Different Causes of Chest Discomfort

Patient: Have fluttering in my chest but feels like its in my throat more at night when i lay down and when im at a fast pace the right side of my neck hurts when this happens and i feel some pressue fro my right ear down to my chest

Doctor: I had a hard time understanding your question as I am not sure if your symptoms happen all at the same time but let me t ry analyzing it. I’m not sure what you meant w/ “fluttering”? Is it like flapping waves on your chest? And also on your throat? Or would it be discomfort? It is possible you are having reflux symptoms (upward flow of acid from the stomach to the esophagus and may reach the throat, some may feel nauseated [?], acid taste in the mouth, some feels chest tightness or discomfort). The reason for this is acid from the stomach can easily slide upward when lying down than when standing or sitting up (laws of gravity). More importantly, peak acid secretion of the stomach happens at night that’s why some people wake up in the middle of the night because of reflux symptoms. Common factors associated with increased acid production (which may result to reflux) are smoking, stress, too much caffeine, among others. Heart disease, especially in older individuals can also cause chest tightness, pain on shoulder and neck; it is usually triggered by exercise or increased activity (e.g. walking on a fast pace because the heart will need to pump more). ECG and different blood tests can differentiate simple heartburn (aka reflux symptoms) from serious heart disease (e.g. impending heart attack). In your age group, an example of a common cause of heart disease is illicit drug use (e.g. methamphetamine), although there are other organic causes; an example would be a congenital heart defect that did not produce symptoms earlier as a child, only now that you’re older. To be sure that your symptoms are only benign and has no serious underlying condition, I strongly suggest to have it checked by a doctor urgently to prevent unwanted consequences.  I do hope this helps. Take care always.