Chest pain - when to go see a doctor?

  1. 34 yo male
  2. ~218 lb, 24% body fat (per globo-gym electronic measurement about 10 months ago)
  3. 38" waist
  4. Been strength training for ~3 years, 6 years in Army prior to that with all the associated running

Dating back at least into my teens, I’ve occasionally (2-3 times per year?) had a sharp chest pain in the center-right or my chest. No numbness or anything I’d associate with a heart attack. Activity that would elevate heart rate typically does not cause it to intensify, but coughing does (briefly).

This morning was the first time I’ve experienced it during a training session. I’d already completed paused DL’s and paused presses, and it seemed to come on during rows. It did seem to moderately intensify at the end of a set (hr ~120bpm), which was the first time I’d noticed any change in pain intensity that I associated with heartrate (or possibly breathing rate?), and it’s now lasted longer than I can ever recall before.

Given my age, history of the issue, and that I’ve been training as long as I have, is this cause for immediate concern? My worry is that by the time I get in to see a doc, the symptom will be gone, they’ll run a bunch of lab tests and find nothing wrong, and I’ll have nothing to show for it but the bill.

May or may not be relevant: ~8 months ago I experienced this chest pain in the evening, and it seemed to last several hours (typically only lasted 30 minutes or so). But by the next morning it was gone and I warmed up and matched a previous squat PR with no chest pain whatsoever.

~4 months ago my wife was massaging a stiff neck when I passed out. Went in to Urgent Care, and the doc ultimately determined that it was a combination of a low resting heartrate (38bpm), and that my wife happened to have had hit my vagel nerve. It had been quite a while since I’d had the chest pain at this point, so it didn’t even cross my mind to mention to the doc.

Thank you!

While the overall story you’re giving isn’t a “slam dunk” for any particular diagnosis, exertional chest pain is something that we do tend to evaluate a bit more seriously. And we need to be very clear here: if you do get evaluated and the tests find nothing wrong, that is a GOOD thing, so you have quite a lot more to “show for it” than just the bill. Properly selected/performed testing can rule out certain potentially dangerous conditions and provide us with substantial reassurance.