Heart Disease (Coronary Artery Disease) Slideshow Pictures Medical Illustrations of the Heart Image Collection Take the Heart Disease Quiz! 16k1097

Medical Author:

John P. Cunha, DO, FACOEP

John P. Cunha, DO, FACOEP

John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.

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Medical Editor:

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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Chest Pain Causes

Heart Attack Causes

A heart attack is caused by coronary heart disease, or coronary artery disease. Heart disease may be caused by cholesterol buildup in the coronary arteries (atherosclerosis), blood clots, or spasm of the vessels that supply blood to the heart.

Risk factors for a heart attack are:

• high blood pressure
  
  
• diabetes
  
  
• smoking
  
  
• high cholesterol
  
  
• family history of heart attacks at ages younger than 60 years, one or more previous heart attacks, male gender
  
  
• obesity
  
  
• Postmenopausal women are at higher risk than premenopausal women. This is thought to be due to loss of the protective effects of the hormone estrogen at menopause. It was previously treated by hormone supplements (hormone replacement therapy, or HRT). However, research findings have changed our thinking on HRT; long-term HRT is no longer recommended for most women.
  
  
• Use of cocaine and similar stimulants.

Angina Causes

• Angina may be caused by spasm, narrowing, or partial blockage of an artery that supplies blood to the heart.
  
  
• The most common cause is coronary heart disease, in which a blood clot or buildup of fatty material inside the blood vessel (atherosclerosis) reduces blood flow but does not completely block the blood vessel.
  
  
• Angina can be triggered by exercise or physical exertion, by emotional stress, or by certain heart rhythm disorders (arrhythmias) that cause the heart to beat very fast.

Aortic Dissection Causes

• Aortic dissection may be caused by conditions that damage the innermost lining of the aorta.
  
  
  • These include uncontrolled high blood pressure, connective-tissue diseases, cocaine use, advanced age, pregnancy, congenital heart disease, and cardiac catheterization (a medical procedure).
    
    
• Men are at higher risk than women.
  
  
• A similar condition is aortic aneurysm. This is an enlargement of the aorta that can rupture, causing pain and bleeding. Aneurysms can occur in the aorta in the chest or the abdomen.

Pulmonary Embolism Causes

Pulmonary embolism risk factors include:

• sedentary lifestyle,
  
  
• obesity,
  
  
• prolonged immobility,
  
  
• fracture of a long bone of the legs,
  
  
• pregnancy,
  
  
• cancer,
  
  
• history or family history of blood clots,
  
  
• irregular heartbeat (arrhythmias),
  
  
• heart attack, or
  
  
• congestive heart failure.

Women who use birth control pills and smoke cigarettes are at higher risk than women who have only one or neither of these risk factors (especially over the age of 35).

Spontaneous Pneumothorax Causes

Spontaneous pneumothorax (collapsed lung) occurs when the pressure balance between the sac that contains the lung and the outside atmosphere is disrupted.

• Injury to the chest that pierces through to the lung sac is the most common cause of this condition.
  
  
• This can be caused by trauma, as in a car wreck, bad fall, gunshot wound or stabbing, or in surgery.
  
  
• Some very thin and tall people may suffer a spontaneous pneumothorax due to stretched lung tissues and abnormal air sacs in the upper portions of their lungs. It is possible for these abnormal air sacs to rupture with even a sneeze or excessive coughing.
  
  
• Other risk factors for pneumothorax include AIDS-related pneumonia, emphysema, severe asthma, cystic fibrosis, cancer, and marijuana and crack cocaine use
  

Perforated Viscus Causes

Perforated viscus may be caused by direct or indirect injury. Irritation to the diaphragm in this case comes from below the chest. The diaphragm is the muscle that allows us to breathe. It is located up under the ribs and separates the chest and abdominal cavity. Any irritation to the diaphragm, even from below it, can cause pain to be felt in the chest.

Risk factors not related to trauma are:

• untreated ulcers,
  
  
• prolonged or forceful vomiting,
  
  
• swallowing a foreign body,
  
  
• cancer,
  
  
• appendicitis,
  
  
• long-term steroid use,
  
  
• infection of the gallbladder,
  
  
• gallstones, and
  
  
• AIDS.

Pericarditis Causes

Pericarditis can be caused by viral infection, bacterial infection, cancer, connective-tissue diseases, certain medications, radiation treatment, and chronic renal failure.

• One life-threatening complication of pericarditis is cardiac tamponade.
  
  
  • Cardiac tamponade is an accumulation of fluid around the heart. This prevents the heart from effectively pumping blood to the body.
    
    
  • Symptoms of cardiac tamponade include sudden onset of shortness of breath, fainting, and chest pain.

Pneumonia Causes

Pneumonia may be caused by viral, bacterial, or fungal infections of the lungs.

Esophagus Related Causes

Chest pain originating from the esophagus may have several causes.

• Acid reflux (GERD) may be caused by any factors that decrease the pressure on the lower part of the esophagus, decreased movement of the esophagus, or prolonged emptying of the stomach. This condition may be brought on by:
  • consumption of high-fat foods,
    
    
  • nicotine use,
    
    
  • alcohol use,
    
    
  • caffeine, pregnancy,
    
    
  • certain medications (for example, nitrates, calcium channel blockers, anticholinergics, estrogen, progesterone),
    
    
  • diabetes, or
    
    
  • scleroderma.
    
    
• Esophagitis may be caused by yeast, fungi, viruses, bacteria, or irritation from medications.
  
  
• Esophageal spasm is caused by excessive, intensified, or uncoordinated contractions of the smooth muscle of the esophagus. Spasm may be triggered by emotional upset or swallowing very hot or cold liquids.