Sudden Brief Chest Pains: Heart or Other Cause?
What are the odds that sudden brief chest pains mean a pending heart attack or other heart problem like angina?
“Very brief chest pain is often non-cardiac, although this complaint requires an appropriate workup for proper evaluation,” says Lance S. Burns, MD, emergency medicine specialist, of Legacy ER & Urgent Care, Frisco East location.
A doctor wants to tell you that based on test results, your sudden brief chest pains are NOT being caused by a heart problem, rather than tell you this simply because the brief nature is not typical for pending heart attack or blocked arteries.
Dr. Burns continues, “Brief chest pain is often either chest wall or pulmonary in etiology, usually eluding a definitive diagnosis.
“The feeling of a ‘catch’ or sharp pain in the chest is very common and typically benign. The longer the pain lasts, the higher the possibility that there is a more concerning underlying etiology.
“Of note, pleurisy is a lay term describing sharp chest pain, which is worse with inspiration [inhaling] or movement.
“It is important to rule out potential life threatening diagnosis such as pulmonary embolus, aortic aneurysm, collapsed lung (pneumothorax), cardiac tamponade [collection of fluid] or coronary insufficiency.”
Sudden pain in the chest of very short duration can also be nerve or muscle/soft tissue related, stemming from a hard workout involving muscles and soft tissue in that region.
Make a note of when any sharp short chest pains occur. Is there a pattern? Are they usually the day after your chest workout or hardcore chin-up routine?
(Yes, the hanging and then pulling up causes stretching and isometric stress, respectively, on the chest muscles.) Muscle spasms can be brief and hurt quite a bit.
A ruptured or dissecting thoracic aortic aneurysm typically causes a ripping, excruciating chest pain —and it’s not brief, but it’s of sudden-onset. It’s life threatening and requires immediate medical intervention.
However, whenever anyone presents to the ER with chest pain, physicians will move fast to rule out the most serious possible causes.
Dr. Burns has over 30 years of experience, and he specializes in emergency medicine as well as family medicine. For more info: Legacy ER & Urgent Care.
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.
Top image: Shutterstock/Aaron Amat
Does Your Chest Pain Improve with Activity?
Can angina chest pain be “cured” or reversed with exercise in the absence of medical intervention?
Have you found that your chest pain tends to improve with exercise or physical activity?
Perhaps you begin with chest pain, but after several minutes or so of the activity, it begins to subside?
There could be a benign explanation such as a musculoskeletal issue, especially if the situation overall disappears after a few weeks.
However, don’t count on that. If exercise brings on chest pain, immediately see a cardiologist — even if after several minutes, the situation “gets better” or even disappears.
Don’t assume that the best thing for a heart problem that causes chest pain during activity is to keep doing the activity if you have not been medically treated for it.
“Angina cannot be cured or reversed in the absence of medical intervention,” says Lance S. Burns, MD, emergency medicine specialist, of Legacy ER & Urgent Care, Frisco East location.
“Trying to do so would be medically unwise and potentially lethal. Angina by definition is either a blockage or spasm in a coronary artery.
“Currently, the term coronary syndrome is used to describe this clinical constellation of cardiac issues.”
You can’t make chest pain from angina more medically stable by continuing to exercise even if it improves during the activity.
“It is extraordinarily dangerous to exercise despite chest pain,” says Dr. Burns.
“The thought that exercise will ‘improve the heart’ does not apply when chest pain, shortness of breath or dizziness are present.
“In this setting, the assumption is that the pain is secondary to a diminished blood and oxygen supply to the heart muscle.
“Continuing to exercise only exacerbates the inadequate blood flow and can lead to arrhythmia, permanent damage and potentially death.
“Anyone who experiences chest pain during exercise should stop immediately and seek medical attention.”
The discomfort may also be caused by a non-coronary artery issue of the heart, such as a pre-existing arrhythmia or structural defect.
Dr. Burns has over 30 years of experience, and he specializes in emergency medicine as well as family medicine. For more info: Legacy ER & Urgent Care.
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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Top image: Shutterstock/Straight 8 Photography
Chest Pain When Coughing, Possible Causes
What can chest pain when coughing actually mean?
This isn’t about chest pain that has an accompanying cough. I’m talking about chest pain that is brought on by coughing.
“Chest pain when coughing is also known as pleurisy,” says Lance S. Burns, MD, emergency medicine specialist, of Legacy ER & Urgent Care, Frisco East location.
Dr. Burns continues, “This can be from the lung lining ‘catching’ on the chest wall lining. The pain of coughing may also be secondary to direct irritation of the bronchioles.
“Further, there can be irritation of the intercostal nerves that run between each set of ribs.”
A pending heart attack or blocked arteries will not cause chest pain from movement or changing positions.
Coughing involves movement and has a positional component.
Coughing exerts pressure on the chest wall, and hence, when conditions such as soft tissue injury (like very sore or strained pectoralis muscles) or bronchioles irritation are present, the chest pain or discomfort results.
Dr. Burns has over 30 years of experience, and he specializes in emergency medicine as well as family medicine. For more info: Legacy ER & Urgent Care.
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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Top image: Shutterstock/Image Point Fr
Chest Pain Every Day except During Exercise?
Chest pain is a very common symptom that can occur every day for benign reasons but also heart related reasons.
One condition that can cause chest pain on a daily basis is gastroesophageal reflux disease (GERD). This is chronic acid reflux.
It will feel reassuring to the person who experiences chest pain nearly every day except during exercise, making them believe that it can’t possibly be heart related.
Unexplained chest pain, however, needs to be investigated by a doctor.
It may not be heart related, but may have some other serious cause such as cancer (e.g., lung, lymphoma) or a blood clot in the lung.
- The No. 1 reason that people present to emergency rooms is chest pain.
- Most of these patients are not diagnosed with a heart problem.
“There are many factors that contribute to the burden of daily chest pain,” says Lance S. Burns, MD, emergency medicine specialist, of Legacy ER & Urgent Care, Frisco East location.
“Such include the straining of chest wall muscle fibers and irritation within the lining of the lungs.
“One should always see their physician when chest pain is a concern, either daily or intermittently.”
Dr. Burns adds that “a cardiac stress test and blood work to evaluate for potential clotting may be indicated” when standard ER tests turn up negative.
“Certainly at a minimum a chest X-ray would be a useful diagnostic tool.”
What can a chest X-ray show?
A chest X-ray can help diagnose chest pain by providing images of the heart, lungs and chest wall.
It can reveal abnormalities such as:
• Fluid accumulation around the lungs (pleural effusion) or heart (pericardial effusion).
• Enlarged heart (cardiomegaly), which may indicate heart failure.
• Lung infections or diseases, like pneumonia or bronchitis.
• Collapsed lung (pneumothorax) or pulmonary embolism.
Dr. Burns has over 30 years of experience, and he specializes in emergency medicine as well as family medicine. For more info: Legacy ER & Urgent Care.
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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Top image: Shutterstock/Africa Studio
Angina in a 21-Year-Old: Could Be a Heart Problem?
If you’re 21 or around this age and think you might have angina, go see a cardiologist.
“Yes, any age can suffer from acute coronary insufficiency, even millennials,” says Lance S. Burns, MD, emergency medicine specialist, of Legacy ER & Urgent Care, Frisco East location.
Just what is angina?
It’s chest pain resulting from insufficient blood flow throughout the heart.
Blood flow in the heart takes place via the coronary arteries.
These arteries branch from the aorta (the largest blood vessel in the body) and are essential for maintaining the heart’s function and overall cardiovascular health.
An inadequate blood flow is usually caused by narrowing of the coronary arteries due to plaque buildup or the so-called clogging or blockages.
This narrowing, called atherosclerosis, results from the accumulation of fatty deposits, cholesterol and other substances, and this is collectively known as plaque.
Over time, these deposits can harden and restrict blood flow, leading to reduced oxygen delivery to the heart muscle.
Angina is more likely to occur during physical exertion (“stable angina”), when the oxygen demands of the heart are increased.
But not enough blood is getting through, due to the smaller diameter of the inner arteries, thanks to the plaque buildup.
This situation can actually be present in a 21-year-old. Note the image below depicting the reduced diameter due to plaque buildup.
Shutterstock/Explode
Dr. Burns continues, “There are multiple factors involved with early-onset coronary syndromes.
“Genetics has a significant role. Lifestyle issues, particularly smoking and drug use (cocaine), are additional risk factors.
“In women, hormonal therapy and pregnancy are risk factors.
“Prizmental’s angina, ‘coronary spasm,’ has a higher frequency in younger, otherwise healthy individuals.”
The spasm has nothing to do with arterial blockages or heart disease, but will produce the chest pain because the spasms interfere with blood flow in the heart. This can happen in a person who’s only 21.
So though it’s very uncommon for 21-year-olds to have symptomatic heart disease, it’s certainly not unheard of in the medical world.
Dr. Burns has over 30 years of experience, and he specializes in emergency medicine as well as family medicine. For more info: Legacy ER & Urgent Care.
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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Top image: Shutterstock/siam.pukkato
You Smell Like Onions Because…
A doctor explains what could make you stink like onions.
“There are multiple reasons why a person might smell like onions,” begins Kathryn Boling, MD, a board certified family medicine practitioner with Mercy Medical Center in Baltimore, MD.
“The first reason (which you have no control over) is genetics. You could have inherited a propensity to smell a certain way.
“Another reason you could smell like onions is that you have been eating onions – or other foods like garlic, shallots, etc., – that contain volatile sulfurous substances.
“These substances make their way into the bloodstream and by this route cause our sweat and other body fluids to smell like onions – especially in the 24-48 hours after eating them.”
You may not even know you’ve recently eaten onions in, for instance, a chicken pot pie.
Dr. Boling continues, “Even if you have not been eating onions, body sweat (especially under the arms and in the groin) can smell like onions when sweat is mixed with bacteria on the skin.”
Solutions
Dr. Boling explains, “You can limit this by showering regularly and preventing excessive sweating – by using an antiperspirant.
“A less common reason for unusual body odor is illness – for example kidney or liver disease.”
Dr. Boling diagnoses and treats a wide range of conditions from acute illnesses to chronic diseases such as diabetes and hypertension, and has 20 years’ experience with Mercy Medical Center-Baltimore.
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.
Brain Tumor Can Cause Smelling Something Bad that’s Not There
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Wake Up Dog Tired After Feeling Great the Night Before?
Just WHAT is going on when you’re full of energy straight through the late evening but then wake up dog tired after eight hours of sleep?
Perhaps the following has happened to you many times: All day long you’re full of energy, feeling great, and even right up to the last minute before bedtime, you still feel like you have a lot of productivity left in you, but it’s time to go to bed because you want eight hours of sleep.
You sleep soundfully; the alarm goes off after eight hours, and doggone, you feel like you’ve had only four hours of sleep, and feel like you can sleep another four hours—easily.
But you absolutely must get up to begin the new day, and furthermore, you keep reading that getting more than nine hours of sleep is associated with health ailments—even exceeding eight hours has been linked to medical problems. So you drag yourself out of bed.
Strangely, within 10 minutes, you’re beginning to feel quite awake, and you accomplish another very productive day.
Even when you’ve had seven or even six hours of sleep (having to get up early for an appointment), you feel energized throughout the day and evening and never experience drowsiness or the need for even a single catnap.
Now let’s assume you don’t ingest much caffeine, if at all. You work out and are very physically fit.
Freepik.com
And you don’t have sleep apnea (a person with sleep apnea will feel drowsy throughout the day and want to take naps).
“A person could wake dead tired for a number of reasons,” begins Kathryn Boling, MD, a board certified family medicine practitioner with Mercy Medical Center in Baltimore, MD.
“Drinking alcohol at night can interfere with sleep and cause a person to awaken tired the next day, even if they think they slept soundly,” continues Dr. Boling. But what if you don’t drink?
“Exercising too late in the evening can also interfere with sleep – as it acts as a stimulant,” she continues.
- But what if your exercise routine was earlier in the day?
- Or what if it was one of your light-day workouts? Why does eight hours of sleep feel like only four?
Why do you feel your body needs at least two more hours of sleep, and your eyes are so heavy and groggy, as you lie there in bed, dreading having to get up for the day?
Why aren’t you one of those people who have no problem exiting their bed the moment they awaken—those enviable individuals who’ve told you that if they stay in bed once they awaken, they won’t be able to fall back asleep?
Dr. Boling offers more explanations: “Eating a heavy meal late at night can also interfere with sleep and make a person feel sluggish the next morning.” But you don’t eat heavy meals late at night, right?
“Keeping the room too warm at night might cause restless sleeping and cause a person to awaken feeling dead tired.”
And what if your room’s temperature is kept at a steady 72, and what if you’ve tried other temperatures, and you continue to feel dead tired in the morning?
“We make melatonin once the sun goes down to help us sleep at the correct time and keep our circadian clock functioning properly – it’s a chemical produced primarily in the pineal gland,” says Dr. Boling.
“Exposure to a computer or TV at night reduces melatonin production as well as stimulates a nerve pathway from the eye to parts of the brain that control hormones, body temperature and other functions that could influence the quality of sleep.”
Try to get all of your eight hours of sleep between 10 pm and 6 pm.
Yes, I know that’s utterly impossible for some people, but logistically quite feasible for others. Or shoot for 11 pm to 7 am, or midnight to 8 pm as the third option.
But the later you push bedtime back, the more you’ll throw off your circadian rhythm.
Could it be psychological?
Psychological explanation should be strongly considered. Do you feel dead tired after eight hours of sleep on the first day of your vacation at the ski resort or at the tropical island?
In fact, I’m betting that on the first day of your much-anticipated vacation in Las Vegas, Spain or with beloved extended family members only a few hundred miles away, you jumped out of bed after only five hours of sleep, as wide awake as if you’d already been up for a few hours. No need for an alarm clock.
After five or six hours you naturally awakened and were minus that awful grogginess and heavy eyes, unable to drift back into slumber.
You threw off the covers and instead of dragging yourself around, excitedly bounced about as you got ready for the day.
It’s also possible that you may not actually be asleep for as much time as you think.
Does it take a long time to fall asleep because you keep reflecting upon all of your problems or tasks for the next day?
Do you wait until mornings to organize your day and figure out what needs to be done? The anticipation of this can cause trouble falling asleep.
So even though you were in bed for eight hours, you were asleep for only five; hence, why you feel dog tired in the morning.
Dr. Boling diagnoses and treats a wide range of conditions from acute illnesses to chronic diseases such as diabetes and hypertension, and has 20 years’ experience with Mercy Medical Center-Baltimore.
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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Top image: Freepik.com
Chin Muscle Twitching: Harmless or Disease?
Has your chin been twitching lately, making you scared that you might have a neurological disease?
Before I go any further with this, I want to make sure you understand that this article is about twitching muscle fibers that are located in the chin.
There are other kinds of “twitches” that can occur about the chin, such as tics.
But I’m referring to fasciculations: the firing of muscle cells by electrochemical nerve impulses.
The face is full of muscles, and this includes the area below the surface of the chin.
Just like an eyelid might begin twitching like mad one day (yes, there are muscles there), the chin may one day begin twitching.
Do not lose sleep just because your chin is twitching.
Shutterstock/LStockStudio
“Benign muscle twitching is very common,” says Kathryn Boling, MD, a board certified family medicine practitioner with Mercy Medical Center in Baltimore, MD.
Dr. Boling continues, “Usually a muscle moves because we have directed it to do so, but occasionally a muscle fiber becomes overly sensitive and will move, or twitch on its own.”
Causes of Twitching Muscles in the Chin
“This can happen because a person is fatigued, not getting enough sleep, under a lot of stress, drinking too much coffee or other stimulants, overexertion or dehydration,” says Dr. Boling.
Image: Freepik.com
And just because the muscles of the chin don’t work like the muscles of your legs and feet, doesn’t mean they shouldn’t twitch from fatigue, inefficient water intake, stress or the other benign causes of fasciculations.
Dr. Boling adds: “If muscle twitching happens continuously for days or weeks, or intermittently for more than two months, then further evaluation might be indicated.
“However, most muscle twitches are completely benign and will resolve on their own.”
Do not panic if your chin (or other body part) has been twitching for weeks or even months, especially if there are no other symptoms, namely marked muscle weakness.
The longer that you have time behind the twitching with nothing ever coming of the twitching, the more reassuring this is, but in the meantime, the rule of thumb is that there’s no need to panic.
Nevertheless, a clean bill of health by a physician, after examining you for any neurological ailments, will provide enormous peace of mind.
Dr. Boling diagnoses and treats a wide range of conditions from acute illnesses to chronic diseases such as diabetes and hypertension, and has 20 years’ experience with Mercy Medical Center-Baltimore.
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.
Top image: Shutterstock/George Rudy
Can Obesity Itself Cause a Bleeding Belly Button?
There IS a link between a bleeding belly button and being obese. The situation needs prompt treatment by a doctor.
“Obesity itself does not cause a bleeding belly button, but it may contribute,” says Kathryn Boling, MD, a board certified family medicine practitioner with Mercy Medical Center in Baltimore, MD.
Dr. Boling explains, “The most common reason for a bleeding belly button is a skin infection of some sort – bacterial or fungal.
“We all have bacteria and fungus, but usually the skin is an effective barrier. However, dry skin can crack and allow bacteria or fungus to penetrate and take hold.”
The Obesity Factor
“Because water loss is greater for obese persons (due to greater skin surface area), morbidly obese patients have significantly drier skin (and thus a less effective barrier) as well as impaired wound healing,” says Dr. Boling.
“All of this makes getting a skin infection of the belly button more likely. Also, obese patients have larger skin folds and tend to sweat more profusely due to thick layers of subcutaneous fat.
“This could cause wet skin folds to rub together and become inflamed, further breaking down the barrier function of skin.”
Dr. Boling diagnoses and treats a wide range of conditions from acute illnesses to chronic diseases such as diabetes and hypertension, and has 20 years’ experience with Mercy Medical Center-Baltimore.
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.
Can Appendicitis Come and Go or What? Doctor Explains
Can on-again, off-again severe pain in your stomach be appendicitis?
“There is controversy about this even in the medical community,” says Kathryn Boling, MD, a board certified family medicine practitioner with Mercy Medical Center in Baltimore, MD.
“Several studies have documented both recurrent acute appendicitis as well as chronic appendicitis,” continues Dr. Boling.
“One of these studies quoted the following: The perception that acute appendicitis might subside spontaneously and re-emerge with bouts of right lower quadrant pain (so-called recurrent appendicitis) has met debate and disbelief.
“Nonetheless, 10% of patients presenting with acute appendicitis report previous similar physical findings that settled without surgery.”
Causes
Dr. Boling explains, “Acute appendicitis is caused by an infection that may be preceded by the appendix becoming obstructed by a lump of feces, calcium salts or fecal debris (called fecaliths).
“There are theories as to how this could happen. Some hypothesize that the appendix might be only partially obstructed and this obstruction clears on its own or is so mild that a chronic condition ensues.
“However, the lion’s share of appendicitis is acute and requires life-saving surgery.”
So if you’ve been having abdominal or stomach pain that comes and goes, the coming and going nature does not eliminate the possibility that it’s appendicitis.
Dr. Boling diagnoses and treats a wide range of conditions from acute illnesses to chronic diseases such as diabetes and hypertension, and has 20 years’ experience with Mercy Medical Center-Baltimore.
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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