Any pain in the chest while walking, no matter what its cause, can be troubling -- especially if you've reached middle age, when the risk of heart disease rises. Such pain may have nothing to do with your heart, however.
We are warned so often about heart disease that the slightest twinge in the chest area can conjure up frightening visions of permanent disability or even death. A seizure in the chest can be, and sometimes is, caused by cardiovascular disease. But more often it is caused by a simpler and less threatening ailment, such as heartburn or a strained muscle.
In this section, we'll explain some of the possible causes of chest pain. (Any chest pain or discomfort, no matter how minor, however, should be brought to the attention of your doctor.)
Muscular causes: Chest pain or discomfort can be caused by a muscle spasm. A pulled pectoral (chest muscle) or a strained intercostal (muscle between the ribs) can cause a great deal of pain. A pulled muscle produces pain that is felt near the surface, and movements such as swinging the arm across the chest can initiate or worsen the pain.
Bruised muscles and ligaments may cause pain during deep breathing. Pressure during sleep from a hand, mattress button, or even a wrinkled sheet may aggravate bruised muscles. Pain associated with this kind of condition usually happens only during a certain motion or when pressure is applied to the area. Rest and time are usually the best treatments. Consult your doctor to be sure.
Heartburn: The pain brought on by indigestion, or heartburn, is frequently confused with pain caused by heart trouble. But this pain has nothing to do with the heart. Acid from the stomach backs up into the esophageal (food) tube, causing contractions of the circular muscle of the esophagus. Milk or antacids may provide temporary relief, but a simple, well-balanced diet is the best prevention.
Angina pectoris: This type of chest pain or discomfort can occur when you're at rest, but it often develops during exercise or after a heavy meal. The condition is the result of a temporary failure of the coronary arteries to deliver enough oxygenated blood to the heart muscle. Such a failure is usually the result of obstructions to coronary circulation.
Angina usually isn't a sharp pain; it is usually a sensation of heaviness, as if the chest were being squeezed or crushed. The discomfort often spreads to the left shoulder, arm, or hand, where it may be felt as numbness. It may also be felt in the neck, jaw, and teeth. Pain or discomfort may occur minutes, days, weeks, months, or even years apart.
Angina is a warning sign. Your heart is telling you to stop. The problem is that the heart is not getting enough blood, and therefore, not enough oxygen. If you experience any pain or discomfort resembling angina, report it to your doctor immediately. Your doctor will probably want you to be very specific about where and when the discomfort occurs so he or she can more fully understand your condition.
The other pains or discomfort associated with heart disease are varied, yet similar to angina. They may be sharp, mild, or numbing. If you experience any of these pains, particularly a heavy sensation in the chest or a pain that radiates up the neck or down the arm, contact your doctor immediately.
The following symptoms may signal a heart attack: an extreme heaviness in the center of your chest, as if there was an elephant sitting there; an extreme tightness, like a clenched fist inside the center of your chest; or a feeling of stuffiness (something like indigestion) high in your stomach or low in your throat. Whenever you have a symptom that resembles any one of these, get emergency medical attention.
You may have gone through a stress electrocardiogram before you started a walking program and passed it with flying colors. If so, your chances of experiencing these symptoms are relatively small. But don't become cocky. A stress electrocardiogram, like most tests, is not 100 percent reliable. In the final analysis, your body, not somebody else's electronic equipment, has the final word. So listen to it.
If you're serious about walking, use the information presented in this article to familiarize yourself with the causes of common injuries and take steps to avoid them. Prevention is the key to keeping your walking program free from injury.
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Peggy Norwood Keating, MA, Contributing consultant Rebecca Hughes, Contributing writer