Acute Chest pains

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Submitted by Dr T on June 21, 2011 – 10:52am

Question: 
Hi Dr T,
Lying on back, watching TV on couch 11pm one evening, girlfriend spooning on top of chest.Experience sudden contraction in chest, almost like a muscle spasm, causing pain and shortness of breath (4/10 pain).
Pain increases in severity, like a strain or load increasing on a muscle, pain is located just left of my sternum (maybe 4 inches/10cm). Pain gets to the point where it’s above any prior pain threshold I’d experienced, literally taking my breath away. Feels like extreme heartburn combined with a muscle trying to lift too much weight, and tearing. I shift posture, try to breath, try to stretch. Stretching amplifies the pain, so I switch to a fetal position. At this point I get my girlfriend to drive me to hospital. I can only breath shallowly. Pain is 8/10. Previous worst pain experienced would be muscle tears, dislocation etc at 6/10.Get to hospital, Just after arrival, something pops (gives) inside, giving relief, and bringing pain down to 4/10. They take me through ultrasound. Imagine tech describes no comet tails on the scan on the left hand lung, could be partially collapsed? Right hand lung is normal, with comettails. I go through for an x-ray. Heart rate is low, around 45 bpm.This was 4 weeks ago, but the pain in my chest reoccurs (back to 4/10) after I have been lying stationary, particularly in the mornings and evenings in bed, the tightness comes back.I dont think that it is my heart, but given that this has not subsided, thought it would be worth asking the question.My family has no history of heart disease, I am a male, non smoker, slightly overweight (175lbs, 5’10”)probably around 30% Body fat atm, and 34 years old.The initial pain was primarily my chest, secondarily my left arm. It did not move, just got more intense.Current pain is restricted to chest only. No pain in arm, abdomen, or elsewhere.I’m thinking most likely it was a muscle tear on the inside of my chest, and just has to heal by itself, but after a quick read online (heh) couldn’t find much in the way of literature to suggest that might be the case, thus the question. Any suggestions or comments would help put me at ease, thanks.
 

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