At rest, I feel a painful tightness in my chest which ...

Have you seen a physician regarding this problem? Have you had any tests done? What were you told about this? Do you smoke? Do you have a chronic cough?

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I am 45 and a smoker. I walk a mile twice a day and ride a stationary bikee for 15 minutes every morning. Saw a Dr. a year and a half ago-- did a bunch of tests, all came out good. (stress test, ekg, cholesteral, etc).

The fact that the pain has been persistent for over a year - and seems to be worse with breathing - would tend to argue against this comming from the heart.

The fact that the symptoms are chronic would suggest that this is not related to a pulmonary embolism.

My best bet is that it is some kind of musculoskelatal problem. A referral to a physical therapist and/or a physiatrist (a physician who deals with physical medicine and rehabilitation) may be in order.

The fact that you are a smoker and 45 years old would however be factors more consistent with a cardiac (heart) problem. A negative stress test 1 1/2 years ago - would not rule out a cardiac cause. I think it is reasonable to repeat the stress test - possible a nuclear stress test looking for an evidence of ischemia (which suggests blockages)

The other thing that would be consistent with the smoking - a pulmonary problem. Chronic bronchospams may contribute to some of these symptoms. A pulmonary function test is probably also appropriate to rule this out.


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To clarify, the pain has not been persistent for a year and a half. It comes and goes, with no predictability. It does seem like it occcurs more frequently; in fact, this weekend is the first time it did not subside after a day or two.

Also, it occurs just to the right of my breastbone, beneath my front collarbone. It is not painful or sensitve to touch or manipulation, though tilting my head back seems to increase the pain level, which can be a dull pain or, as it has been since Saturday, a frighteningly sharp pain. It feels like if I took a real full breath, something would pop, or rupture.

The first time this happened, I went to the ER, with no relief or answers. Followed that up with an appointment with a Dr. at an internal medicine group here in town. Did a pulminary function test-- I performed well.

As I told you, I also did a stress test (on the treadmill that tilts) and did well. What is a nuclear stress test?

Finally, after reading your initial response, and thinking out what's been going on, I do feel fairly confident that this is not cardiac in nature.

Any response?

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