Wait till you find out the likely cause of sharp, stabbing chest pain when all your heart tests keep coming back normal.

If you’ve been having sharp, stabbing or otherwise severe chest pain, but the doctors “can’t find what’s wrong” after giving you all sorts of tests, don’t assume nothing is wrong.

That’s because … something probably is wrong.

Probable Cause of Severe Chest Pain when Tests Come Back Normal

“This type of stabbing, ripping chest pain with normal tests is seen with acute pericarditis, especially in younger people,” says Dr. Sameer Sayeed, a cardiologist at ColumbiaDoctors of Somers, NY.

“This is an inflammation of the sac that surrounds the heart, and when it gets irritated classically causes stabbing chest pain,” continues Dr. Sayeed.

Acute pericarditis can be missed.

“Oftentimes, lab tests, EKG, chest x-ray, echo are all normal, particularly very early in the course,” says Dr. Sayeed.

“The symptoms can be anywhere from mild and brief up to a day or two, to more severe and long-lasting up to several months.”

The sharp stabbing pain may be in the middle of the chest (behind the breastbone or sternum) and/or on the left side.

Of note, the pain isn’t always of a piercing or stabbing nature. It may also be dull or aching.

In either case it may radiate to the left shoulder and even the neck. The discomfort, wherever it is located, may get worse when you inhale deeply, cough or lie down.

Other symptoms may be swelling in the stomach or a leg, weakness or fatigue, and shortness of breath which may be worse upon lying down.

If symptoms last longer than three months, the situation is considered chronic.

Treatment for Acute Pericarditis

Dr. Sayeed says, “It is usually treated with high dose NSAIDS for one month. ” A NSAID is a non-steroidal anti-inflammatory drug.

If not treated in a timely manner, it’s possible for this condition to result in a fatal heart arrhythmia or permanent scarring of the pericardium.

Though a person may prefer that any sharp or stabbing chest pain be the result of pericarditis rather than a heart attack, one must never take the mindset of “It’s just pericarditis.”

Dr. Sayeed performs echocardiograms and stress tests at the Midtown Manhattan and Westchester offices at Columbia Doctors. He is also trained in cardiac CT imaging.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.  
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