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Molly Maloof, MD

Director of Clinical Content

Chest pain for two days?

I've had chest pain for two days. I'm 21. It gets worse when I lie down. I've tried taking antacids, but they don't help. What could it be and how could I fix it?
  • Female | 21 years old
  • Complaint duration: 3 days
  • Medications: No
  • Conditions: Prediabetic, depression

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Get EKG and Echo to r/o pericarditis
Professor M Zak Khalil MD MRCPUK
If this pain is significant that it interferes with what you do you should probably get checked. There are many questions that I could ask you but I assume that you have never had this type of chest pain before. With a thorough history your provider should be able to narrow it down

No more than two possibilities. Reflux is certainly one of them the other common atypical chest pain and someone your age would be musculoskeletal. Any respiratory infection causes pain. A significant chest pain that is not exertional and appears to atypical should probably be evaluated. The simple complaint of chest pain is not enough. In our ER everyone complaining of chest pain gets an EKG . This easy to get exam is well worth it. Even if it doesn't make you better you feel reassured that someone is listening to you . As long as you don't do stimulant drugs your chances of coronary disease are extremely low .
Juan Nieto
It is very unlikely that the chest pain is due to coronary artery disease, so it is what we call ( atypical chest pain ) and from the way you describe that , sound most likely due to reflux disease which is very common ( with late snacking, certain food such as spicy food, pizza, coffee, tea, sodas ,) and mostly preventable when you avoid these items, elevate the head of the bed and you can use something over the counter stronger than antacids, call Prilosec or even Nexium as both became available as over the counter medications. if after all that, chest pain persist, then go and see your doctor for further evaluation . Thanks
Adel Eldin
Chest pain associated with emotional illness is more common than we think. IT is unusual for a young female to have problems with her heart, but the esophagus, stomach , ribs and sternum can cause pain. You cannot fix a problem until you know what the cause might be. It is worthwhile to see your doctor.
It is unlikely that your chest pain is related to a heart attack but given you are a prediabetic it is important to get it checked out. There are other causes of chest pain in the younger group including pericarditis which is inflammation around the heart which typically gets worse with lying down. minor cases are treated with anti-inflammatory medications such as motrin.

It could be a pneumothorax which is a collapses lung and could occur spontaneously.

Other causes include acid reflux, esophageal spasm, and even anxiety can cause chest pain. More serious causes can usually be excluded with a chest xray and an EKG. Sometimes lab tests may be necessary. In general, it should be evaluated especially if it is persistent or worsening. At the very minimum, I would call your primary care physician if you elect not to seek urgent/emergent care
2 days?! What are you waiting around for?! You need to get it evaluated soon at an ER! OK, since yo are still here, its probably not a heart attack, but it should still be evaluated!
Alvin K. Eng