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 Chest
Pain
What is Chest Pain?
Chest pain is discomfort or pain
that you feel anywhere along the front of your
body between your neck and upper abdomen.
Considerations:
Many people with chest pain fear
a heart attack. However, there are many
possible causes of chest pain. Some causes are
mildly inconvenient, while other causes are
serious, even life-threatening. Any organ or
tissue in your chest can be the source of pain,
including your heart, lungs, esophagus, muscles,
ribs, tendons, or nerves.
Angina is a type of
heart-related chest pain. This pain occurs
because your heart is not getting enough blood
and oxygen. Angina pain can be similar to the
pain of a heart attack.
Angina is called stable
angina when your chest pain begins at a
predictable level of activity. (For example,
when you walk up a steep hill.) However, if your
chest pain happens unexpectedly after light
activity or occurs at rest, this is called
unstable angina. This is a more dangerous form
of angina and you need to be seen in an
emergency room right away.
Emergency Options: Call 911
immediately if:
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You have sudden crushing,
squeezing, tightening, or pressure in your
chest.
-
Pain radiates to your jaw,
left arm, or between your shoulder blades.
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You have nausea, dizziness,
sweating, a racing heart, or shortness of
breath.
-
You know you have angina and
your chest discomfort is suddenly more
intense, brought on by lighter activity, or
lasts longer than usual.
-
Your angina symptoms occur
at rest.
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You have sudden sharp chest
pain with shortness of breath, especially
after a long trip, a stretch of bedrest (for
example, following an operation), or other
lack of movement that can lead to a blood
clot in your leg.
Know that your risk of heart
attack is greater if you have a family history
of heart disease, you smoke or use cocaine, or
you have high cholesterol, high blood pressure,
or diabetes.
Call your doctor if:
What to expect at your health
care provider's office
Emergency measures will be
taken, if necessary. Hospitalization will be
required in difficult or serious cases or when
the cause of the pain is unclear.
The doctor will perform a
physical examination and monitor your vital
signs (temperature, pulse, rate of
breathing, blood pressure). The physical
examination will focus on the chest wall, lungs,
and heart. Your doctor may ask questions like
the following:
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Is the pain between the
shoulder blades? Under the breastbone? Does
the pain change location? Is it on one side
only?
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How would you describe the
pain? (Severe, tearing or ripping, sharp,
stabbing, burning, squeezing, constricting,
tight, pressure-like, crushing, aching,
dull, heavy)
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Does it come on suddenly?
Does the pain occur at the same time each
day?
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Is the pain getting worse?
How long does the pain last?
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Does the pain go from your
chest into your shoulder, arm, neck, jaw, or
back?
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Is the pain worse when you
are breathing deeply, coughing, eating,
bending?
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When you are exercising? Is
the pain better after you rest? Is it
completely relieved or just less pain?
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Is the pain better after you
take nitroglycerin medication? After you
drink milk or take antacids? After belching?
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What other symptoms are also
present?
Diagnostic tests that may be
performed include:
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Blood tests (such as LDH,
LDH isoenzymes, CPK, CPK isoenzymes,
Troponin, CBC, and blood
differential)
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Cardiac catheterization
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ECG
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Exercise ECG
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Lung scan
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X-rays of the chest
More complex tests may be
required depending on the difficulty of
diagnosis or the suspected cause of the chest
pain.
Prevention
Make healthy lifestyle choices
to prevent chest pain from heart disease:
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Achieve and maintain normal
weight.
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Control high blood pressure,
high cholesterol, and diabetes.
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Avoid cigarette smoking and
second-hand smoke.
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Eat a diet low in saturated
and hydrogenated fats and cholesterol, and
high in starches, fiber, fruits, and
vegetables.
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Exercise 3 hours per week or
more (such as 30 minutes per day, 6 days per
week).
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Reduce stress.
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