, such as nausea, abdominal pain, or chest burning?

This could simply be due to heavy, unaccustomed exertion or even smoking. However, given your history of smoking, alcohol consumption, and obesity, we need to rule out a cardiac condition called chronic stable angina. In this condition, the EKG (electrocardiogram) can be normal at rest, but changes may appear during exercise. Therefore, you should get a treadmill test done. If the results are normal, we can be more reassured.

In the meantime, you should gradually increase your exercise intensity and avoid heavy activities until cardiac disease is ruled out. Also, avoid smoking and alcohol, and maintain a healthy diet by avoiding fatty, oily, and high-calorie foods.

I hope this helps.

Feel free to reach out if you have any further questions.

Thank you.

Answer 2

Hello,

Welcome back to icliniq.com.

Did you have similar symptoms during your previous treadmill tests? If so, then I do not think any further testing is necessary. These seem to be exercise-related symptoms, and the fact that you only notice them when thinking about them suggests a psychological component as well. However, if these symptoms are new, it would be advisable to repeat the treadmill test and, if possible, an echocardiogram.

I suggest the following:

Go for a walk immediately after meals instead of resting.
Eat multiple small meals rather than large ones.
Maintain regular sleep habits and avoid stress.
Include plenty of green leafy vegetables and fruits in your diet.
You can take a tablet of Domperidone and Pantoprazole 40 mg or a combination of Esomeprazole and Domperidone before breakfast, once a day for two weeks.

All the best.