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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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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.

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