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Chest pain occurs in the course of many diseases, not only those of the cardiovascular system. Chest pain may also appear in the course of diseases of the digestive, nervous or musculoskeletal systems. Therefore, its causes are varied. What does chest pain mean?

Chest painis a common complaint reported by patients to doctors. Most often they complain of discomfort described as:

  • oppression
  • tearing
  • flatulence with burping sensation
  • indigestion
  • smoking
  • dull, stinging, sometimes sharp, stabbing pain in the chest

This pain may be present on the right or left side of the chest , when exerting or at rest, while breathing or coughing, swallowing, as well as when lying down or bending over .

Chest pain or discomfort occurs with many medical conditions.

Some of them are immediate threats to life (e.g. heart attack).

OtherThe causes of chest painrange from serious, potentially life-threatening to plain discomfort. It is often impossible to establish the cause of the pain.

Chest pain - diseases of the cardiovascular system

  • angina(acute coronary syndrome / unstable angina, stable angina) is characterized by sharp, crushing pain that radiates to the jaw or forearm. This pain most often occurs after exercise and is relieved at rest
  • thoracic aortic dissection aneurysmpresents with sudden, excruciating pain in the chest and back. Some patients may experience fainting, stroke or lower limb ischemia. Characteristically, the heart rate and blood pressure in the extremities can be different. The risk factors for this type of aneurysm are age (over 55) and arterial hypertension
  • pericarditisis found when the patient complains of constant or intermittent sharp pain in the chest, often worsening when breathing, swallowing or lying down. You feel relieved when you lean forward. Moreover, it is noticeablewidening of the jugular veins
  • myocarditisis diagnosed when there is fever, shortness of breath, fatigue, chest pain, and in some cases symptoms of heart failure, pericarditis, or both. Myocarditis may be a complication following viral (or other cause) infections
  • formyocardial infarctionis a sudden, pressing pain in the chest, specifically behind the breastbone, often radiating to the lower jaw and left shoulder. Pale, sweating, severe weakness, sometimes shortness of breath and wheezing are also characteristic
  • hypertrophic cardiomyopathy- stress angina pains are characteristic - these are pains in the chest - behind the sternum, which have the nature of burning pain, distension, pressure. They can radiate to the mandible and upper limbs, especially to the left. They appear during exercise and disappear within 3-5 minutes after stopping it.

Chest pain - respiratory disorders

  • pulmonary embolismis a condition characterized by pleural pain, shortness of breath, and tachycardia (heart rate higher than 100 beats per minute). Occasionally a slight fever, hemoptysis or even shock may appear
  • pneumoniais characterized by fever, chills, coughing and the production of purulent sputum. Often there is also shortness of breath, tachycarida
  • pneumothoraxmanifests as shallow, rapid breathing and chest pain that sometimes radiates to the arm, neck or abdomen; the most dangerous is tension pneumothorax, which manifests itself with significant dyspnea, hypotension, and widening of the jugular veins. Sometimes you may feel the presence of air under the skin
  • pleurisy , sometimes preceded by pneumonia, pulmonary embolism, or viral respiratory infection, with painful breathing and coughing;
Important

Chest pain in a child

Chest pain in children and young adults (under 30 years of age) is probably not the result of myocardial ischemia, although a heart attack can occur in people over 20 years of age. More common causes of pain in this age group are musculoskeletal and pulmonary disorders.

Chest pain - digestive system disorders

  • rupture of the esophaguscauses sudden, severe pain after previous vomiting or instrumentation procedures (e.g. gastroscopy or transesophageal echocardiography)
  • pancreatitismanifested by pain in the epigastrium or in thelower chest, increasing in the supine position, and a feeling of relief appears when leaning forward. There may also be vomiting, epigastric tenderness and even shock. People who frequently consume alcohol or suffer from cholelithiasis are particularly vulnerable to pancreatitis
  • peptic ulcer diseasemanifests as recurrent vague discomfort in the upper abdomen or right upper abdominal square in smokers or abusing alcohol. Relief appears after a meal, taking antacids, or both

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  • gastroesophageal reflux diseaseis manifested by a burning sensation in the chest radiating to the throat. This pain is exacerbated by leaning forward or lying down, and a feeling of relief appears after taking antacids
  • biliary tract diseaseis characterized by recurrent discomfort in the right upper abdominal or epigastric square after eating (but not exercise)
  • esophageal motility disordersis manifested by prolonged pain with an insidious onset, not necessarily during swallowing. There is also usually difficulty swallowing

Chest pain - other causes

Another common cause of chest pain ismusculoskeletal painfrom the chest wall (traumatic, strain, osteochondral). It is a long-term pain lasting several days or more, and worsens with passive and active movements.

Chest pain may also indicatebreast cancers . Then symptoms of a chronic disease appear: weight loss, fever, enlarged lymph nodes, cough.

Another cause of chest discomfort may beshingles , which presents as sharp, streaked, one-sided pain in the center of the chest. Typically linear, vesicular skin lesions may also appear. Pain may occur several days before the onset of skin changes.

Chest paincan be caused by stress. Then the patient feels tense and nervous, which may even indicate neurosis. Then the pain comes from the psyche.

Chest pain and medications

Chest pain can also be caused by medications, incl. those that contribute to the contraction of the coronary vessels (including triptans, phosphodiesterase inhibitors), as well as non-steroidal anti-inflammatory drugs.

Important

When should you see a doctor as soon as possible?

You should report to the doctor without delay if the pain is accompanied by:

  • Tachycardia (significant increase in heart rate)
  • bradycardia (heart rate too slow or irregular)
  • rapid breathing
  • low blood pressure
  • symptoms of hypoperfusion (e.g. confusion, cyanosis, profuse sweating)
  • shortness of breath

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Category:

Cardiology