Definition and Overview
Chest pain is one of the leading causes of emergency room visits worldwide. The definition of chest pain and its intensity can vary from one person to another. It may be described as a persistent, dull pain in the chest area to a sudden, sharp stabbing pain. Chest pain is not necessarily a condition, but a symptom of an underlying disease ranging from mild to life-threatening. Seeking immediate medical attention, especially when the pain is persistent or regular, can be life-saving.
Causes of chest pains
Chest pain is oftentimes, but not always, attributed to a heart or lung condition. Possible diseases related to the heart and lungs will be presented shortly. Meanwhile, here are other conditions that can also result in chest pains:
- Inflammation, strain or soreness of the surrounding chest walls and the muscles around it
- Inflammation in the back muscles, nerves and the spine
- Inflammation on the rib joints, especially near the breastbone (a condition called costochondritis)
- Problems in the lungs including the trachea and the lining
- Pain that radiates from the abdominal cavity including the stomach (such as in peptic ulcer or hiatal hernia), pancreas (pancreatitis), and gallbladder
- Shingles or Herpes zoster caused by the varicella virus
- Anxiety and panic attacks (often accompanied by other symptoms such as palpitations, shortness of breath, trembling)
Heart-Related Chest Pain
Chest pain could be a possible sign of a heart condition. Some of the common conditions that result in chest pain include the following:
Heart Attack or Myocardial Infarction. A sharp, persistent crushing pain in the central or left side of the chest accompanied by sweating, nausea, and severe weakness can be an indication of blocked arteries that causes the cells of the heart muscles to die, leading to heart failure.
Coronary Artery Disease. Chest pain (angina) can indicate a blockage in the blood vessels that can lead to possible heart attack.
Pericarditis. A condition characterized by infection of the sac surrounding the heart, this causes sharp, steady pain along the shoulder and upper neck muscles that gets worse when you breathe or lie on your back.
Myocarditis. Also known as heart muscle inflammation, this condition doesn't only cause chest pain, but also fatigue, palpitations and fever.
Cardiomyopathy. This is a genetic disease that makes heart muscles to grow thicker than normal, requiring the heart muscles to pump harder.
Mitral Valve Prolapse. This condition occurs when the heart valves are unable to close properly, leading to mild chest pains.
Lung-Related Chest Pain
Pneumonia. This and lung abscess can cause deep chest pains. Pneumonia is often accompanied by high fever, cough, and chills.
Pleurisy. Characterized by inflammation of the lung and chest linings, this condition causes sharp chest pains during breathing, sneezing, or coughing.
Other Conditions. Less common lung-related causes of chest pain include viral infections, rheumatoid arthritis, and cancer.
Key symptoms of Chest Pain
The key symptoms of chest pain vary depending on the underlying condition that causes it. Chest discomfort is often described as one or more of the following:
- Pain in the chest area that persists more than a few minutes
- Pain that gets worse during breathing, coughing, physical activity, or even when lying on the back
- Pain that can go away only to come back in various intensities
- Pressure on the chest or the feeling of tightness and fullness
- Sharp, crushing pain in the chest that radiates upward to the neck and jaw, and downward to the back, shoulders and arms
Chest pains are often accompanied by shortness of breathing, palpitations, cold sweats, weakening of the body, dizziness and nausea or vomiting. Non-heart related chest pains, on the other hand, come with other symptoms such as trouble swallowing, a sour after-taste in the mouth, and tenderness in the chest area.
Who to See & Types of Treatments Available
Whether or not they indicate a heart condition, chest pains often require immediate medical attention. If you experience a new kind or an unexplained chest pain, you must call for emergency help as soon as possible.
Your general practitioner should be able to help you diagnose the cause of your chest pain. The doctor can order the following tests for proper diagnosis or to eliminate the possibility of a heart-related problem:
- Blood tests to check for cholesterol, fat and enzyme levels
- Chest x-ray to check the lungs, heart and blood vessels
- Electrocardiogram to check the heart’s electrical activity
- Echocardiogram to determine possible physical abnormalities in the heart
- Magnetic resonance imaging to check for damage on certain parts of the heart, such as of the aorta
- Stress tests to measure heart function
- CT scan or angiogram to determine blockages of the arteries
The doctor will formulate the best treatment plan based on the underlying cause of the condition. Treatment of chest pain caused by heart conditions can include routine medications such as clot-busters, artery relaxers and blood thinners, cardiac catheterization to remove blocked arteries and surgery.
Meanwhile, the treatment options for non-heart related chest discomfort include antacids (for acid reflux), anti-anxiety medications (for panic attacks), antibiotics (for infections), and anti-inflammatory medications. Your doctor could also refer you to specialists such as a cardiologist, an internist, gastroenterologist, neurologist, or pain management specialist - depending on the diagnosed cause of your chest pain.
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