What are chemotherapy you receiving at this time? I would not blame straining as the cause of your substernal pain unless you have history of GERD which can be exacerbated with too much straining. Heart-related pain is usually associated with shortness of breath, sweating and radiating to the jaw or left arm. Pain from the heart cover (pericariditis) gets worse with supine & improved with sitting.
Answered 5/19/2023
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