Chest pain
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Go to Disease home
Chest pain is a common symptom that
can be caused by many different conditions.
The cause can be difficult to
determine.
Chest pain can have a serious
cause, such as heart attack, angina or tearing of the aorta.
You
should not ignore chest pain. Self-diagnosis may be inappropriate; you wont
know whether the cause is serious until a medically trained person has evaluated
you.
Other
causes of chest pain may be unrelated to the heart and can be evaluated as
non-emergencies, such as gastroesophageal reflux disease, gallstones, or
inflammation of the chest wall.
Even if your chest pain
has nothing to do with your cardiovascular system, the problem may still be
important.
Cause
Chest pain can be due to a heart attack or angina or could be caused by other
factors:
Heart attack
Important: Chest pain
can be an important warning symptom of a heart attack. The symptoms of a heart
attack include:
Chest
pain that is crushing, squeezing, or feels like a heavy weight on the chest, a
tight band around the chest or a dull ache in the middle of the chest resembling
indigestion
Chest pain associated with
shortness of breath, nausea or vomiting, pain radiating from the chest to the
neck, jaw, or one or both arms, dizziness or light-headedness, increased
perspiration, fast or irregular pulse.
If
you have symptoms of a heart attack, call your nearest emergency service
immediately.
Angina
If
chest pain is caused by angina it also requires urgent medical attention. The
symptoms of angina include pain that:
Feels like squeezing, pressure,
heaviness, tightening, or aching across the chest, usually in the middle of the
chest
Often radiates to the
neck, jaw, arms, back, or even the teeth
Might
feel like indigestion or heartburn
Is associated with
weakness, sweating, nausea and shortness of breath
Is precipitated by exercise.
Other
Many
conditions may cause chest pain similar to that of a heart attack or angina,
including:
Pleuritis/pleurisy
inflammation of the lining of the lung
Pulmonary embolism a
blood clot lodged in one of the arteries in the lung
Pneumothorax air leakage
from the lung into the chest cavity
Pericarditis
inflammation of the sac lining the heart
Mitral valve prolapse a
relatively benign valve abnormality in the heart
Aortic dissection a
tear running in the wall of the aorta
Costochondritis
inflammation of the cartilage in the small joints between ribs and the
breastbone
Rib fractures usually
related to trauma
Nerve compression
pressure on the nerves running in the chest
Shingles
nerve infection by the herpes zoster virus
Oesophageal spasm and reflux
spasm of the oesophagus and regurgitation of the stomach acid into the
oesophagus
Gallbladder
problems, such as a gallstone attack
Anxiety and panic attack
often associated with hyperventilation
Diagnosis
Here
are some things to think about when you or someone you know has chest pain that
is not caused by angina or heart attack. This information should be relayed to
the medically trained person you consult.
Have
you had an injury?
Pain may be caused by an
injury to muscles, tendons or ribs
Pain related to an injury
occurs with movement of a shoulder, an arm, the rib cage, or the trunk of the
body
Deep breathing, coughing
or sneezing may also increase the pain
Pain that starts
immediately after a severe injury may mean there has been damage to organs
inside the chest, such as the lungs, heart or blood vessels. Or other symptoms,
such as true shortness of breath or shock, develop quickly.
This type of injury requires urgent medical attention
What
makes the pain better or worse?
Pain
that gets worse when you press on the area may be caused by chest wall pblems,
such as inflammation of cartilage in the chest wall (costochondritis)
Pain
that gets worse with deep breaths, coughing or sneezing may be caused by
inflammation of the lining of the lung (pleurisy), or free air in the chest
cavity (pneumothorax).
Pain that is made better or worse
by eating may be caused by a problem in the abdomen, such as an ulcer,
gallbladder disease, reflux disease or inflammation of the stomach.
What
does the chest pain feel like?
A
sharp pain that lasts only a few seconds may be caused by a minor problem such
as chest wall pathology.
Sudden, severe chest pain
with a fever may be caused by inflammation of the membrane (pericardium) that
surrounds and protects the heart (pericarditis).
Burning or gnawing pain
at the top of the abdomen may be caused by an ulcer, gallbladder disease,
heartburn or inflammation of the stomach (gastritis).
In very rare cases,
severe chest pain may be caused by an aortic aneurism bulging out of the main
vessel (aorta) that carries blood from the heart to the body. Pain may indicate
that the aneurism is getting bigger or has torn into the wall of the aorta.
Does
the pain seem to spread to other areas of the body?
Pain
that starts in the upper belly and spreads up into the chest may be caused by
heartburn
Pain that spreads around
only one side of the chest may be caused by an inflammation such as shingles.
Shingles may cause a rash of chickenpox-like blisters around one side of the
chest.
Pain
that spreads from the upper belly to the chest and back may be caused by
gallbladder disease or disease of the pancreas.
Do
you have chest pain with any other symptoms?
Chest pain and a fever,
runny nose or cough may mean a respiratory infection
Chest
pain and true shortness of breath may mean there is a blood clot in the arteries
of the lung (pulmonary embolus).
Treatment
Home
Minor chest pain
Specific home treatment for chest pain depends on the cause of the pain. Often
minor chest pain improves with home treatment and does not require a visit to a
health professional.
Chest wall pain caused by strained muscles or ligaments or a fractured rib
Use
pain relievers (analgesics), such as nonsteroidal anti-inflammatory drugs
(including Brufen), or Panado. Ointments containing anti-inflammatories, such as
Voltaren Gel, may also help. Do not give aspirin to anyone under the age of 20.
Use
an ice pack to help relieve pain the first few days after an injury.
Use
heat (a hot-water bottle, warm towel or heating pad) after 48 to 72 hours of
cold treatments (or when the swelling is down) to help relieve the pain. Experts
do not agree on the use of heat after an injury. Some think it increases
swelling and bruising; others believe it may speed healing. If you use heat, be
careful not to burn your skin. Use heat that is no warmer than bath water or the
low setting on a heating pad. Remember, do not go to sleep with a heating pad.
As
your pain lessens, slowly return to your normal activities. Any increased pain
may be a sign you need to rest a while longer.
Hyperventilation
For
home treatment of hyperventilation caused by anxiety or panic attacks:
Focus on slowing your breathing.
Breath in and out of a
paper bag held over the nose and mouth. Keep this treatment up for two to three
minutes. Remove the bag for five minutes, and repeat breathing into the bag for
two to three minutes. Keep this cycle up until breathing has returned to normal.
This will help bring the amount of CO2 in the blood back to normal. To prevent
the level of oxygen (O2) in the blood from dropping too low, it is important to
take breaks from breathing into the bag.
Symptoms to watch for during home treatment
Consult with your doctor if:
Your
chest pain is not relieved by home treatment
The pain lasts longer than four
weeks
Your symptoms become more
severe or frequent
