Description

The chest pain is pain or discomfort in the area between the neck and the belly. Chest pain may be sharp or dull. It may come and go, or you might always feel the pain. The exact symptoms depend on the cause.

Many different things can cause pain in the chest. The most life-threatening causes involve the heart or lungs. So it is important to seek medical help for an accurate diagnosis.

If you think that your chest pain is due to a heart attack, call 911 or the local emergency number immediately.

Symptoms

Pain in the chest, symptoms depend on the cause.

Heart-related chest pain

Chest pain is often related to heart disease. Pain in the chest, symptoms due to a heart attack or other heart disease can include:

  • Pressure, tightness, pain, tightness, or pain in the chest.
  • Pain that radiates to the shoulders, arms, back, neck, jaw, teeth or the upper part of the abdomen.
  • Shortness of breath.
  • Fatigue.
  • Heartburn or indigestion.
  • Cold sweats.
  • The dizziness.
  • Fast heartbeat.
  • Nausea.

Other types of pain in the chest

It can be difficult to know if the chest pain is due to a heart problem or something else. Usually, the chest pain is less likely to be due to a disease of the heart if it happens with:

  • A sour taste or a feeling of food coming back into your mouth.
  • Difficulty swallowing.
  • Pain that gets better or worse when you change the position of the body.
  • Pain that gets worse when you breathe deeply or cough.
  • Sensitivity to pressure on your chest.
  • The pain that continues for many hours or days.

The classic symptoms of heartburn, pain, burning sensation behind the breastbone (sternum) — may be due to a health condition affecting the heart or the stomach.

When to see a doctor

If you have new or unexplained chest pain or think they are having a heart attack, call 911 or emergency medical help immediately. Never ignore symptoms of a heart attack.

If you can't get an ambulance or emergency vehicle to come to them, to have someone drive you to the nearest hospital. The unit itself only if you do not have any other way to get there.

Causes

Chest pain has many possible causes.

Heart and the blood vessels causes

Some heart-related causes of chest pain are:

  • Angina. This is the chest pain due to reduced blood flow to the heart muscle. It is often described as squeezing, pressure, heaviness, tightness or pain in the chest. Angina is a symptom of coronary artery disease. Unstable angina can cause a heart attack or near heart attack.
  • Heart attack. A heart attack occurs when the flow of blood to the heart muscle is blocked. It can cause angina chest pain. You will need emergency treatment for a heart attack to prevent death.
  • The aortic dissection. This life-threatening condition that involves the body's main artery, called the aorta. If the inner layers of the aorta separate, the blood is forced between the layers. This can cause the aorta to rupture.
  • Inflammation of the sac surrounding the heart, called pericarditis. This condition usually causes sharp pain that gets worse when breathing or lying down.

Digestive causes

Chest pain can be caused by diseases or disorders of the digestive system, including:

  • Gastroesophageal reflux disease (GERD). In this condition, the acid in the stomach washes back up from the stomach into the tube that connects the throat with the stomach. That tube is called the esophagus. GERD can cause a burning sensation in the chest, called heartburn.
  • Swallowing disorders. Diseases that affect the esophagus can make swallowing difficult and even painful. This can lead to pain in the chest.
  • Of the gallbladder, or pancreas disease. Gallstones or inflammation of the gallbladder, or pancreas can cause stomach pain spreading to the chest.

Lung-related causes

Many diseases of the lungs can cause chest pain, including:

  • A blood clot in the lung, called a pulmonary embolism. A blood clot that gets stuck in a pulmonary artery can block the flow of blood to the lung tissue. The symptoms of a pulmonary embolism may feel like a heart attack.
  • The irritation of the thin layers of tissue that separate the lungs from your chest wall, called pleurisy. This condition causes severe pain in the chest that gets worse when breathing or coughing.
  • Collapse of the lung. A collapsed lung happens when air leaks into the space between the lung and the ribs. Also called pneumothorax. Pain in the chest due to a collapsed lung usually starts suddenly. It can last for hours. It usually causes difficulty breathing.
  • High blood pressure in the arteries of the lung called pulmonary hypertension. This condition affects the arteries that carry blood to the lungs. It can cause chest pain or pressure.

The muscle and bone causes

Some types of pain in the chest due to an injury or damage to the structures that make up the chest wall. These conditions include:

  • Costochondritis. This is the inflammation of the cartilage that connects a rib to the breastbone (sternum). It can cause pain in the chest that may seem like a heart attack. The pain is most commonly felt in the left side of the body.
  • Injured ribs. A bruised or broken rib can cause pain in the chest.
  • Long-term pain syndromes. Conditions such as fibromyalgia, which can cause sore muscles, may cause long-term pain that affects the area of the chest.

Other causes

Chest pain can also be caused by:

  • Panic attack. If you feel intense fear of pain in the chest, you may be having a panic attack. Panic attack symptoms include a rapid, pounding heartbeat, rapid breathing, a lot of sweat, shortness of breath, nausea and dizziness. It can be difficult to tell the difference between a heart attack and a panic attack. Always seek medical help if you are not sure of the cause of chest pain.
  • Herpes zoster. This is an infection caused by the varicella-zoster virus — the same virus that causes chickenpox. Can cause severe pain and a band of blisters around the chest area.
  • Nerve pain. Some people with a compression of the nerves in the middle of the back you may feel pain in the chest.

Diagnosis

Chest pain does not always mean that you are having a heart attack. But that's what emergency medical help usually tests for the first because it can be deadly. Their health care professionals also will find that life-threatening lung conditions — such as the collapse of a lung or a blood clot in the lung.

Immediate tests

Some of the first tests to diagnose the cause of chest pain are:

  • Electrocardiogram (ECG or EKG). This quick test shows how the heart is beating. The test can tell you if you have had or are having a heart attack. Adhesive patches with sensors go in the chest and sometimes the arms and legs. Connect the cables from the sensors to a computer, that prints or displays the results.
  • Blood tests. Some of the proteins and other substances slowly leak into the blood after heart damage from a heart attack. Blood tests may be done to check for these.
  • X-ray of the chest. An x-ray of the chest shows the condition of the lungs, and the size and shape of the heart. A chest x-ray can diagnose pneumonia or a collapsed lung.
  • Computed tomography (CT scan). A ct scan uses X-rays to create cross-sectional images of specific parts of the body. A ct scan of the chest can detect a blood clot in the lung or find a aortic dissection.

Follow-up tests

Depending on the results of the first tests for the chest pain, you may need more tests, which may include:

  • The echocardiogram. Sound waves create images of the beating heart. This test shows how blood moves through the heart and the heart valves.
  • CTcoronary angiography. This test looks at the arteries that supply blood to the heart. Used a powerful X-ray machine to produce images of the heart and its blood vessels. The test is used to diagnose many different diseases of the heart.
  • Exercise stress test. For this test, you walk on a treadmill or ride a stationary bike while a professional of the health of the watches of the heartbeat. Exercise tests help to show how the heart responds to exercise. If you are unable to do exercise, you could get drugs that affect the heart as the exercise you do.
  • Coronary catheterization. This test can detect blockages in the arteries of the heart. A long, thin, flexible tube that is inserted into a blood vessel, usually in the groin or the wrist, and guided to the heart. Contrast medium flows through the tube of the arteries in the heart. The dye helps the arteries to show up more clearly on X-ray images and video.

Treatment

Chest pain treatment depends on what is causing the pain.

Drugs

The medications used to treat some of the most common causes of chest pain include:

  • The nitroglycerin. This medicine is given when your health care team believes that your chest pain is due to a blockage of the arteries in the heart. It is often taken as a tablet under the tongue. The medicine relaxes the arteries of the heart so that blood can flow more easily.
  • Blood pressure medications. Some blood pressure medicines also relax and widen the blood vessels. This can relieve the chest pain related to the heart.
  • The aspirin. If the health professionals think that their chest pain is heart-related, you may be given aspirin. Aspirin does not remove the pain in the chest. But it is part of the treatment for patients who have or may have obstructions in the arteries of the heart.
  • Thrombolysis, also called thrombolytics. If you are having a heart attack, you can get these drugs. They work to dissolve the clot that is blocking blood from reaching the heart muscle.
  • A blood thinner. If you have a blood clot in an artery leading to the heart or lungs, you can get these drugs to avoid in the future the formation of blood clots.
  • Acid-reducing medication. These medications reduce stomach acid. They can be suggested if you have heartburn.
  • Anti-anxiety medications. If you are having panic attacks, your health care professional may recommend these medications. Psychotherapy, such as cognitive-behavioral therapy, may also be recommended.

Surgical and other procedures

Other treatments for some of the most dangerous causes of chest pain include:

  • Angioplasty and stent placement. This treatment helps to remove a blockage in an artery that goes to the heart. The doctor inserts a thin tube with a balloon on the end into a large blood vessel, usually in the groin, and the guide for the heart. The balloon expands. This widens the artery. The balloon is deflated and removed with the tube. A small wire mesh tube called a stent is often placed in the artery to keep it open.
  • Coronary artery bypass graft surgery (CABG). This is a type of open-heart surgery. During CABG , a surgeon takes a vein or artery from another part of the body. The surgeon uses a blood vessel to create a new path for the blood to go around a blockage or narrowing of the coronary artery. The surgery increases the flow of blood to the heart.
  • Emergency repair of the surgery. You may need emergency heart surgery to repair a rupture of the aorta, also called an aortic dissection. It is a life-threatening condition.
  • Lung reinflation. If you have a collapsed lung, a health care provider may place a tube in the chest to expand the lung.

Preparing for your appointment

You may not have time to prepare. If you are having severe chest pain, or new or unexplained chest pain or pressure that lasts more than a few moments, call 911 or the emergency medical services.

Not to lose time for fear of embarrassment if it is not a heart attack. Even if there isn't another cause for your chest pain, you need to be seen immediately.

What you can do

Share the following information with the emergency medical aid, if it is possible to:

  • Symptoms. Describe your symptoms in detail. Note when they started and if anything makes the pain better or worse.
  • History of medicine. Tell the healthcare team if you have had chest pain before and what caused it. To tell if you or any member of the family has a history of heart disease or diabetes.
  • Drugs. Get a list of all the medications and supplements that you regularly take help of emergency care professionals. You might want to prepare a list in advance to carry in your wallet or purse.

Once you're in the hospital for pain in the chest, usually considered quickly. Based on the results of blood tests and a heart rate monitor, your health care professional can quickly know if you are having a heart attack or not.

You or your family may have many questions. If you have not received the following information, you can ask:

  • What is the most likely cause of my chest pain?
  • There are other possible causes of your symptoms or condition?
  • What kinds of tests do I need?
  • Do I have to stay in the hospital?
  • What treatments do I need right now?
  • What are the risks associated with these treatments?
  • What are the next steps in the diagnosis and treatment?
  • I have other medical conditions. How might that affect my treatment?
  • Do I have to change my activities after you get home?
  • You should see a specialist?

Do not hesitate to ask more questions.

What to expect from your doctor

A health professional who attends to the chest pain may ask:

  • When did the symptoms begin? They have gotten worse over time?
  • The pain spread to other parts of your body?
  • What words would you use to describe your pain?
  • On a scale of 1 to 10, with 10 being the worst, how bad is the pain?
  • Do you have dizziness, lightheadedness or difficulty breathing?
  • Have you vomited?
  • Do you have high blood pressure? If so, do you take drugs?
  • Does or is used for smoking? How much?
  • Make use of alcohol or caffeine? How much?
  • Does the use of illicit drugs, such as cocaine?
Symptoms and treatment of pain in the Chest