The symptoms of chest pain can range from mild to severe, and they can occur in a variety of parts of the chest, such as the center, left, right, upper, or lower portions. Chest pain can also radiate to other parts of the body, including the neck, jaw, shoulder, arm, or back.
What causes chest pain?
Heart, lung, esophagus, stomach, muscles, bones, nerves, or skin conditions can all cause chest pain. Here are some of the most common causes:
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Heart attack: A life-threatening condition that occurs when the blood flow to the heart muscle is blocked by a clot or plaque in a coronary artery. This causes damage or death of the heart muscle cells and leads to severe chest pain that may last for more than 15 minutes.
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Angina: A condition that occurs when the heart muscle does not get enough oxygen due to narrowed or blocked coronary arteries. This causes chest pain that usually occurs during physical or emotional stress and lasts for a few minutes.
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Pericarditis: An inflammation of the pericardium, which is the thin sac that surrounds and protects the heart. This causes chest pain that may worsen when lying down, breathing deeply, or coughing.
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Aortic dissection: A tear in the inner layer of the aorta, which is the large artery that carries blood from the heart to the rest of the body. This causes chest pain that may be sudden, severe, and sharp.
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Pulmonary embolism: A blockage of one or more pulmonary arteries by a blood clot that travels from another part of the body, usually the legs. This causes chest pain that may be accompanied by shortness of breath, coughing up blood, or fainting.
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Pneumonia: An infection of the lungs that causes inflammation and fluid buildup in the air sacs. This causes chest pain that may be worse when breathing or coughing.
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Pleurisy: An inflammation of the pleura, which are the thin membranes that line the lungs and chest wall. This causes chest pain that may be sharp and stabbing and may increase with movement or breathing.
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Gastroesophageal reflux disease (GERD): A condition that occurs when the stomach acid flows back into the esophagus, which is the tube that connects the mouth to the stomach. This causes chest pain that may be burning or sour and may occur after eating or lying down.
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Esophageal spasm: A sudden and involuntary contraction of the muscles in the esophagus. This causes chest pain that may be squeezing or cramping and may mimic a heart attack.
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Costochondritis: An inflammation of the cartilage that connects the ribs to the breastbone. This causes chest pain that may be sharp and localized and may worsen with movement or pressure.
What are the symptoms of chest pain?
The symptoms of chest pain depend on the cause and severity of the condition. Some common symptoms that may accompany chest pain are:
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Shortness of breath or difficulty breathing.
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Sweating or clamminess.
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Nausea or vomiting.
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Dizziness or lightheadedness.
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Palpitations or irregular heartbeat.
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Anxiety or panic.
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Fever or chills.
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Coughing or wheezing.
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Difficulty swallowing or hoarseness.
How is chest pain diagnosed?
If you have chest pain, your doctor will ask you about your symptoms and medical history. He or she may also order some tests to determine the cause and extent of your condition. These tests may include:
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An electrocardiogram (ECG) to measure the electrical activity of your heart and detect any abnormalities such as arrhythmias or ischemia.
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A blood test to check for markers of heart damage such as troponin or enzymes such as creatine kinase (CK) or lactate dehydrogenase (LDH).
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A chest X-ray to look at your lungs and heart and rule out any infections, fractures, or tumors.
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A computed tomography scan (CT) to create detailed images of your chest and abdomen and detect any problems such as aortic dissection, pulmonary embolism, or cancer.
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A magnetic resonance imaging scan (MRI) to produce high-resolution images of your heart and blood vessels and assess their function and structure.
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An echocardiogram to use sound waves to create images of your heart and evaluate its size, shape, motion, valves, and blood flow.
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A stress test to monitor your heart’s response to physical or pharmacological stress and detect any signs of reduced blood flow or ischemia.
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An endoscopy to insert a thin, flexible tube with a camera and light into your mouth and down your esophagus and stomach and examine their lining and contents.
How is chest pain treated?
The treatment for chest pain depends on the cause and severity of the condition. Some common treatments include:
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Medication to relieve pain, inflammation, infection, or spasm. These include over-the-counter pain relievers such as ibuprofen or acetaminophen, prescription anti-inflammatory drugs such as corticosteroids or nonsteroidal anti-inflammatory drugs (NSAIDs), prescription antibiotics such as penicillin or erythromycin, or prescription antispasmodics such as dicyclomine or hyoscyamine.
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An agent that improves blood flow, lowers blood pressure, or prevents clotting. These include prescription nitrates such as nitroglycerin or isosorbide, prescription beta blockers such as metoprolol or atenolol, prescription calcium channel blockers such as amlodipine or diltiazem, prescription angiotensin-converting enzyme (ACE) inhibitors such as lisinopril or enalapril, prescription angiotensin receptor blockers (ARBs) such as losartan or valsartan, prescription diuretics such as furosemide or hydrochlorothiazide, or prescription anticoagulants such as warfarin or heparin.
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A medication that neutralizes acid, reduces acid production, or protects the esophagus from acid. Among these are over-the-counter antacids such as calcium carbonate or magnesium hydroxide, prescription proton pump inhibitors (PPIs) such as omeprazole or pantoprazole, prescription histamine receptor blockers (H2 blockers) like ranitidine and famotidine, and prescription mucosal protectants like sucralfate and bismuth subsalicylate.
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An operation to repair or replace a damaged heart valve, bypass a blocked coronary artery, remove a blood clot from the pulmonary artery, remove a tumor from the chest, or remove an esophagus section. The types of surgery may vary from minimally invasive procedures such as balloon angioplasty or stent placement to more complex procedures such as open heart surgery or esophectomy.
How can you prevent chest pain?
You can prevent chest pain by taking some steps to reduce your risk of developing the conditions that cause it. These include:
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A healthy diet is low in saturated fat, cholesterol, salt, and sugar and high in fiber, fruits, vegetables, and lean protein.
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Regularly exercising for at least 30 minutes a day, five days a week.
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Avoiding tobacco products or quitting smoking.
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Drinking no more than one drink per day for women and two drinks per day for men.
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Practice relaxation techniques such as meditation, yoga, or deep breathing to manage your stress levels.
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By taking prescribed medication and following your doctor's instructions, you can control your blood pressure, cholesterol, blood sugar, and weight.
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Regularly checking your heart, lungs, and esophagus based on your age and risk factors.
Whenever you experience chest pain, it should not be ignored. You should seek medical attention if it is sudden, severe, persistent, or accompanied by other symptoms such as shortness of breath, sweating, nausea, dizziness, or fainting. It is possible to recover from chest pain and avoid complications with proper diagnosis, treatment, and prevention.
