Hi, so I was in gym class a and had pain in side

Patient

Q: Hi, so I was in gym class today and we were doing an eight minute very light jog. After about one minute of very light jogging, I started to get a light side stitch. I thought it was just going to pass, so I kept running while pressing the pained area. After about 5 minutes, the pain got unbearable. It was in the heart area. And when I breathed, it hurt a lot, so I had to keep extremely short breaths. I have gotten side stitches in the past, but not this painful. I am a good runner and get around level 8 in the beep test without any pain. So as the pain continued, I tried to get breath by putting my hands on my head. The pain only temporarily stops when I stretch my arm up and to the right; the opposite side of the pained side. And it took a very good 20 minutes after I stopped running and I was in one spot playing some badminton. I'm not sure what to make of this. Do I have a weak heart? I usually don't get side stitches anymore. Thanks for your answer.

Doctor

A:   Hello.
Welcome to Ask The Doctor.

I understand your concern.
I have following diagnosis for you:
1. Muscular Pain
2. Cardiac Chest pain.
3. Acid reflux.
It is important to differentiate between the all as the treatment course is entirely different.
The Muscular chest pain aggravates with movement. It is dull, diffuse and continuous in nature.
However, the Cardiac chest pain is severe and crushing in nature. It increases on activity like walking, exercising. It also radiated to left arm.
In such scenario, I would advise you to get an ECG and Chest Xray done. This will give an idea that pain is cardiac in nature or not.
If the ECG and Chest Xray are normal, the pain is probably Muscular or due to Acid reflux.
For acid reflux, I would advise you to take a combination of Pantoprazole and Domperidone once a day.
I advise following to my patients in case of Muscular pain:
1. To do hot fomentation over the involved area 3-4 times a day.
2. To apply Diclofenac Gel locally over the involved area.
3. To take anti-inflammatory and analgesic pain killer like Ibuprofen, Etoricoxib.
On taking this treatment, this usually resolves in 5-7 days.
Share my opinion with your doctor before acting upon it.

I hope it helps.
Stay Healthy

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