What causes chest pain despite having normal EKGs?

Question

Hi doctor,

I have been having occasional chest pain, mostly in the center of my chest, but sometimes in my abdomen, upper back, and on the left side of my chest. The pain has mostly been dull or burning. I have had blood work and two EKGs done, and all were normal. I want to rule out anything more serious. The doctor was initially concerned about pericarditis following streptococcal infection, but he has ruled that out with blood work, chest X-ray, and EKGs. It feels like the pain is in the middle of my chest most of the time, and it is sometimes accompanied by mild pain and a sour stomach in my upper abdomen, usually in the middle or left side. I have no issues when running or exercising, and seems worse when sitting or at rest. Sometimes I feel it in my upper back in the middle or left side after sitting for a while. I have lower back lumbar issues (piriformis syndrome) but seem unrelated. The worst pain level is 1 or 2 out of 10 (it is pretty mild). Sometimes it seems like breathing deeply makes the pain more noticeable. At other times breathing and position changes do not seem to make any difference. My doctor thinks it is possibly GERD, but Omeprazole does not seem to be helping much. I would like to rule out anything more serious with my heart. Please help.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

Your pain does not fit into cardiac pain. Moreover, your cardiac workup is normal. Possible causes can be musculoskeletal chest pain or related to the lungs. These pains worsen with movement and deep inspiration. Your ECG is very normal. Do you have hypertension, diabetes, or a family history of cardiac issues?

Revert with answers.

Regards.

Answer 2

Hello,

Welcome back to icliniq.com.

I understand your concern.

There is no serious cause. Serious causes of chest pain are heart attack or angina, pulmonary embolism, pneumothorax, aortic dissection, and esophageal rupture. Your symptoms are not related to any of these. Have a chest X-ray done, especially if you have a cough or fever. To prevent heart disease, I suggest the following:

Avoid smoking or drinking.
Avoid fast foods.
Avoid a sedentary lifestyle.
Avoid stress and anxiety.
Do regular exercise.
Keep body weight in control.
Eat a healthy diet (like the Mediterranean diet, and the DASH diet).
Lower sodium and refined sugar intake

I also suggest doing some tests like fasting blood sugar, HbA1c (glycated hemoglobin), and fasting lipid profile.

Hope this helps.

Kind regards.

What causes chest pain despite having normal EKGs?

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