I have a sudden, sharp pain in my chest. What tests do I need?

Question

Hello doctor,

I am 20 years old and have been experiencing left-sided chest pain for the past two years. The pain disappeared for a long time but has now returned, worse than before.

Over the last four months, the episodes have become more frequent, usually lasting around 30 minutes. The pain is sudden, sharp, and worsens with breathing.

I would like to know the possible causes and recommended steps or tests.

Kindly give your suggestions.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

The chest pain you are describing, sharp, left-sided, sudden in onset, worsened by breathing, lasting 20 to 30 minutes, and recurring over months, is most commonly non-cardiac at your age, but it still requires proper evaluation.

The most likely causes based on your description include:

Musculoskeletal pain (such as costochondritis or intercostal muscle spasm).
Pleuritic pain from mild lung or pleural irritation.
Acid reflux.
Anxiety-related chest pain.

In young individuals, heart-related causes are uncommon, but they should be ruled out at least once, especially since the pain has become more frequent and severe. The next appropriate steps include a clinical examination, ECG (electrocardiogram), chest X-ray, and basic blood tests.

An echocardiogram may be advised if the ECG or symptoms raise concern.

If you notice an increase in your pain with movement or deep breathing, it often suggests a chest wall origin. Seek urgent medical care if the pain is associated with breathlessness, fainting, fever, persistent cough, or radiation to the arm or jaw.

A proper evaluation from a doctor or gastroenterologist will help identify the exact cause and relieve both the pain and related anxiety.

I hope this helps.

For more queries, feel free to reach out to me anytime.

Take care and regards.