DEAR DR. ROACH: I have been having pains and discomfort in my chest area for over a month now. I am a woman and in my early 30s. My doctor says my heart is OK, but I can't help but wonder. The pain is mostly in the right side of the chest but will stretch to the left and recently, I feel like the muscles in the left side of my chest are vibrating. -- R.H.

ANSWER: Any kind of pain or discomfort in the chest should make a physician concerned about blockages in the coronary arteries. They can cause angina, a sensation of discomfort, usually on the left side of the chest, but sometimes in the inside of the left arm, the jaw, the back or the upper abdomen and are often (but not always) associated with shortness of breath, sweating and palpitations. These blockages may lead to a heart attack, where heart muscle cells die. Symptoms are highly variable one person to another, and women are even more likely than men to have less typical symptoms.

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Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or send mail to 628 Virginia Dr., Orlando, FL 32803.

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