Chest Pain – Causes, Symptoms and Treatment
Chest pain refers to any discomfort, pressure, or pain felt in the chest area and may indicate harmless or serious conditions. Medical evaluation is always recommended.
Things worth knowing about "Chest Pain"
Chest pain refers to any discomfort, pressure, or pain felt in the chest area and may indicate harmless or serious conditions. Medical evaluation is always recommended.
What Is Chest Pain?
Chest pain (medically referred to as thoracic pain) describes any sensation of pain, pressure, tightness, or burning in the chest area. It is one of the most common reasons people seek emergency medical care. Chest pain can have both harmless and life-threatening causes, and should therefore always be taken seriously and evaluated by a healthcare professional.
Possible Causes
Chest pain can be triggered by a wide variety of conditions and diseases, which can broadly be divided into cardiac and non-cardiac causes.
Cardiac Causes
- Heart attack (myocardial infarction): A blocked coronary artery causes intense, persistent chest pressure that may radiate to the left arm, jaw, or back.
- Angina pectoris: Temporary reduced blood flow to the heart, causing exertion-related chest tightness.
- Myocarditis: Inflammation of the heart muscle, often following a viral infection.
- Pericarditis: Inflammation of the sac surrounding the heart, causing sharp pain that worsens with breathing or lying down.
Non-Cardiac Causes
- Gastroesophageal reflux (heartburn): Stomach acid entering the esophagus causes a burning sensation behind the breastbone.
- Pulmonary embolism: A blood clot in the lungs can cause sudden, breathing-related chest pain.
- Pneumonia: Lung inflammation may cause chest pain that worsens when breathing deeply.
- Pleuritis (pleurisy): Inflammation of the lining around the lungs, causing sharp, breathing-related pain.
- Muscle strain or rib injury: Common, less serious causes of chest pain after physical exertion or trauma.
- Panic attacks and anxiety disorders: Psychological conditions can cause chest tightness and a racing heartbeat.
Symptoms and Associated Signs
The specific characteristics of chest pain can provide important clues about its underlying cause. Common accompanying symptoms include:
- Pain radiating to the arm, shoulder, jaw, neck, or back
- Shortness of breath or difficulty breathing
- Dizziness or lightheadedness
- Nausea and vomiting
- Cold sweats
- Rapid or irregular heartbeat
- Paleness or bluish discoloration of the lips
Important: If chest pain is accompanied by shortness of breath, radiation to the left arm or jaw, sweating, or loss of consciousness, emergency services should be called immediately (911 or local emergency number), as a heart attack may be occurring.
Diagnosis
Diagnosing the cause of chest pain involves a thorough physical examination and several diagnostic procedures:
- Medical history: Detailed questions about the nature, duration, radiation, and triggers of the pain.
- Electrocardiogram (ECG): Records the electrical activity of the heart to detect arrhythmias or signs of a heart attack.
- Blood tests: Measurement of cardiac biomarkers such as troponin to rule out myocardial infarction.
- Chest X-ray: Assessment of the lungs and heart structure.
- Echocardiography (cardiac ultrasound): Imaging of the heart to evaluate its function and structure.
- Computed tomography (CT scan): Detailed imaging when pulmonary embolism or other serious conditions are suspected.
Treatment
Treatment of chest pain depends entirely on the underlying cause:
- Heart attack: Emergency care including blood thinners, cardiac catheterization, and possible stent placement.
- Angina pectoris: Nitroglycerin to dilate coronary vessels; long-term use of beta-blockers and statins.
- Reflux disease: Acid-suppressing medications (proton pump inhibitors) and dietary changes.
- Muscle strain: Pain relievers, heat therapy, and physiotherapy.
- Panic attacks: Psychotherapy, relaxation techniques, and medication if necessary.
When to See a Doctor
Any new, unexplained, or persistent chest pain should always be evaluated by a medical professional. If chest pain is sudden and severe, accompanied by shortness of breath, radiation to the arm or jaw, or loss of consciousness, call emergency services (911 or your local emergency number) immediately.
References
- World Health Organization (WHO): Cardiovascular Diseases – Fact Sheet. Available at: https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds)
- Collet JP et al. – 2020 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. European Heart Journal, 2021; 42(14): 1289–1367.
- Steg PG et al. – ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation. European Heart Journal, 2012; 33(20): 2569–2619.
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