For the past two weeks I have been experiencing a sharp pain directly in the middle of my chest (a bit to the right). It happens mostly at night when im lying down, when I cough, sneeze, laugh or breathe deeply. It is nothing age related becuase im young, and im only a waitress so not becuase of heavy duty work. I also have been experiencing loss of apetite, and sleeplessness. I also did move from America to England. So there may be multiple reasons. For me to be experiencing these multiple problems. Thanks for the help.
Any time someone complains of chest pain, we worry about heart attacks, regardless of age and sex. Of course, it's more of a concern in the older patient and less so in someone younger. Nevertheless, at least in the States, a missed heart attack diagnosis is one of the top reasons for malpractice (missed cancer diagnosis is the other). Heart attacks are typically associated with chest pain that may or may not radiate/extend to the jaw or arm, shortness of breath, nausea, sweating, aggravated by activity. However, in women, it often presents in an atypical fashion, often preceeded by poor sleep!
With that said, many other things can cause chest pain. Pneumonia is often associated w/cough, phlegm and fever. Pleurisy is the inflammation of the lining of the lung. Pleurisy can be due to pneumonia or it can be due to an unknown cause. Pleurisy makes it painful to take a deep breath. Pneumothorax is collapse of the lung which then leads to shortness of breath and painful breathing. Esophageal spasm can present as chest pain. However, none of the above should be positional or time related.
On the other hand, heart burn or gastroesophageal reflux can be positional in nature such that you're fine when upright. Then when you lay down the presence of stomach acid in the esophagus leads to chest pain, although I can't explain the association w/coughing, sneezing, laughing or breathing deeply. We don't like to diagnosis something as due to stress until we've evaluated for all other possible & dangerous causes. Therefore, it's a good idea that you get checked out as soon as possible. Good luck!
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