Dear Ask The Doctor: I'm a 34 year old male.(6'2 235lbs) I have been having tight chest pains off and on for the past 10yrs or so. I have been to a Cardiologist (when I was 25) and did a bunch of tests (EKG,Stress,Blood Ect) and he said I was fine. I have not had any pains for about a year or so until last night. I always get them at night while watchin tv, just before bedtime. It feels like my chest has a lump in the middle of it and its hard to breath. I usually roll around in bed in pain for a few hours and it goes away. When I have a drink of water it feels like it moves or weakens for about 10secs then comes back. I went to my Doctor and she said I was fine. I have a history of heart disease in my family, I lost my Dad when he was only 56 of his second heart attack. Any Ideas??
Dear Patient: There are many causes of chest pain, including pain arising from the heart, lungs, upper gastrointestinal system and chest wall. Cardiac chest pain is typically worse on exertion and is often associated with shortness of breath. Based on the history you provide, cardiac chest pain seems an unlikely diagnosis because your pain occurs at night, while at rest. It may be helpful to note in a diary how often the pain is occurring, at what time of the day, what you are doing when the pain starts, how long it lasts for and what relieves the pain. I would advise attending your family doctor, with a diary of your symptoms, to obtain a diagnosis for your symptoms.