Chest pain: Types, Symptoms, Causes, Diagnosis and Treatment

Chest Pain - Medicover

Chest pain is a common symptom that makes people visit the emergency room. Discomfort in the chest involves burn or crush feeling, and pain that transmits to the neck, shoulder, or abdomen. Chest pain differs from person to person. chest pain varied in:

  • Quality
  • Severity
  • Duration
  • Location

Chest pain feels like a sharp, mute ache(dull ache) or stabbing pain, it can be a sign of a heart-related problem.

Types of chest pain

  • Left Side chest pain: Left side chest pain can be serious. It might be heart attack or other medical conditions like lung problems or inflammation around the heart.
  • Right Side chest pain: Right side chest pain is not so serious when compared to left. It might be caused due to stress, muscle strain, heartburn, and other reasons as well.
  • Angina: Angina is caused when there is not enough oxygen-rich blood flowing to a certain part of the heart. The arteries of the heart become narrow due to fatty deposits in the artery walls. The narrowing of arteries means that blood supply to the heart is reduced, causing angina. Angina usually doesn’t cause much damage to the heart.
  • Heart Attack: A heart attack is caused when Cholesterol deposits in the coronary artery, and blocks the blood flow to the heart. If there is no blood flow in the arteries, the heart muscle gets damaged.
  • Stent Pain: A stent is placed when an artery becomes narrow restricting blood flow to the heart muscle. Stent pain is common with those who have undergone coronary stent surgery. Pain might appear in the middle or left side of the heart.
  • Pericarditis: Pericarditis is an inflammation in the pericardium(the fibrous sac surrounding the heart). Pericardium keeps the heart from over-expanding when the blood volume increases, keeps functioning of the heart effectively. Pericarditis causes sharp chest pain and discomfort when breathing heavily. Pericarditis is usually mild and goes without treatment. But some severe cases treatment may include medication and rarely surgery.
  • Pulmonary embolism: Pulmonary embolism is a blockage in the pulmonary arteries in the lungs. In most cases, pulmonary embolism is caused by blood clots that travel to the lungs from the veins in the legs and the other body parts.
  • Gastroesophageal Reflux Disease(GERD): Gastroesophageal Reflux Disease is caused when stomach acids flow esophagus(tube that connecteds to the mouth and the stomach). This acid reflux can irritate the lining of the tube connected and causes discomfort in the chest.
  • Pleuritic chest pain:  The thin tissues that line your lungs and chest wall, are called the pleura or pleuritis. When pleura is infected or inflamed, it becomes irritated and swollen, causing sharp chest pain when breathing, coughing, or sneezing. This condition is called pleurisy or pleuritis.

Symptoms

Chest pain can develop for many reasons, but many think it’s only related to a heart attack. In general, chest discomfort related to a heart attack or other heart issues can be described or associated with one or more of the following symptoms:

  • chest pressure or tightness
  • Back, jaw, or arm pain
  • Fatigue: Fatigue is when you are feeling exhausted, lack of energy, and a strong feeling of sleep.
  • Lightheadedness: a feeling of faintness, dizziness, or being close to passing out.
  • Dizziness
  • shortness of breath
  • abdominal pain
  • Nausea
  • pain during exertion

The other symptoms which are associated with chest pain that is caused by other health issues include:

  • a sour or acidic taste in your mouth
  • pain that only occurs after you swallow food
  • pain that causes when the body position is changed
  • pain that causes when you breathe deeply or cough
  • Tenderness when you push on your chest
  • fever
  • aches
  • chills
  • runny nose
  • anxiety
  • hyperventilating
  • Pain that is persistently present for many hours

Causes

Most of the chest pain causes are not dangerous to health, but some are serious, while the least cases are life-threatening.

The following are heart-related causes of chest pain:

  • Heart attack
  • Angina pectoris, caused by a blockage in the blood vessels leading to your heart.
  • Pericarditis is an inflammation in the pericardium(the fibrous sac surrounding the heart).
  • Myocarditis, an inflammation in the heart muscle (myocardium).
  • Cardiomyopathy, a disease of the heart muscle that makes it harder for the heart to pump blood to the rest of the body.
  • Aortic dissection, a rare condition involving an inner tear of the aorta in the large vessel that comes from the heart.

The following are gastrointestinal causes of chest pain:

  • Acid reflux or heartburn
  • Difficulty swallowing related to disorders of the esophagus
  • Gallstones
  • Inflammation of the gallbladder or pancreas
  • Gastroesophageal reflux disease (GERD)
  • Esophageal contraction disorders

The following are lung-related causes of chest pain:

  • Pneumonia: Pneumonia is an infection and inflammation of the air sac in the lungs. The air sacs are filled with fluid or pus, which causes coughing with phlegm(a type of mucus), fever, and difficulty in breathing.
  • Acute bronchitis: Acute bronchitis is caused by viruses, it is the same virus that causes cold and flu. Antibiotics are not effective to treat this virus in most cases of acute bronchitis.
  • Pneumothorax: Pneumothorax occurs when air leaks into space between the lungs and the heart wall. This air pushes on the outside of the lungs and makes the lungs collapse. It can be a complete collapse or a collapse of only a particular portion of the lung.
  • Bronchospasm: Bronchospasm is a tightening of the muscles that line the bronchi in your lungs. When these muscles tighten, airways narrow. Narrow bronchi don’t let as much air come in or go out of your lungs.
  • Chronic obstructive pulmonary disease (COPD): is a chronic inflammatory lung disease, which causes it difficult to breathe. There are two main COPD: Chronic bronchitis which involves long-term cough caused by mucus and Emphysema involves damage to the lungs over time.
  • Pulmonary embolism:  Pulmonary embolism is a blockage in the pulmonary arteries in the lungs. In many cases, pulmonary embolism is caused by blood clots that travel to the lungs from the veins in the legs and the other body parts.

The following are issues related to muscles or bones causing chest pain:

  • Rib problems
  • Sore muscles from exercise or chronic pain syndromes
  • Compression fractures that put pressure on a nerve

Other problems that cause chest pain include:

  • Shingles: Caused by a reactivation of the chickenpox virus, shingles can cause pain and a strip of blisters from the back to the chest wall.
  • Panic attacks: If you have intense anxiety along with chest pain, rapid heart rate, fast breathing, excess sweating, and fear of dying, you may have a panic attack.
  • Palpitations: The sensation of heart skipping a beat or an extra beat, like pounding, racing, or fluttering. This sensation feels in the neck, throat, or chest.
  • Tingling sensations
  • Trembling
  • Dizziness
  • A sensation of shortness of breath
  • Pain down your back or chest
  • Anxiety

Diagnosis

Chest pain due to heart-related problems can be diagnosed with the following tests:

  • An electrocardiogram (EKG or ECG), which records the electrical activity of the heart through electrodes attached to the skin.
  • Blood tests, which measure enzyme levels.
  • A chest X-ray was used to examine the heart, lungs, and blood vessels. A chest X-ray can also detect lung problems like pneumonia or a collapsed lung.
  • An echocardiogram uses sound waves to record moving images of the heart.
  • An MRI is used to look for damage to the heart or aorta. Magnetic Resonance Imaging (MRI) is a medical test that is used to make pictures of organs and structures inside the body using a magnetic field and pulses of radio wave energy.
  • Stress tests are used to measure your heart and blood vessel response during exercises, which may show if chest pain is related to heart-related problems.
  • An angiogram is used to look for blockages in specific arteries. It is a procedure that uses x-ray imaging and contrast dye to view the condition of the coronary arteries, the blood vessels that carry blood to the heart.

Treatment

Treatments for heart-related problems causes of chest pain include:

  • medications, including nitroglycerin and other medications that open partially closed arteries, anticoagulants, or blood thinners.
  • cardiac catheterization, which may use balloons or stents to open blocked arteries.
  • surgical repair of the arteries is also known as coronary artery bypass grafting or bypass surgery.

Treatments for other problems causes of chest pain include:

  • re-inflation of the lungs for a collapsed lung, which your doctor will do by inserting a chest tube or related device.
  • antacids or certain acid reflux and heartburn procedures used to treat the symptoms.
  • anti-anxiety medications used to treat chest pain related to panic attacks.

FAQs

Q. Can stress cause chest pain?

A. Yes, stress causes chest pain, increased muscle tension in the chest, this tension may become painful. Likewise, in more stressful moments the heart rate increases and the force of the heartbeats can increase stronger.

Q. Which doctor should I consult for chest pain?

A. First, consult a general physician immediately if your chest pain is severe and let him know what symptoms you have along with the chest pain. Then the doctor will examine and refer you to the specialist according to your chest pain-related problem.

Q. People with anxiety disorder suffer from chest pain. True or false?

A. True, people who suffer from anxiety disorder suffer from chest pain. Patients who have Generalized Anxiety Disorder(GAD) experience chest pain or palpitations.

Q. What is the difference between chest pain and angina?

A. Angina is caused when there is not enough oxygen-rich blood flowing to a certain part of the heart. Angina and some other chest, lung, and gastro related problems are types of chest pain.

Q. What to do if You have chest pain?

A. Most of the chest pain is not related to the heart. If you have severe chest pain with rapid breathing, rapid heartbeat, excess sweating, dizziness. Then immediately seek the doctor and describe your symptoms along with chest pain.