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Symptoms and Signs of Chest Pain

Doctor's Notes on Chest Pain

Chest pain is discomfort and/or soreness in or around the chest. It can cardiac (heart related) or non- cardiac. Signs and symptoms of cardiac pain are chest discomfort that may include pressure, squeezing, heaviness, soreness and/or burning, often associated with shortness of breath. The pain can range from dull to stabbing and may be located anywhere in the chest (classically, left chest), upper abdomen, back, neck, jaw, left arm (sometimes both arms, especially in women) and shoulders. Cardiac chest pain in women may experience more nausea and vomiting plus lightheadedness. Chest pains can be symptoms of a life-threatening heart attack; 911 should be called. Non-cardiac chest pains may have, unfortunately, one or more of the above signs or symptoms; however, non-cardiac chest pain may change (quality and/or intensity) with respiration, cough or position and cardiac causes usually do not. If you cannot tell if chest pain is cardiac or non-cardiac, call 911.

The cause of cardiac chest pain is blockage of blood to cardiac muscles that become stressed, damaged or killed due to lack of oxygen.

Non-cardiac chest pain can have wide range of potential causes including any trauma to the chest, pregnancy, indigestion, infections like pneumonia, anxiety, pericarditis, gastritis, pulmonary embolism, aortic dissection lupus, pleurisy and many others. If you are unsure about a condition causing non-cardiac chest pain, you should see your doctor for a diagnosis because even some non-cardiac causes of chest pain can be life-threatening.

Medical Author:
Medically Reviewed on 3/11/2019

Chest Pain Symptoms

This signs the symptoms of cardiac chest pain are chest discomfort, including pressure, squeezing, heaviness, or burning sometimes associated with a sensation of choking or shortness of breath. The discomfort is often described as ranging from sharp to dull and is usually located in the upper abdomen, back, neck, jaw, left arm, or shoulders. It can be precipitated by

  • exertion,
  • eating,
  • exposure to cold, and/or
  • emotional stress

and usually lasts about 1 to 5 minutes. For some, this pain is relieved by rest or from taking the medication nitroglycerin. The pain intensity usually doesn't change with respiration, cough or position change. Classically, cardiac chest pain is in the left chest. However, it may occur in the center or right chest.

Non-cardiac chest pain may have many of the above symptoms. However, non-cardiac chest pain may change with respiration, cough, or position. Regardless, chest pain is not normal and should be diagnosed by a doctor because it can represent a serious health risk.

Women may have somewhat different cardiac chest pain symptoms including more nausea and vomiting, lightheadedness, and pain or discomfort in one or both arms. Pregnant women may experience chest pain from heartburn, indigestion, enlarged breasts, pressure (baby putting pressure on diaphragm/ribs), widening of the rib cage, and stress. In children and teens, chest wall pain is the most common cause of chest pain. Rarely is there a heart problem in these ages, but it can occur with conditions such as Marfan syndrome or tearing of the aorta.

Chest Pain Causes

Although there are many causes of chest pain, the two large groups of causes are cardiac-related problems and non-cardiac causes. Cardiac chest pain is caused by an imbalance between the blood supply to the heart and oxygen needs of the heart muscle. Cardiac chest pain is most commonly a result of atherosclerosis (leading to fixed narrowing of coronary arteries), but also can be caused by coronary spasms that narrow the arteries intermittently. Cardiac chest pain is also referred to as angina or angina pectoris.

Non-cardiac chest pain has many causes, ranging from infections and muscle or bone problems to conditions such as lung tumors, lung collapse, chest trauma, upper abdominal pain, and gastric reflux. Although some of the non-cardiac causes of chest pain may require emergency care (for examples, lung collapse and severe chest trauma), most do not.

Costochondritis Symptoms, Causes, and Treatment Slideshow

Costochondritis Symptoms, Causes, and Treatment Slideshow

Costochondritis is an inflammation of the area where the ribs join the cartilage that is attached to the sternum. Costochondritis causes chest pain, especially upon palpation of the area. It is a benign condition that often resolves on its own without treatment. Chest pain from costochondritis must be differentiated from that of more serious conditions including heart attack, pericarditis, and other conditions. Costochondritis is a common cause of chest pain in children and adolescents.

REFERENCE:

Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.

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