Dealing With Chest Tightness During Exercise

by Richard Ellin, MD, FACP

Question:  I am a 69-year-old mainly weekend road cyclist. This year I started getting tightness of the chest during rides. It wears off by end of a ride. I’ve been checked out and had a treadmill test by my general practitioner and told my heart is OK. Now I’m told it is my chest muscles that are giving me problems. Do you agree?  What exercise will strengthen my muscles? Will chest expanders help and what regime should I follow? — Frank K.

Dr. Richard Ellin Responds:  There are many possible causes of chest tightness with exertion. Some are serious and others not so serious.

The most serious is coronary artery disease. However, the predictive value of a negative stress test is very high. So if you had a good treadmill test, Frank, (of at least 8 minutes) and no changes were seen, you can be reasonably certain your symptoms are not caused by inadequate blood flow through the coronary arteries to your heart muscle.

However, further tests should be done (if they have not already been done) to rule out common problems such as asthma, anemia, and a number of other conditions.

Your symptoms could be coming from your chest wall muscles. In that case, they would not be serious, just bothersome. However, this is a diagnosis of exclusion, meaning other causes need to be ruled out first.

With regard to which exercises might help, if indeed the diagnosis is ultimately determined to be your chest wall muscles, my advice would be to consult a personal trainer or physical therapist, who could suggest exercises that would target your specific needs.

Richard Ellin, MD, FACP, is a board-certified specialist in Internal Medicine who practices in Alpharetta, Georgia. He received his medical degree and completed residency at Emory University, and has been in practice with Kaiser Permanente for more than 26 years. He is also an avid cyclist.