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Possible causes of chest pain...

by (2318)
Updated about 12 hours ago
Created February 05, 2014 at 2:55 AM

I'm a 26 yo female. Up until this august I was extremely active (probably over doing it) and now I can't seem to do any type of extended activity without feeling wiped out. I took off a few months (just took it easy) and tried to focus on myself. The problem is now I seem to have become very anxious (it's disrupting my life) and I can't tell if I've become anxious due to the symptoms of something medically related OR if the anxiety itself from stress causing the symptoms.

I've been having chest pain (top left of my torso) for a couple months now. It feels like a stabbing type of pain, and it's usually accompanied by having difficulty breathing like someone is sitting on my chest. I seem to get lightheaded and dizzy at the same time each day (morning) and then have difficulty breathing (cant seem to get a deep breath in) before bed once I've laid down flat on my back. I already have an apt with a cardiologist to check everything out and I've started seeing a new naturopath to help deal with the anxiety. I've had standard blood tests that come back normal and I've had an ECG done that didn't show anything. I've also had a halter monitor for 48hours and my doctor seemed to think the results were fine.

One week (when I'm not active) I will feel awesome and then suddenly the next week I can barely function. I used to enjoy working out but now when I have a hard session I seem to flat line for a week and get extremely anxious. Is this my body telling me to not work out? It feels like the second I do any type of cardio or heavy exercise, the next day my anxiety is back. I've really cut back and I've started to get some chub around my stomach and I feel like I'm losing the lean muscle I've worked so hard for.

So far I've not seen any changes. I'm taking vitamin d3, omega 3 (DEA and DHA), magnesium citrate, FCLO and an adrenal support vitamin. My diet has been low carb since August when this all started.

I'm waiting for test results but in the mean time I would like to know if anyone has any similar experiences or thoughts. I'm really feeling like I'm stuck here. What the heck could be causing this? Could low carb cause this type of reaction?

UPDATE: Doctor says its Costochondritis

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2318 · February 06, 2014 at 8:09 PM

I'm hoping it doesn't last long because it makes doing activities I enjoy pretty impossible. I guess the best thing is to rest though. I really wish I knew what caused it though...

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2318 · February 06, 2014 at 8:07 PM

Thanks for the info! I'm sure it will defininitely help someone.

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41538 · February 06, 2014 at 1:38 PM

I've had costochondritis (didn't know the name, but the link describes it to a T) a few times in my life. Sucks, but it will go away eventually.

Medium avatar
15 · February 06, 2014 at 1:22 PM

Glad it wasn't something more serious. I thought it was likely mechanical like you were told you ended up with since it was lasting for so long.

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2318 · February 06, 2014 at 12:15 PM

@paleocrush yes it does -- costochondritis is what I was told I have. @BobK no X-ray or CT scan has been ordered

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4458 · February 06, 2014 at 4:41 AM

i actually missed your update..."Doctor says its Costochondritis".

could have saved myself some typing, oh well, the info in my answer may come in handy for someone else.

hopefully you have got to the bottom of your issues, good luck

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690 · February 06, 2014 at 12:56 AM

Does not the point of LC vs VLC depend of level of activity & lean muscle mass? ie how many carbs the person "earns" ?

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690 · February 06, 2014 at 12:54 AM

I hope all the xray / CT scan stuff has been put on hold?

141c6b3d5e9506dd93881e3f9737f297
55 · February 06, 2014 at 12:27 AM

"Reflux is usually associated post-eating and positional such as laying after eating"

usually, correct. lpr is a bit more complex tho

Medium avatar
0 · February 05, 2014 at 10:45 PM

Does it hurt when you press on your ribs, as you push down near the sternum and along the rib bone?

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1005 · February 05, 2014 at 10:03 PM

For an extremely active person weighing 108lbs, who is "probably over doing it" to the point of costochrondritis, I'd consider < 50g carbohydrates to be VLC nutritional ketosis. 100-125g is the low carb sweet spot of a 12-18% macro, where the american diet is 50%+.

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2318 · February 05, 2014 at 6:47 PM

Yes to a few of those things -- I'm definitely stressed. But I'm actually getting winded walking around and the feeling of pain radiating in my chest surely can't just be anxiety? I'm feeling the need to cough and am struggling to get a full deep breath (it's like a cold burning feeling) ... I get what you're saying about anxiety but part of me thinks the anxiety is stemming from some other issue. I'm going to see my GP again today to further discuss.

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2318 · February 05, 2014 at 6:44 PM

Ha -- I knew you were going to say that. It's already on my to do list for the day.

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584 · February 05, 2014 at 5:44 PM

I wouldn't get a CT scan, that's 300 X-rays worth of radiation and could substantially increase your life-time probability of developing cancer (more so the younger you are). Opt for an MRI instead, no radiation there. CT is usually given when there is something clearly wrong and the labs provide substantial evidence that further research into the matter might be required.

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2318 · February 05, 2014 at 11:30 AM

Since I've stopped working out I have also lost my appetite. I usually have half avocado and an egg for breakfast, sometimes with an apple. For lunch I'll have half avocado and a huge salad with kale and veg. Afternoon I'll have some home made kombucha tea. Dinner I'll have a bigger meal, usually with some protein like liver or chicken or fish/shrimp with lots of veg like bamboo (fresh), broccoli, onions, garlic, daikon etc...used to have some sweet potatoes (but now this makes me feel like crap next day). I've also been having some spoonfuls of coconut butter. Not a lot but I feel so full

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2318 · February 05, 2014 at 11:24 AM

I'm 5'7" @ 108 lbs. I've always been quite small. We got back from a trip to Europe in August and I had lost weight (down to 95 :S...I know!!) so since then I've tried to put on more weight. Not sure of BF but I've always enjoyed lifting weights. I used to workout with chronic cardio 5 days a week and tried lower carb (150g) at the same time because of how I felt after I consumed carbs which was a huge mistake. Usually 45min run 4-5 days with 2-3 days strength training. Now I'm around 100-125 carbs a day with gentle walking and currently not much of a strength routine due to anxiety...

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2318 · February 05, 2014 at 11:16 AM

I also get winded very easily now and that is very unusual for me... Maybe it's lung related? I also get very anxious and light headed when I have the chest tightness in the morning and have trouble concentrating. If I try to close my eyes to concentrate I can feel my eye lids fluttering like crazy -- this is all new to me and is freaking me out....

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2318 · February 05, 2014 at 11:14 AM

I'm not sure if he did a d-dimmer. I think he is chalking the pain up to anxiety (tried to prescribe me medication). The pain starts usually at rest, sometimes after a workout I'll get the stabby pain that will last for a couple days. Then everyday in the morning and night I'll get intense pressure in my chest and I have a hard time breathing like someone is sitting on me. Propping myself to sit up makes me feel better enough to fall asleep or laying on on side--but flat back it's tough to breathe. I haven't asked about a CT scan, had to push for him to check out my heart.

Medium avatar
15 · February 05, 2014 at 3:48 AM

LINDS - there can be many causes for chest pain. Glad your ECG didn't show anything. Do you know if your doctor ever drew a blood test called a d-dimer? I'm assuming he did - it's pretty standard these days for the symptoms you're having.

You didn't mention what you're doing when the pain comes around. Are you just sitting on the couch and the pain starts or are you starting activity and the pain starts? Is there a certain position that makes the pain worse or better?

Have you ever asked your doctor for a CT scan to look at the soft tissue to see if it's tissue related?

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5b9a25a1a676397a25579dfad59e1d7b
0
2318 · February 06, 2014 at 8:07 PM
Medium avatar
0
15 · February 06, 2014 at 12:10 AM

Reflux is usually associated post-eating and positional such as laying after eating. It's not usually associated with shortness of breath, dizziness, and anxiety. The anxiety could be a related issue or an issue of itself. As far as your symptoms are concerned and in relation to your answers to my first response - I'm still curious if your MD drew a d-dimer or not. Your symptoms are pretty consistent with that of a pulmonary embolism that's why I asked about the d-dimer (It's a pretty good indicator of a P.E.).

141c6b3d5e9506dd93881e3f9737f297
55 · February 06, 2014 at 12:27 AM

"Reflux is usually associated post-eating and positional such as laying after eating"

usually, correct. lpr is a bit more complex tho

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4458 · February 05, 2014 at 11:05 PM

this one is a bit left field (possibly), but something to be aware of, as your search continues. plus i guess there could be multiple things going on, some may be connected, some may not.

anyway, it may be worth you checking out laryngopharyngeal reflux (lpr, silent reflux). lpr is similar to gerd but not so obvious that you have it, ie. fluids from your stomach may only be travelling back up your throat & sinuses when you sleep (hence sometimes also know as night time reflux, i think).

some signs to look for (there are many), sore throat, 'lump in throat' sensation, feel the need to clear your throat, hoarseness, heartburn (pain in chest).

breathing can also become affected/restricted & i seem to remember reading there may be a link to asthma (or asthma type symptoms). i guess this makes sense, if stomach fluids are travelling up the esophagus (possibly into mouth & sinuses) & then down your airway effecting your larynx (voice box) & lungs.

here are few links to get you started,

1. wiki-Laryngopharyngeal_reflux

2. webmd-laryngopharyngeal-reflux-silent-reflux

3. Laryngopharyngeal Reflux Disease: Not just heartburn

5b9a25a1a676397a25579dfad59e1d7b
2318 · February 06, 2014 at 8:07 PM

Thanks for the info! I'm sure it will defininitely help someone.

543a65b3004bf5a51974fbdd60d666bb
4458 · February 06, 2014 at 4:41 AM

i actually missed your update..."Doctor says its Costochondritis".

could have saved myself some typing, oh well, the info in my answer may come in handy for someone else.

hopefully you have got to the bottom of your issues, good luck

Medium avatar
0
0 · February 05, 2014 at 10:26 PM

Considering your age and other data, Coronary Vasospasm should be ruled out (troponin would/could be elev. during acute episode; EKG can be normal). It can evolve into Prinzmetal angina and then there will be EKG changes.

http://www.med.ucla.edu/modules/wfsection/article.php?articleid=473

http://emedicine.medscape.com/article/153943-overview

If chest pain is worse with a deep breath, pleural (lung) issue should be at least considered.

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584 · February 05, 2014 at 5:36 PM

100-125 grams isn't really low-carb (< 50g is low carb), more like moderate-carb really. Still, it sounds like you have to relax a little. Don't assume more exercise = more health. Performance and health are two different things. If your labs are fine, your ECG is fine and you're 26 years old, female, and 108 lbs, I seriously doubt that you have any real health issues. Anxiety is very common however, and I would definitely be more inclined to go with that possibility. Have you experienced any big changes in your life lately that might have brought on a lot of stress? New job, lost a job, married, bought a house, had a child, lost a family member? Big changes can cause anxiety.

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1005 · February 05, 2014 at 10:03 PM

For an extremely active person weighing 108lbs, who is "probably over doing it" to the point of costochrondritis, I'd consider < 50g carbohydrates to be VLC nutritional ketosis. 100-125g is the low carb sweet spot of a 12-18% macro, where the american diet is 50%+.

5b9a25a1a676397a25579dfad59e1d7b
2318 · February 05, 2014 at 6:47 PM

Yes to a few of those things -- I'm definitely stressed. But I'm actually getting winded walking around and the feeling of pain radiating in my chest surely can't just be anxiety? I'm feeling the need to cough and am struggling to get a full deep breath (it's like a cold burning feeling) ... I get what you're saying about anxiety but part of me thinks the anxiety is stemming from some other issue. I'm going to see my GP again today to further discuss.

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690 · February 05, 2014 at 5:34 AM

Not really an answer but a series of questions to help answer the OP. Plus this wouldn't post as a comment. :(

How about a some additional data?

Ht, wt, waist, est BF %

What you actually eat; foods & amounts

Exercise; intensity & duration.

We need some numbers.... Exactly how low carb are you? 100g? 50g?

Relative to your physical condition & level of exercise maybe you're too low carb

Updated Wed 8:30 PST.... I think you need to eat more, just my SWAG and get all your hormones checked. Perhaps the severe weight loss, low carb & heavy exercise has some of them out of wack.

@raydawg or @Matt 11 might say, "eat a ribeye and call me in the morning".

5b9a25a1a676397a25579dfad59e1d7b
2318 · February 05, 2014 at 6:44 PM

Ha -- I knew you were going to say that. It's already on my to do list for the day.

5b9a25a1a676397a25579dfad59e1d7b
2318 · February 05, 2014 at 11:30 AM

Since I've stopped working out I have also lost my appetite. I usually have half avocado and an egg for breakfast, sometimes with an apple. For lunch I'll have half avocado and a huge salad with kale and veg. Afternoon I'll have some home made kombucha tea. Dinner I'll have a bigger meal, usually with some protein like liver or chicken or fish/shrimp with lots of veg like bamboo (fresh), broccoli, onions, garlic, daikon etc...used to have some sweet potatoes (but now this makes me feel like crap next day). I've also been having some spoonfuls of coconut butter. Not a lot but I feel so full

5b9a25a1a676397a25579dfad59e1d7b
2318 · February 05, 2014 at 11:24 AM

I'm 5'7" @ 108 lbs. I've always been quite small. We got back from a trip to Europe in August and I had lost weight (down to 95 :S...I know!!) so since then I've tried to put on more weight. Not sure of BF but I've always enjoyed lifting weights. I used to workout with chronic cardio 5 days a week and tried lower carb (150g) at the same time because of how I felt after I consumed carbs which was a huge mistake. Usually 45min run 4-5 days with 2-3 days strength training. Now I'm around 100-125 carbs a day with gentle walking and currently not much of a strength routine due to anxiety...

Medium avatar
0
15 · February 05, 2014 at 4:36 AM

LINDS - there can be many causes for chest pain. Glad your ECG didn't show anything. Do you know if your doctor ever drew a blood test called a d-dimer? I'm assuming he did - it's pretty standard these days for the symptoms you're having. You didn't mention what you're doing when the pain comes around. Are you just sitting on the couch and the pain starts or are you starting activity and the pain starts? Is there a certain position that makes the pain worse or better? Have you ever asked your doctor for a CT scan to look at the soft tissue to see if it's tissue related?

5b9a25a1a676397a25579dfad59e1d7b
2318 · February 05, 2014 at 11:14 AM

I'm not sure if he did a d-dimmer. I think he is chalking the pain up to anxiety (tried to prescribe me medication). The pain starts usually at rest, sometimes after a workout I'll get the stabby pain that will last for a couple days. Then everyday in the morning and night I'll get intense pressure in my chest and I have a hard time breathing like someone is sitting on me. Propping myself to sit up makes me feel better enough to fall asleep or laying on on side--but flat back it's tough to breathe. I haven't asked about a CT scan, had to push for him to check out my heart.

5b9a25a1a676397a25579dfad59e1d7b
2318 · February 05, 2014 at 11:16 AM

I also get winded very easily now and that is very unusual for me... Maybe it's lung related? I also get very anxious and light headed when I have the chest tightness in the morning and have trouble concentrating. If I try to close my eyes to concentrate I can feel my eye lids fluttering like crazy -- this is all new to me and is freaking me out....

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