Do you get chest pain or what feels like angina that comes and goes, literally hurting one second then going away the next, like intervals?

“By definition, angina occurs when the oxygen supply to the myocardium is not adequate to meet the demand,” says Monica Reynolds, MD, a cardiologist with ColumbiaDoctors Medical Group in White Plains, NY.

“Theoretically, this can occur for a second or so, or it can last hours until ischemia (myocardial strain from oxygen deprivation) becomes infarction (myocardial cell death from prolonged oxygen deprivation),” continues Dr. Reynolds.

“Some patients are very attuned to their symptoms and can differentiate angina from non-cardiac aches.  Symptoms will vary.  Anything is possible.”

Non-cardiac conditions can cause a chest pain or ache that smarts or comes and goes like a light blinking on and off.

Two such conditions are esophageal spasms and muscle spasms. It’s not well-understood what triggers esophageal spasms, but muscle spasms are usually caused by fatigued muscles from a workout.

These non-cardiac and benign conditions can cause a smarting on-and-off chest pain that’s alarming, and each wave of chest pain may last only a second or so.

Another potential source of a “smarting” type of pain that seems near or in the chest is a gas bubble or fecal matter moving through the GI tract.

Transient irritation of nerves can also cause an intermittent pain in or near the chest.

“Angina usually occurs under emotional or physical stress when the heart is beating faster and harder and needs more oxygenated blood into the coronary arteries, but which cannot be provided by the partially blocked arteries,” explains Dr. Reynolds.

“Angina theoretically can also occur when there is a minor plaque rupture and blood flow is transiently disrupted.”

If you’ve been having chest pain that blinks on and off, lasting only seconds or even one second at a time, especially if you fear angina, get a complete cardiac exam by a cardiologist.

Before you see the doctor, however, it would be wise to document if anything triggers these episodes of smarting chest pain, e.g., do they tend to occur the day after heavy bench pressing?

Does it occur only upon inhalation? This suggests a musculoskeletal cause or possible inflammation of the sac around the lungs. Does the chest pain occur only upon exhalation? This suggests a musculoskeletal cause.

Since 1992 Dr. Reynolds has practiced clinical cardiology at ColumbiaDoctors Medical Group, one of the largest multi-specialty practices in New York State.
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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