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Intermittent Chest Pain After Increased Physical Activity

6/17/2025, 9:40:40 PMMale25-34

I'm a 19-year-old female who has recently ramped up my walking routine due to my new commute. On the fifth day into this change, while hiking a particularly steep hill, I noticed a sharp pain in the left side of my chest, especially since I was also experiencing fatigue from lack of sleep and mild dehydration. I assumed it would subside, but surprisingly, the discomfort resurfaced even during normal, flat walking. I decided to seek medical attention at the emergency room. The tests revealed a normal ECG, though there was a slight and temporary rise in troponin levels. The doctors sent me home, assuring me that the chest pain would diminish as I adapted to my increased walking schedule; I had originally been walking for just an hour daily, but I had now pushed it to two. Despite following their advice, the pain has persisted, often occurring even when I am at rest. The most intense pain I’ve felt was the day after my initial episode, as well as today, four days later, both times while I wasn’t active. During class, a sudden wave of pain struck, leading to breathlessness and a racing heart that lasted for about five minutes. I suspect this could have been a panic attack triggered by the pain, although I’ve only experienced one such attack last year. Now, the pain continues to return, fluctuating between a mild ache and a more pronounced discomfort. I’m particularly worried because today marked the return of my commute, and the pain felt significantly stronger. Even after being examined by multiple doctors, who assured me that everything checked out fine, I can’t shake the concern regarding the ongoing symptoms. While I have experienced chest pain in the past, I’ve never dealt with such consistent discomfort. For context, I struggled with disordered eating for about eight months, which included a two-month period of insufficient protein intake. Though it wasn’t severe, it did leave me feeling dizzy and impacted my memory for a while. Nevertheless, I’ve been maintaining a balanced diet for the last three months. Previously, I engaged in endurance running without any issues. Additionally, there’s a family history of elevated cholesterol levels at a young age, even among those who are physically active, which adds to my worries.

ExerciseLifestyle ChangesFamily Medicine

Answers (1)

Cony

6/17/2025, 9:40:55 PM

OpenHealth AI

It’s understandable to feel worried about ongoing chest pain after a significant increase in physical activity, especially in light of your medical history and family background. Let's break this down and determine practical next steps for managing your situation.

Main Points:

  1. Chest pain can stem from various causes, including muscle strain, stress, or anxiety.
  2. The normal ECG and temporary troponin elevation indicate no acute heart issue, but ongoing symptoms warrant further attention.
  3. Implementing stress-reduction techniques and managing hydration may help alleviate symptoms.

Explanation: Given that your tests came back normal, the sharp chest pain you are experiencing could be related to muscle strain from increased physical activity or stress and anxiety. It’s also possible that your past experiences with disordered eating and your family history may heighten your concern about the pain, which can sometimes lead to anxiety or panic attacks that can mimic physical symptoms.

Having an adjustment period when increasing your physical activities like walking or hiking is completely normal, but prolonged discomfort, especially alongside episodes of breathlessness and a racing heart, should not be ignored.

Next Steps:

  1. Hydration and Nutrition: Ensure you are well-hydrated and consuming a balanced diet rich in protein, complex carbohydrates, and healthy fats. Since you previously experienced disordered eating, replenishing nutrients is crucial for overall wellbeing.

  2. Gradual Increase of Activity: Rather than maintaining a rigorous two-hour walking routine, consider gradually increasing your physical activity level. Start with shorter walks and gradually build back up to your desired routine while listening to your body.

  3. Monitor Symptoms: Keep a diary noting when the pain occurs, its intensity, and any associated symptoms like breathlessness or heart rate changes. This information can be valuable for healthcare professionals and may help identify triggers for your pain.

  4. Stress-Reduction Techniques: Begin incorporating relaxation techniques such as deep breathing exercises, yoga, or mindfulness app sessions to manage any potential anxiety and reduce stress levels. Engaging in these activities can also prepare your body to handle physical exertion more effectively.

  5. Follow-Up: If your symptoms persist or worsen, considering a follow-up with a healthcare professional is important. They can assess other possible causes, including musculoskeletal issues or anxiety-related responses, and suggest appropriate treatment if necessary.

Your wellbeing is important, and taking reasonable steps to address both your physical and emotional health can lead to improved outcomes. Reach out if you need further assistance or have any more questions!

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