I've completed my prescribed medication course for the flu and my symptoms have largely resolved, except for an occasional cough and lack of energy, but I've experienced two episodes of sudden upper chest pain radiating to my back with tightness in the back of my head, lasting less than 5 minutes, could this be something concerning or just gas?

Immediate Evaluation Required for Chest Pain After Influenza

You need urgent medical evaluation, ideally within 24 hours, because chest pain radiating to the back with head tightness—even if brief—can represent serious cardiac complications of influenza and cannot be safely dismissed as "just gas" without proper assessment. 1

Why This Requires Prompt Attention

While your flu symptoms have largely resolved, the chest pain pattern you describe raises concern for several reasons:

• Cardiac complications of influenza are well-documented, including myocarditis (heart muscle inflammation), pericarditis (heart lining inflammation), and ECG abnormalities that can occur even without obvious cardiac symptoms 1
• The radiation pattern matters: Chest pain radiating to the back, accompanied by head/neck tightness, overlaps with presentations of both cardiac ischemia and pericarditis 1, 2
• Timing is critical: Cardiac complications can develop during the convalescent phase of influenza, which is exactly where you are now—symptoms mostly resolved but still experiencing fatigue 1

What You Should Do Immediately

Call 9-1-1 or go to the emergency department if you experience:

• Chest pain lasting more than 5 minutes 1
• Pain that interrupts your normal activities 1, 2
• Associated symptoms including cold sweats, nausea, vomiting, lightheadedness, or syncope 1, 2
• Severe shortness of breath or inability to catch your breath 1

Schedule urgent evaluation (within 24 hours) even if pain has resolved because:

• ECG abnormalities are common during influenza (reported in up to 81% of hospitalized influenza patients) and most occur without cardiac symptoms 1
• Brief, self-resolving episodes do not exclude serious cardiac pathology 1

What Your Doctor Needs to Evaluate

Your healthcare provider should obtain:

• ECG within 10 minutes of evaluation to identify ST-segment changes, PR depression, or other abnormalities suggestive of myocarditis or pericarditis 1, 2
• Cardiac troponin levels to assess for myocardial injury 1, 2
• Detailed characterization of your pain: Does it worsen with lying flat? Improve when leaning forward? Worsen with deep breathing? These features help distinguish pericarditis from other causes 2
• Assessment for other post-influenza complications including pneumonia, which can present with chest pain 1

Why "Just Gas" Is an Unsafe Assumption

While gastrointestinal causes can produce chest discomfort, several features of your presentation argue against this:

• Radiation to the back with simultaneous head tightness is not typical of gas-related pain 1
• The post-influenza timing places you at risk for documented cardiac complications 1
• Brief duration does not exclude serious pathology: Both pericarditis and cardiac ischemia can present with intermittent symptoms 1, 2

Common Pitfalls to Avoid

• Do not use antacid response as reassurance—esophageal spasm and other non-cardiac conditions also respond to antacids, and this does not rule out cardiac causes 2, 3
• Do not assume young age or prior good health excludes cardiac complications—influenza-related cardiac complications occur regardless of pre-existing conditions 1
• Do not wait for symptoms to worsen—myocarditis and pericarditis can progress rapidly, and early detection improves outcomes 1

The Bottom Line

Your ongoing fatigue and cough are consistent with normal post-influenza recovery, which can persist for weeks 1. However, new chest pain with radiation to the back and head tightness requires cardiac evaluation to exclude myocarditis, pericarditis, or ECG abnormalities—all recognized complications of influenza that can occur during convalescence. 1 This evaluation should occur urgently, not at your next routine appointment.