But how do you know when you need medical help for chest pain? It’s not always easy to tell. If you’re not sure why your chest hurts, it’s best to check it out.
Common Causes of Chest Pain
Pain, heaviness, pressure or discomfort in the chest is chest pain. Another common cause of chest pain is costochondritis. Chest wall pain can also come from chest muscles sore from excessive coughing, rib injuries and bruised muscles. Muscle–related pain tends to hurt when you twist side–to–side or raise your arms. Other causes of non–cardiac chest pain can include pinched nerves or shingles (an infection of nerve pathways caused by the chickenpox virus). Chronic pain syndromes, such as fibromyalgia, can also cause chest pain.
In addition, gallstones or inflammation of the gallbladder (cholecystitis) or pancreas can cause acute upper abdominal pain that radiates to the chest. Rarely, cancer involving the chest or cancer that has spread from another part of the body can cause chest pain.
Heartburn, anxiety, esophageal disorder and certain lung conditions. Consult your physician to determine the best course of treatment. It varies depending upon the source of the pain. Sometimes, rest or over–the–counter medications will relieve your symptoms. Your doctor will probably put you through certain tests to determine the problem.
Diagnosis of Chest Pain
ECG or EKG – This test helps doctors diagnose a heart attack as well as other heart problems by recording the electrical activity of your heart through electrodes attached to your skin.
Blood test – Blood tests measure levels of certain enzymes normally found in heart muscle. Higher levels may indicate damage to heart cells.
Stress tests – These measure how your heart and blood vessels respond to exertion.
Nuclear scan – Trace amounts of radioactive material, such as thallium, are injected into your bloodstream to help determine if there are blood flow problems.
Coronary catheterization (angiogram) – A liquid dye is injected into the arteries of your heart through a catheter, a long, thin tube inserted through another artery in your body. This test can show if blood vessels are narrowed or blocked.
Chest x–ray – An x–ray can show the condition of your lungs and the size and shape of your heart and major blood vessels.
Types of chest pain
Heartburn (Gastroesophageal Reflux Disease or GERD)
Heartburn is the most common cause of related chest pain. It occurs when acid from your stomach moves up into your esophagus, producing a painful, burning sensation in your chest. You may also have a sour taste in your mouth and the sensation of food or liquid coming back up.
Heartburn usually follows meals and may last for hours. Symptoms occur more frequently when you bend at the waist or lie down. They’re usually relieved by belching and antacids. Left untreated, chronic, very frequent heartburn can occasionally lead to scarring and narrowing of your esophagus.
Diagnosis – A barium swallow and endoscopy, a procedure in which a thin, flexible instrument attached to a camera is passed down your throat. This allows your doctor to view your esophagus and your stomach.
Esophageal motility disorders – These affect the muscles of your esophagus, making swallowing difficult and even painful.
Esophageal spasm – A condition that affects a small percentage of people with chest pain. When they swallow, the muscles that normally move food down their esophagus are uncoordinated, resulting in painful spasms. Since esophageal spasms can be calmed with the medication nitroglycerine – which also rapidly relieves some heart–related pain – this condition is sometimes mistaken for a heart problem. Dysphagia – when swallowing becomes difficult.
Achalasia (ak–uh–LA–zhuh ) – With this condition, the valve in the lower esophagus doesn’t open properly to allow food to enter the stomach. Instead, food backs up into the esophagus, causing pain.
Motility disorders can usually be treated with minor surgery, medication or endoscopic techniques.
Anxiety disorders – Stress–related causes of chest pain include:
General anxiety – Some people who’ve had a heart attack or have a family history of heart attacks have greater anxiety about chest pain than others. If they experience any chest pain, they fear the worst – a heart attack! Their fear, in turn, worsens their pain. However, most people in this category feel better once they’ve been reassured that nothing is wrong with their heart.
Panic attacks – This is a stress–related, diagnosable condition that can cause chest pain. A panic attack is defined as a discrete period of intense fear, accompanied by symptoms similar to those of a heart attack – chest pain, rapid heart beat, profuse sweating and shortness of breath.
Anxiety disorders are very common and may account for or co–exist with other causes of chest pain. Lifestyle changes to reduce stress are often recommended. Antidepressants may help.
However, with costochondritis, it hurts when you push on your sternum or the ribs near your sternum. Heart attack pain is usually more widespread and the chest wall usually isn’t tender. In general, chest wall pain is treated with rest, heat and non–steroidal anti–inflammatory drugs, such as ibuprofen.
Lung conditions – These are somewhat less common but important causes of chest pain. These conditions, which are often diagnosed with a chest x–ray or a Computed Tomography (CT) scan, include:
Pulmonary Embolism – This occurs when a blood clot becomes lodged in a lung artery, blocking blood flow to lung tissue. It’s a life–threatening cause of chest pain doctors check for right away.
Symptoms of a pulmonary embolism can include sudden, sharp chest pain that begins or worsens with a deep breath or cough. Other symptoms can include shortness of breath, rapid heartbeat, anxiety or faintness. Pulmonary embolism is treated with emergency blood thinning medications and, rarely, surgery.
Pleurisy – Pain that is sharp and localized and made worse when you inhale or cough can indicate pleurisy, an inflammation of the pleura, the membrane that lines your chest cavity and covers your lungs.
Pleurisy may result from a wide variety of underlying conditions, including an acute viral infection, bacterial infection of the lung (pneumonia) and autoimmune conditions such as lupus. It can also result from lung damage from pulmonary embolism, tumors involving the surface of the lung and even rib fractures that lead to lung damage.