Chest pain is one of the common cause to visit Emergency Room(ER) as worldwide, chest pain affects 20 to 40 percent of the general population. 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.
Chest region consist of two major organs i.e. lungs and heart, so the major causes of chest pain involves some medical condition in these organs
What are the causes of chest pain?
Chest pain has many possible causes, all of which need medical care:
Heart-related causes of chest pain includes:
Heart attack: It results due to complete blockade of artery which supply blood the heart muscle
Angina: When the artery is partially blocked & the blood flow to heart is compromised, it leads to angina Site, onset, character, radiation all remains same in both heart attack & angina but the major factor to differentiate between them is time. If the pain continue for more than 15 minute then it confirms heart attack, if less than 15 minute it might be angina (not surely angina).
Aortic dissection: In aorta, if the inner layers gets separated, blood is forced between the layers and can cause aorta to rupture
Pericarditis: This is the inflammation of the sac (pericardium) surrounding your heart. It usually cause sharp pain that gets worse when you breath in or when you lie down
image source: verywellhealth.com
Digestive and gastrointestinal related causes
Digestive causes includes:
Heart burn: it occurs when the acid from the stomach washes up to the esophagus.
Swallowing disorders: Disorders of the esophagus can make swallowing difficult and even painful.
Gallbladder and pancreas problem: Gallstones or inflammation of your gall bladder or pancreas can cause abdominal pain that radiate to your chest.
Muscle and bone causes
Problems affecting the structure that make up the chest wall can also leads to chest pain which include:
Costochondritis: in this condition, the cartilage which joins ribs to sternum(the central bone in your chest), becomes inflamed and painful
Sore muscle: chronic pain, such as fibromyalgia, can produce persistent muscle related chest pain.
Injured ribs: A bruised or broken rib can cause chest pain
Lung and respiratory related causes
Lung disorders which leads to chest pain includes:
Pulmonary embolism: when the blood flowing through your lungs is disturbed either by clot or thrombus leads to pulmonary embolism
Pleurisy: if the membrane that covers your lungs becomes inflamed, it can cause chest pain that worsen when you inhale or cough.
Pulmonary hypertension: This condition occurs when you have high blood pressure in the arteries carrying blood to your lungs, which can produce chest pain
Collapsed lung: A collapsed lung appears when air leaks between the lungs and the ribs. The pain related to it begins suddenly and can last for hours.
Chest pain can also be caused by:
Panic attack: If you have periods of intense fear accompanied chest pain, a rapid heartbeat, rapid breathing, profuse sweating, shortness of breath, nausea, dizziness, and a fear of dying, you may be experiencing a panic attack.
Shingles: caused by reactivation of the chickenpox virus, shingles can produce pain and a band of blisters from your back around to your chest wall
What investigations you need to do when you have chest pain?
When a patient visit emergency room (ER) with chest pain the first differential diagnosis made is heart attack & the doctor will test first for it. They may also check for life threatening condition of lung like collapsed lung or a clot in your lung. Major investigation related to chest pain includes which help to make diagnosis includes:
- Electrocardiogram (ECG)
- Blood tests
- Chest X-ray
- CT scan
The above listed investigation provide the confirmation result for the cause of heart attack or if it is the other causes of chest pain.
When to seek medical help immediately?
It is always preferred to contact a doctor if chest pain comes on suddenly, especially if taking pain-killer does not relief symptoms. Anyone experiencing chest pain along with difficulty breathing should go to nearby hospital or call for emergency medical help.
Symptoms that may require emergency medical help include:
- A crushing sensation on the breastbone (like elephant seating on your chest)
- Chest pain that spread to the left arm, jaw or back
- Confusion, an accelerating heartbeat, or rapid breathing
It is always suggested not to get panic with chest pain and also to not take chest pain as simple pain as it can be sometimes symptoms of life threatening diseases.