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Chest Pain (cont.)

Chest Pain Symptoms

Heart Attack Symptoms

Typical heart attack pain occurs in the mid to left side of the chest and may also extend to the left shoulder, the left arm, the jaw, the stomach, or the back.

Other associated symptoms are shortness of breath, increased sweating, nausea, and vomiting.
Symptoms vary considerably from person to person.
Women may experience symptoms of heart attack similar to men (chest pain), but they also may be more atypical. Atypical symptoms include:
neck,
jaw,
shoulder,
upper back
abdominal discomfort,
shortness of breath,
nausea or vomiting,
abdominal pain,
heartburn,
sweatiness,
lightheadedness,
dizziness, or
unexplained fatigue.

Angina Symptoms

Angina is similar to heart attack pain but occurs with physical exertion or exercise and is relieved by rest or nitroglycerin.

Angina becomes life threatening when pain occurs at rest, has increased in frequency or intensity, or is not relieved with at least three nitroglycerin tablets taken five minutes apart.
This is considered to be unstable angina, which may be a warning sign of an impending heart attack.

Aortic Dissection Symptoms

The chest pain associated with aortic dissection occurs suddenly and is described as "ripping" or "tearing."

The pain may radiate to the back or between the shoulder blades.
Because the aorta supplies blood to the entire body, symptoms may also include:
- angina-type pain,
- shortness of breath,
- fainting,
- abdominal pain, or
- symptoms of stroke.

Pulmonary Embolism Symptoms

Symptoms of a pulmonary embolus include:

the sudden onset of shortness of breath,
rapid breathing, and
sharp pain in the mid chest, which increases with deep breaths.

Pneumothorax Symptoms

Symptoms of pneumothorax include:

the sudden onset of shortness of breath,
sharp chest pain,
rapid heart rate,
dizziness,
lightheadedness, or
faintness.

Perforated Viscus Symptoms

Perforated viscus comes on suddenly with severe abdominal, chest, and/or back pain. Abdominal pain may increase with movement or when breathing in and may be accompanied by a rigid, boardlike abdominal wall.

Pericarditis Symptoms

The pain of pericarditis is typically described as a sharp or stabbing pain in the mid-chest, worsened by deep breaths.

This pain may mimic the pain of a heart attack, because it may radiate to the left side of the back or shoulder.
One distinguishing factor is that the pain is worsened by lying flat and improved by leaning forward. When lying flat, the inflamed pericardium is in direct contact with the heart and causes pain. When leaning forward, there is a space between the pericardium and the heart.
Many people report a recent cold, fever, shortness of breath, or pain when swallowing just before developing pericarditis.

Mitral Valve Prolapse Symptoms

Mitral valve prolapse usually has no symptoms, but some people experience palpitations (sensation of rapid or strong heartbeat) and chest pain.

Chest pain associated with mitral valve prolapse differs from that of typical angina in that it is sharp, does not radiate, and is not related to physical exertion.
Other symptoms include fatigue, lightheadedness, and shortness of breath.
Complications include infection of the heart valves, mitral valve regurgitation (an abnormal blood flow within the chambers of the heart), and abnormal heart rhythms, which rarely cause sudden death.

Pneumonia Symptoms

The chest pain of pneumonia occurs during prolonged or forceful coughing.

The pain is usually one-sided an is worsened by coughing.
Other associated symptoms include fever, coughing up mucus (sputum), and shortness of breath.

Esophagus Related Symptoms

With chest pain originating from the esophagus, symptoms depend on the source.

Symptoms of gastroesophageal reflux disease (GERD) include:
- heartburn,
- painful swallowing,
- excessive salivation,
- dull chest discomfort,
- chest pressure, or
- severe squeezing pain across the mid chest.
- You may feel uncomfortable or may experience:
  - profuse sweating,
  - pallor,
  - nausea, and
  - vomiting.
- Other symptoms include:
  - sore throat,
  - sour or bitter taste in the mouth or throat,
  - hoarseness, and
  - persistent dry cough.
- Pain from GERD is often relieved with antacids.
Symptoms of esophagitis include difficulty swallowing, painful swallowing, or symptoms of GERD. The chest pain comes on suddenly and is not relieved by antacids.
The pain of esophageal spasm is usually intermittent and dull. It is located in the mid-chest and may radiate to the back, neck, or shoulders.