Dear Doctor;

Last week, I was in the bathroom when I bent down to pick something. Two pricking pains within seconds on the chest area nearly left me breathless. What could this have been? Should there be cause for alarm even as there has been no recurrence ever since? Malume, 37. 

Dear Malume,

The kind of pain you describe could be muscular. A momentary stretching of muscle fibres due to bending could have caused that pain. Another cause which is a bit sinister for such a fleeting pricking pain could be angina.

Due to block or spasm in the coronary artery, during some effort momentarily blood supply of the heart is cut off resulting in a pressure-like pain. This is usually associated with breathlessness and or sweating. There has to be some underlying risk factors for angina like hypertension, diabetes, alcohol, obesity, physical or mental stress. Even those with a family history of angina are usually more prone to it.

Stress of any kind precipitates an attack, bending forwards being one of such movements as there is surge of neurochemicals like adrenalin, corticoids, etc, while bending. You can get the blood pressure and blood glucose tested to screen for hypertension and or diabetes.

If obese try to reduce weight by dietary measures and regular exercise. Quit alcohol and smoking. If the pain relapses get an electrocardiogram done, because it shall be non-conclusive if done any other time.