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Pain at the centre of the chest with normal ECG

Resolved Question:

Hi Sir,

Good Evening!
I have been facing pain at the center of the chest. Its a sharp pain and used to occur for couple of minutes and later disappears. Pain occurs on left side of the body and pain is across the chest and backside of the chest(only left side). I am not feeling the pain during the sleep.
Just for my safer side I have undergone ECG test and consulted a general physician nearby and came to know that there is no issues of cardiology.
As per doctor, he says the pain is because of chest muscle sprain and suggested for some light massage(using Flambid-Gel). started using this massage from today, Now the pain is continuous instead of mild pain.

Attached is the ECG for your reference.

Does ECG is enough test to identify cardiology problem? But I am worried whether I need to go for alternate consult to be on a safer side ? How can I differentiate whether the pain is cardiac pain or muscle sprain (something else)?

Please suggest me a way forward.


Category: Cardiologist

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Category: Cardiologist
Dr. Vivek Mahajan is online now

Expert:  Dr. Vivek Mahajan replied 4 Days.

Hello Naveen,
Thanks for your query at doctorspring.com. Firstly, your BP 110/70 doesn't qualify as hypertension. You are a 22 year old male without traditional risk factors. So the probability before performing any test that you have any cardiac disease at all is very low. Cardiac pain is not described as sharp. It is dull aching or burning or heaviness or constriction or choking sensation not necessarily on the left site. It may frequently be precipitated by exercise and relieved by rest. If it happens at rest then it is called acute coronary syndrome and is usually dangerous and associated with sweating vomiting or nausea and feelng of impending doom. On the other hand musculoskeletal pain is precipitated or aggravated by movement and may sometimes hurt by deep pressure and may be relieved by analgesics like those that you have been prescribed. Another pain occuring on one side of chest in a localised area burning sharp and radiatng from front to back is herpes zoster pain which will
be followed few days later by a rash in that location. Probably ypur doctor is correct that you have only a musculoskeletal pain. Your ecg appears normal. It has a early repolarization pattern and a high voltage which may be normal for your age. In view of your atypical symptoms and low pretest probability I would not recommend a treadmill test as it would invariably be negative. But still if you have a doubt lingering in your mind you may go ahead although it would be a waste of time and money. So please relax. Try analgesics prescribed. You may get another ecg done when you are having ongoing chest pain and compare with this one for dynamic changes. But I still feel its non cardiac.
Dr Vivek Mahajan

Dr. Vivek Mahajan
Category: Cardiologist
Fellowship: DM, Cardiology, PGIMER, 2013
Residency: MD, Internal Medicine, AIIMS, 2007
Internship: King Edward Memorial (KEM) Hospital, 2003 
Medical School: MBBS, Seth G.S. Medical College, 2002
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