Doctor's Notes on Chest Pain
Chest pain is discomfort and/or soreness in or around the chest. It can be 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.
What Are the Treatments for Chest Pain?
Treatments for chest pain depend on what is causing the pain. If it seems likely to be a heart-related problem, call 911. The following are a list of some medications and procedures that treat chest pain from multiple common causes:
- Aspirin: heart causes
- Nitroglycerin: heart causes
- Beta blockers: heart causes
- Thrombolytic drugs: clot causes
- Blood thinners: clot prevention
- Acid-reducing drugs: upper GI causes
- NSAIDs: chest muscle and other structural causes
- Prescription pain medications: pain control
Dangerous chest pain causes may need procedures done like the following:
- Angioplasty and/or stent placement
- Cardiac artery bypass surgery
- Aortic dissection repair
- Collapsed lung reinflation
- Chest trauma repair to tissue and/or bones
The causes, both apparent and underlying, need an accurate and speedy diagnosis. Many causes are considered medical emergencies. If you are not sure about what to do about anyone's chest pain, call 911.
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REFERENCE:
Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.