Chest Pain

Chest pain occurs in many forms, from sharp stabbing, to feeling of tightness, burning, to dull pain. Many different health problems can cause chest pain. The most dangerous causes of chest pain are conditions and diseases of the heart. However, the most common cause of chest pain is GERD (gastroesophageal reflux disease), not a heart attack. Since chest pain can be a sign of a serious and life-threatening condition, it is important to seek medical help immediately.

What is pain in the chest?

Chest pain is a pain that occurs in any part of the chest. It can be extended to other areas, down the arms, to the neck or jaw. Chest pain can be sharp or dull. A person may feel a tightness or have a feeling that something heavy is pressing on the chest. The pain in the chest can last for a few minutes or hours. In some cases, it can last six months or longer.

Misconceptions about chest pain

Most people think the same thing: chest pain automatically means a heart attack. But that’s not always true. Usually, chest pain is not caused by heart problems if it occurs together with a feeling of acid or regurgitation of stomach contents, difficulty swallowing. For example, pain can also be caused by inflammation of the cartilage that connects the ribs to the sternum. The symptoms of panic attack and heart attack are similar, so people with a panic attack often think they have a heart attack. However, although both panic and heart attack cause chest pain, there is a difference. In a heart attack, the pain spreads to the arm, jaw, or neck, and in a panic attack, the pain remains in the chest. A panic attack is unlikely to cause a heart attack, but it is still possible. Therefore, any chest pain requires a doctor’s examination.

Symptoms and causes

Common symptoms associated with chest pain

Pressure, burning or tightness in the chest
Pain and burning sensation spreading to the back, neck, jaw, shoulders and one or both arms.
Pain that lasts longer than a few minutes worsens during activity, disappears and returns or varies in intensity.
Shortness of breath.
Cold sweat.

Symptoms of chest pain that are not related to heart disease

Difficulty swallowing or sour taste in the mouth
Pain that is felt only after you swallow or eat
Pain that decreases or intensifies depending on your body position, pain that worsens when you breathe deeply or cough
Chest pain followed by skin rash
Elevated temperature
Pain in the back that spreads to the front of the chest
Anxiety or panic
Hyperventilation

Factors that can affect the formation of chest pain

Most common causes of chest pain are conditions and diseases of the lungs, heart disease, stress, digestive problems or problems with the muscles of the chest wall.

The most common causes of chest pain

Heart problems

Heart attack– Pain occurs when the heart muscle is unable to get enough oxygen due to a blockage of the coronary artery that supplies it with blood.

Coronary artery disease – The buildup of cholesterol can narrow and block the blood vessels that lead the blood to the heart. The condition is usually exacerbated by exercise because blood flow to the heart is difficult.

Coronary artery dissection – The wall of the coronary artery can tear, create a bulge and block the artery. This condition causes pressure or chest pain and can lead to a heart attack.

Pericarditis – An infection or other cause can lead to the inflammation of the protective membrane of the heart (pericardial sac), causing sharp pain in the chest. The pain can spread to the left shoulder and arm.

Hypertrophic cardiomyopathy – The muscle walls of the heart chambers become thickened and rigid and not enough oxygen-rich blood reaches the heart. Hypertrophic cardiomyopathy is mainly hereditary.

Aortic dissection – Dissection may occur in the wall of the aorta, as a result of which the layers of the arteria wall separate from each other. This very severe pain happens without warning and feels like something is tearing and is often felt in the chest, back and between the shoulder blades.

Mitral valves prolapse – A valve that allows blood flow between the left atrium and the left ventricle may not close completely every time the heart beats. That’s why the blood goes back to the chamber from which it came.

Digestive problems (pain in the middle of the chest)

Gastroesophageal reflux (GERD) – Acid from the stomach reaches the esophagus, which leads to a burning sensation and tightness under the sternum. This chest pain can be worse in the supine position. It often worsens after fatty spicy foods, and the symptoms are more intense at night after a hearty dinner.

Ulcer – Infection or taking nonsteroidal anti-inflammatory medications leads to inflammation and damage to the gastric mucosa. Symptoms may be burning or pain right under the sternum. Acidic foods and alcohol exacerbate symptoms.

Esophageal muscle spasms – The condition occurs when the muscles that normally push food through the esophagus stop doing so. Instead, there is a strong feeling of tightness under the sternum with or without swallowing problems. It often happens when exercising.

Esophagitis – An allergic reaction to food can cause inflammation of the walls of the esophagus. As with GERD, there is a burning sensation under the sternum.

Digestive problems (pain on the right side)

Gallstone – It can block channels where the fluid that aids digestion (bile) needs to move to reach the small intestine. Due to the swelling of the gallbladder, the pain spreads under the ribs on the right side. The pain is intense and very unpleasant and can last for hours.

Digestive problems (pain on the left side)

Hiatal hernia – Part of the stomach can pass through an opening in the diaphragm muscle, which reduces blood supply to the stomach. People with hiatal hernia often have difficulty swallowing.

Gastritis – Inflammation of the gastric mucosa can cause pain in the lower left part of the chest that can be accompanied by nausea and vomiting.

Pancreatitis – Inflammation of the pancreas can cause severe pain in the upper abdomen. Nausea and vomiting also occur.

Problems with the lungs (pain on the left or right side of the chest)

Pulmonary embolism – A blood clot from another part of the body can get stuck in the pulmonary artery. People with pulmonary embolism have shortness of breath and often sharp pain that worsens when inhaling.

Chronic obstructive pulmonary disease (COPD) – Problems with the alveoli and/or mucous membranes of the airways make breathing difficult. There is a tightness in the chest that accompanies shortness of breath.

Pneumonia – This infection can cause pain on both sides of the chest, but it is usually accompanied by fever, chills, and cough.

Pneumothorax – Air can enter between the layers of tissue covering the lungs, causing it to collapse. There is a sudden sharp pain in the chest, sometimes in the neck and shoulder.

Pulmonary hypertension – Several disorders can cause high blood pressure in the pulmonary arteries, which lead blood to the lungs to exchange carbon dioxide for oxygen. Pain occurs when the heart is struggling and cannot push blood through blood vessels that are narrowed due to hypertension.

Asthma – Allergens or irritants can temporarily narrow the airways, making it difficult to breathe. Chest tightness, coughing or whistling may occur.

Pain in the left or right side of the chest – musculoskeletal problems

Broken rib – Severe pain occurs during rib fracture, especially when inhaling.

Injuries to the muscles of the chest – Injuries cause pain, especially when moving or coughing. Swelling and bruises may also occur.

Musculoskeletal problems (pain in the middle chest)

Costochondritis – Inflammation can occur in the cartilage that connects most of the ribs to the sternum. It is accompanied by a sharp chest pain that worsens during coughing or deep breathing.

Pain in the left or right side of the chest

Herpes zoster – Varicella virus can become active again later in life, usually in people over the age of 50. Like herpes, this virus causes a painful rash that appears on the skin in the upper part of the body. It usually develops in a certain part of the chest, usually only on one side.

Lung cancer – Chest pain from lung cancer becomes stronger when a person coughs, laughs, or takes a deep breath.

Treatment and prevention

Treatment of chest pain depends on the cause of the pain. If the heart attack is causing chest pain, urgent medical attention is required. Treatment may include medications and surgical procedures to restore blood flow to the heart.

How to treat chest pains

Depending on the disease, the doctor may recommend:

Lifestyle changes
Medications
Surgical interventions

Ways to prevent chest pain

The risk of heart, vascular and other diseases that cause chest pain can be reduced by applying a healthy lifestyle.

Healthy eating: the doctor and dietitian can make an appropriate diet plan according to the patient’s condition.
Control of health conditions such as high blood pressure, high cholesterol, and diabetes.
Regular exercise, about the method and intensity you should consult a doctor
Reaching and maintaining a healthy weight
Limiting alcohol intake
Quitting smoking

Diagnosis and tests

Chest pain doesn’t always mean it’s a heart attack. But that’s what emergency physicians check first because it’s potentially the most immediate threat to life.

The doctor can also check whether the cause of the pain is pulmonary embolism, a condition that is life-threatening. A doctor can treat and resolve chest pain caused by many common conditions such as acid reflux, anxiety attacks, asthma, or similar disorders.

Chest pain is treated with drugs, non-invasive procedures, surgical techniques, or a combination of these methods. Treatment depends on the cause and severity of chest pain.

The doctor will also ask the patient some questions, and the answers can help diagnose the cause of chest pain. The doctor must be familiar with all medications, treatment methods or other medical conditions of the patient.

Tests used to diagnose the causes of chest pain

Emergency diagnostic tests

Some of the first tests used by a doctor to diagnose chest pain are:

Electrocardiogram (ECG)

This rapid test measures the electrical activity of the heart. An ECG can tell if your heart is beating too fast or too slowly. An ECG can help to show if a patient has had or is currently having a heart attack.

Blood tests

Certain heart proteins occur in the blood after heart damage from a heart attack. Blood tests can be done to check these proteins.

Chest X-ray

The chest X-ray indicates the condition of the lungs and the size and shape of the heart and large blood vessels. Chest X-rays can also reveal lung problems such as pneumonia or lung collapse.

Computed tomography to (CT):

CT scanner can detect a blood clot in the lungs or aortic dissection.

Additional diagnostics

Depending on the results of the first tests for chest pain, additional diagnostics may be required:

Echocardiogram (ultrasound of the heart)

Sound waves are used to make videos of the heart in motion. Sometimes a more detailed echocardiogram can be done to get better heart images.

Cardiac stress test

These tests often involve walking on a treadmill or riding a stationary bike while monitoring the heart rhythm.

Coronary catheterization (angiogram)

It allows doctors to detect blockages in the heart arteries. A long, thin flexible tube is inserted into the blood vessel, usually in the groin or joint, and leads to the heart. The color flows through the tube to the arteries in the heart. The color helps to show the condition of the arteries more clearly on X-rays and videos.

Home remedies and self-help tips

Home remedies for chest pain are intended to treat chest pain resulting from digestive problems, such as gases, reflux, muscle strain or anxiety. It may not be easy to distinguish between this benign pain and more serious conditions such as a heart attack. When in doubt, people should always seek medical help.

There are a number of home remedies that you can try at home to relieve less chest pain. Home remedies that help relieve minor chest pain caused by digestive problems or muscle strain can be:

Baking soda Many people believe that baking soda (sodium bicarbonate) relieves heartburn. Mix 1/2 teaspoon of baking soda in a glass of cold water and drink. Baking soda neutralizes acid and can help prevent heartburn after eating. But baking soda can have harmful effects on the heart due to narnium, so it is important to use this drug in moderation.

Ginger for stomach pain – If you feel chest pain due to gastrointestinal problems, ginger can help thanks to its anti-inflammatory effects. Ginger is often used as a home remedy for stomach problems such as gas, bloating, gastritis, ulcers, and indigestion. Ginger contains compounds that are said to relieve irritation in the gastrointestinal tract and reduce stomach contractions.

Turmeric anti-inflammatory – Inflammation can cause a multitude of problems in the body and plays a role in many diseases and chronic conditions.

Curcumin – the main active ingredient in turmeric — is known to reduce inflammation in the body, especially in gastrointestinal problems.

Cold compresses for chest muscle pain – Straining the chest muscles is a common cause of chest pain. If you have chest pain due to muscle strain or injury, putting on cold compresses several times a day can help reduce pain and inflammation.

Lying down when heart pain occurs – lying with your head raised above body height can bring relief. A slightly erect position helps in the case when the pain is caused by reflux.

Deep breathing – Try to breathe deeply to help with stress or anxiety.

Important: A person should not use these drugs as a first line of defense. If the pain is new or unusual, people should seek medical attention to make sure it is not the result of something more serious than heartburn and gases.

Self-help tips

There are several ways to treat long-term chest pain of a known cause.

Gastrointestinal pain in the chest

Avoid foods with high acid content such as tomatoes and citrus, fried foods or alcohol. Take an anti-heartburn medicine and an acid-reducing drug. Avoid smoking or staying in smoky areas.

Chest pain caused by inflammation or muscle injury

Rest as much as possible. Put a compression bandage around your chest. Lift the upper part of the body while lying down to reduce chest pain, sleep with extra pillows. Apply cold compresses.

Respiratory infections

Take decongestants as needed to allow easier breathing. Drink plenty of warm liquids at room temperature. Place a humidifier near the bed. Keep in mind that none of these tips will cure the underlying causes of chest pain, they can only help relieve discomfort. If they don’t help relieve symptoms quickly, make an appointment with your doctor or go to the nearest hospital.

Available medicines and treatments

Treatment of chest pain caused by heart problems includes:

Nitroglycerin – a drug commonly taken as a tablet under the tongue, relaxes the heart arteries so that blood can flow more easily through narrowed spaces.
Some blood pressure medications also relax and dilate blood vessels.
Thrombolytics – drugs that dissolve blood clots

Procedures such as:

Catheterization of the heart
Cardiac bypass surgery

Treatment of other causes of chest pain can be:

Medications antacids or certain procedures to suppress the symptoms of acid reflux and heartburn.
If you have panic attacks, your doctor may prescribe antidepressants. Talk therapy, such as cognitive behavioral therapy, may also be an option.
Interventions in lung diseases.

When to seek professional help

Chest pain that returns at intervals or occurs when consuming certain foods, sharp, short chest pain, sudden pain and tightness in the chest, pain with physical exertion is certainly the reason for a visit to the doctor. Chest pain is not normal and should not be ignored.

When to seek emergency medical help

Call an ambulance or have someone drive you to the nearest health care facility immediately if:

– you have chest pain that lasts longer than five minutes and does not stop when you rest or take medication Chest pain can be a sign of a heart attack! Other signs of a heart attack:

Perspiration
Nausea or vomiting
Shortness of breath
Lightheadedness
Rapid or irregular heartbeat
Pain in the back, jaw, neck, upper abdomen, arm, or shoulder.

First aid for chest pain

If you notice that someone has symptoms of a heart attack or severe chest pain, you should provide first aid.

Call an ambulance first.
Until help arrives, help the patient to rest in the position that is most comfortable for him, mainly a semi-seated position with a support for his back and head. If you are outside, kneel behind the patient to support him.
If the patient does not respond, you may need to give him CPR.
Help the patient take any medication prescribed for chest pain, and he has it with him.
Avoid giving food, liquids or stimulants such as alcohol, cigarettes, tea or coffee.
Keep the patient calm, it is very important not to get excited.
Loosen tight clothes on his neck and waist to make breathing easier.
Never transport a patient with chest pain in the car. Extra effort could cause more damage to the heart.

Prognosis and outcome of chest pain

Most often, the prognosis for chest pain (caused by heart disease and other diseases) is good, because there are several drugs that work quite effectively on chest pain. However, the ultimate prognosis for the patient depends on the underlying cause of chest pain. If the underlying cause of the heart or other disease is not resolved, then the prognosis may be poor. Since heart pain in the chest is a symptom of heart disease, if it recurs and lasts longer, it means that the condition worsens.

General expectations for recovery

The pain in the chest can last for a few minutes or hours. In some cases, it can last six months or longer. Recovery depends on the cause of chest pain. If heart surgery is required due to chest pain, recovery takes months.

Recovery from a heart attack takes anywhere from two weeks to three months. During this period, it is important to start adopting lifestyle changes that can reduce the risk of a future heart attack. It is necessary to apply a healthy diet, exercise, avoid alcohol and cigarettes. On the other hand, pain in the pectoral muscles passes in a few days with rest and compresses. Problems with heartburn can be solved with the use of drugs and a customized diet.

Life with chest pains

Living with heart disease or after heart attacks requires strict follow-up to doctor’s advice and taking therapy. The method of physical activity and adjustment of the diet should also be consulted with a doctor.

Avoid foods that cause heartburn and chest pain.
Practice deep breathing. Focused, deep breaths can calm the mind and body.

When to visit a healthcare professional for control

If with the use of drugs and advice does not relieve symptoms or chest pain becomes more intense, it occurs more often, consult a doctor.

When to ask for help immediately

Any chest pain that lasts longer than 15 minutes should be considered serious. A heart attack, also known as myocardial infarction, is one of the most serious heart conditions requiring immediate intervention.