What Is Chest Pain? | Cardiology

Chest pain

Overview of chest pain

Chest pain appears in many forms, ranging from a sharp stab to a dull ache. Sometimes chest pain feels crushing or burning. In certain cases, the pain travels up the neck, into the jaw, and then radiates to the back or down one or both arms.

Many different problems can cause chest pain. The most life-threatening causes involve the heart or lungs. Because this can indicate a serious problem, it’s important to seek immediate medical help.

What are the symptoms of chest pain?

Chest pain can cause many different sensations depending on what’s triggering the symptom. Often, the cause has nothing to do with your heart though there’s no easy way to tell without seeing a doctor.

Heart-related chest pain

Although chest pain is often associated with heart disease, many people with heart disease say they experience a vague discomfort that isn’t necessarily identified as pain. In general, chest discomfort related to a heart attack or another heart problem may be described by or associated with one or more of the following:

  • Pressure, fullness, burning or tightness in your chest
  • The crushing or searing pain that radiates to your back, neck, jaw, shoulders, and one or both arms
  • Shortness of breath
  • Cold sweats
  • Dizziness or weakness
  • Nausea or vomiting

Possible causes of chest pain

Muscle tension

Inflammation of the muscles and tendons around the ribs can lead to persistent chest pain. If the pain worsens with activity, it may be a sign of a muscle strain.

Injured ribs

Injuries, bruises, fractures, and broken ribs can cause chest pain. If there is a broken rib, a person may have heard of a fracture or experienced severe pain during the injury.

Peptic ulcer

Peptic ulcers with ulcers on the lining of the stomach usually do not cause severe pain. However, they can cause recurring chest discomfort. Taking antacids, which can be purchased online and in pharmacies, generally reduces the pain caused by peptic ulcers.

Gastroesophageal reflux disease (GERD)

GERD refers to when stomach contents back up into the throat. It causes a burning sensation in the chest and a bitter taste in the mouth.

Asthma

Asthma is a common breathing disorder that involves inflammation of the airways, causing chest pain. Other symptoms include shortness of breath, coughing, and shortness of breath.

Collapsed lungs

When air collects in the space between the lungs and the ribs, a lung collapses and causes sudden chest pain when breathing. If someone’s lungs collapse, they may also experience shortness of breath, fatigue, and a rapid heart rate.

Esophageal sphincter disorders

Esophageal sphincter disorders are contractions in the esophagus. These disorders can also cause the pain.

Esophageal hypersensitivity

Pressure changes in the esophagus or the presence of acid can sometimes cause severe pain. Currently, experts do not know the cause of this sensitivity.

Esophageal rupture

If the esophagus bursts, it can cause sudden, severe chest pain. Esophageal rupture can occur after severe vomiting or esophageal surgery.

Hyoid hernia

Hyoid hernia when part of the abdomen is pushed towards the chest. This type of hernia is very common and may not cause any symptoms. However, if the upper abdomen is pushed towards the lower chest after eating, it can cause GERD symptoms such as heartburn and chest pain.

Hypertrophic cardiomyopathy

Hypertrophic cardiomyopathy occurs when the heart grows too large for genetic reasons. The hardening of the heart prevents blood from flowing properly from the heart, making it difficult for the muscles to pump blood.

Symptoms of hypertrophic cardiomyopathy include chest pain, shortness of breath, dizziness, mild headache, and epilepsy.

Tuberculosis

Cough The tuberculosis bacteria that grow in the lungs can cause symptoms such as a strong cough, coughing up blood or sputum, or chest pain.

Mitral valve prolapse

Palpitations and dizziness are symptoms of mitral valve prolapse, which means that the heart valve cannot close completely. In mild cases, the condition may not have obvious symptoms.

Pulmonary embolism

Pulmonary embolism occurs when a blood clot gets stuck in the artery that supplies blood to the lungs. It can cause shortness of breath and coughing up blood. Pulmonary embolisms are fatal if not treated right away. A person should consult a doctor if chest pain appears suddenly.

When to see a doctor

If you have new or unexplained chest pain or suspect you’re having a heart attack, call for emergency medical help immediately.

How is chest pain diagnosed?

Seek emergency treatment immediately if you think you may be having a heart attack and especially if your chest pain is new, unexplained, or lasts more than a few moments.

Your doctor will ask you some questions, and your answers can help them diagnose the cause of your chest pain. Be prepared to discuss any related symptoms and to share information about any medications, treatments, or other medical conditions you may have.

Diagnostic tests

Your doctor may order tests to help diagnose or eliminate heart-related problems as a cause of your chest pain. These may include:

  • An electrocardiogram (ECG or EKG), which records your heart’s electrical activity.
  • Blood tests, which measure enzyme levels.
  • A chest x-ray, which is used to examine your heart, lungs, and blood vessels.
  • An echocardiogram, which uses sound waves to record moving images of the heart.
  • An MRI, which is used to look for damage to the heart or aorta.
  • Stress tests, which are used to measure your heart function after exertion.
  • An angiogram, which is used to look for blockages in specific arteries.

Chest pain treatment

Treatment varies depending on the cause of the chest pain.

Medications for chest pain

  • Nitroglycerin, which is usually taken in tablet form under the tongue, relaxes the arteries of the heart so that blood can flow more easily through narrow spaces. Some blood pressure medications relax and dilate blood vessels.
  • If doctors suspect that your chest pain is related to your heart, they may give you an aspirin.
  • Thrombolytic drugs. If you have a heart attack, you can take these blood thinners. These work to dissolve the blood clot in the heart muscle.
  • Thinning of the blood If you have a clot in the artery that feeds your heart or lungs, you may be given medicine that prevents blood clots.
  • Acid suppressing drugs. If your chest pain is caused by a splash of stomach acid in your esophagus, your doctor may prescribe medicine to reduce the amount of acid in your stomach.
  • Antidepressants If you have panic attacks, your doctor may prescribe antidepressants to help control your symptoms.

Surgery and other procedures for chest pain

Procedures to treat some of the most dangerous causes of chest pain:

Angioplasty and stenting

If your chest pain is caused by a blockage in the artery that feeds your heart, your doctor will insert a balloon catheter into the large blood vessel in your groin last and screw it in until it becomes blocked. Your doctor will inflate the tip of the balloon to dilate the artery and remove the catheter. In most cases, a small wire mesh tube (stent) is placed outside the tip of the catheter balloon. When dilated, the stent becomes blocked to keep the artery open.

  • Surgical revascularization. In this procedure, surgeons take a blood vessel from another part of your body and use it to create an alternate way for blood to circulate the blocked artery.
  • Amputation repair. You may need emergency surgery to repair an aortic dissection, an artery that carries blood from your heart to the rest of your body.

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