Chest pain,causes, symptoms,prevention and treatment

healthtipclinic.com February 07, 2020

Chest Pain


 CHEST-PAIN,



CHEST Pain
What is chest pain?
  • Chest Pain is the kind of feeling or discomfort that usually occurs on the front chest.
  • In addition, chest pain may occur on the right side of the chest, on the left side of the chest or in the middle of the chest, or there may be a feeling of burning in the middle of the chest.
  • It can range from very severe to very minor pain.
  • Apart from this, there may be a feeling of chest pressure and pricking.
  • Sometimes with chest pain, this pain spreads in the hands, jaws, neck, shoulders or even the upper part of the stomach.

Also read:-

  1. What to eat after a heart attack what not to eat
  2. Diet plan to lose weight in 10 days
  3. About the causes, symptoms, prevention and treatment of heart attack
  4. Insomnia or sleepiness, cause prevention and treatment
If chest pain spreads in the above parts or if there is a lot of discomfort, nervousness and sweating along with pain, then this kind of pain can usually be due to " heart attack ".
Heart attack patient pressing their chest in chest pain, this is a very special symptom of heart attack.

Photo: - Heart attack patients are pressing their chest due to chest pain, these are the main symptoms of heart attack.

Types of Chest pain

  • Chest pain can be divided into two parts -
  1. Cardiac Chest Pain
  2. Cardiac Non Chest Pain 

Causes of chest pain - Chest Pain cause

What can be the causes of chest pain ?
  • There are two type of causes of chest pain, such as pain that is caused by a problem in the heart, and the other in which there is no problem in the heart.

Causes of heart related chest pain - Cardiac chest pain causes

Why does chest pain occur?
  • Some of the serious and commonly found heart related chest pain may be due to the following reasons.
  • Like: -A- heart attack B- angina pectoris C- Aortic Daisekshn D- Perikardaitis etc.
ALSO READ - About Heart Attack, Causes, Symptoms, Prevention and Treatment

A. Heart Attack

What is a heart attack?
Heart attack
Crushing pain in heart attack
  • It is commonly known as myocardial infarction in medical language.
  • Coronary artery blockage reduces blood supply to the heart muscles.
  • Due to which the muscles of the heart do not get enough oxygen and their ability to contract is reduced.

Symptoms of heart attack

What is the sign of heart attack?
  • Chest pain is the most prominent symptom of heart attack and often in this pain it feels like -
  • Sew is tight, someone is pressing the chest tightly or the chest is being squeezed etc.
  • This pain usually occurs in the left arm along with chest pain . But it can also spread to the lower jaw, right hand, back, shoulders and upper abdomen.
  • Often this pain occurs in the middle or left side of the chest and lasts for more than a few minutes.
  • This pain sometimes feels like a burning sensation in the chest.
  • In addition to chest pain, it feels shortness of breath, nausea / vomiting, fainting, sweating and excessive fatigue.

B. Angina Pectoris - Know about Angina Pectoris

What is angina pectoris?
  • This is often due to blockage or spasm in the coronary arteries that supply blood to the heart muscle.
  • Apart from this, there may be pain due to lack of blood, abnormal heartbeat, increased heart rate etc.

Angina would be of two types: -

1. Stable chest pain - Stable Angina

  • Pain that is aggravated by doing minor work and decreases or stops by resting.

2. Unstable Angina In Hindi

  • Pain that is aggravated by doing minor work and even after resting there is no reduction in pain.
  • This pain often lasts for 10 minutes or more and is very severe.

C. Aortic Dissection

  • The inner layer of the large blood vessel (aorta) coming out of the heart is torn due to some reason, which is called aortic dissection.
  • Aortic dissection is an emergency, if it is not diagnosed and treated at the right time, the disease can prove fatal.
  • The common symptom of this is that there is sudden and sharp chest and back pain that spreads down the neck or back.
  • Fainting and shortness of breath can also be a problem.
Note - Clinical examination is necessary to identify aortic dissection.

D- Pericarditis 

  • For some reason, there is inflammation in the pericardium which is called pericarditis.
  • The sac around the heart is called the pericardium.
  • Sudden chest pain that is felt in the neck, back, and shoulders is also a special sign of this.
  • In this, pain usually gets relief when sitting, especially by bending forward while lying down or breathing deeply increases the intensity of pain.
  • Apart from this, fever, weakness, rapid heartbeat and shortness of breath can also occur.
  • Viral infection is the main cause of pericarditis.
  • In addition to bacterial infections such as T.B. other infections of the respiratory tract also causes pericarditis.
  • In addition, pericarditis can also occur due to chest injury.
  • Pericarditis can occur even after a heart attack.
  • In addition, autoimmune disorders also cause pericarditis.
Note - As in heart attack, almost the same symptoms are found in pericarditis.
cardiac chest pain

cardiac chest pain

Causes of non heart related chest pain - Non cardiac chest pain Causes

What is a Non-Cardiac Chest Pain?
  • Non-heart related chest pain is a term used to define chest pain that is similar to heart related pain but the patient does not have any heart related disease.
  • The pain is usually similar to heart related pain, which is just behind the bone between the chest.
  • Often this pain is also described as sensation in the chest, pressure or squeeze like in a heart attack .
NCCP can be divided into two parts: -
  1. Food hose related chest pain - Esophageal Related NCCP
  2. Non esophagus related chest pain - Non Esophageal related NCCP

1. Esophageal Related Non cardiac chest pain(NCCP)  

A. Gasteroesophageal Reflux Disease (GERD) Or Acid Reflux

Non cardiac chest pain Gastroesophageal reflux disease anatomy illustration


Gastroesophageal reflux disease anatomy illustration
  • Acid reflux is a very common acidity disease associated with the esophagus.
  • There may also be complain of burning sensation in the chest with chest pain called heart burn.
  • In this, the acid present in the stomach reaches the mouth through the tube of food which is called GERD.
  • Due to this, only chest pain can be complained, apart from this there is no other problem.

B. Esophageal Contraction Disorder

  • This is a disease of the esophagus which is of many types like -
  1. The interconnection of the muscles of the esophagus worsens, due to this malfunction, these muscles shrink and spread at different speeds at different times. This causes pain.
  2. Rapid contraction of the muscles of the esophagus . This problem is called nutcracker esophagus.
  3. Apart from this, the ability of the muscles of the esophagus to depleted, which is due to malfunction of the nerves of the esophageal muscles. This is called  Achlasia

C. Over-acting of the esophagus - Hypersensitive Esophagus

  • Sometimes the food pipe of some people becomes very sensitive and slight changes in it, such as slight changes in the pressure inside the nerves or excess of acidity, causes very intense pain.

2. Non-Esophageal related NCCP

  • The main causes of non-heart related chest pain , which are similar to heart related pain, are often related to the food pipe.
  • But there are some chest pains that are neither related to the heart nor the food pipe.

A. Musculo-skeletal and joint related chest pain

  • Costochondritis - It is an inflammation of the soft bone of the chest that connects to the upper rib bone.
  • The chest pain caused by this can range from very minor to very intense.
  • Viral infection is the main reason for this, besides it is also due to bacterial and fungal infection.
  • Apart from this, it is also common to find Costochondritis after a trauma or injury.
  • There is also pain due to swelling or fracture of any chest bone which can be like heart related pain but usually such pain also gives details of trauma or injury and the pain is increased by pressing or deep breathing.

B- Gall bladder and pancreas related chest pain

  • If there is stones, infections or inflammation in the gallbladder and pancreas, then the pain caused by it is sometimes very intense which spreads to the chest and back.

C- Chest pain related to lungs

Some causes of chest pain related to lungs: -
  • Pleuritis - In this, there is swelling or infections in the membranes around the lungs due to which there is chest pain which becomes very severe during inspiration.
  • Apart from this, there are other reasons related to the lungs, due to which such pain can occur like-
  1. Lung infection-like-pneumonia. Etc.
  2. Pleural effusion.
  3. Shrinking of lungs.
non cardiac chest pain oneumothorax

A Human Anatomy of Pneumothorax illustration
  • Due to all these reasons, Chest pain occurs which increases with deep breathing.

D-Stress - Anxiety

Can stress cause chest pain?
  • Stress is also found in some patients with non-heart related chest pain .
  • But it is not clearly known whether there is tension due to chest pain or chest pain due to stress.
  • In such patients, pain details, physical examination and medical examination are required.
Note- To ensure that the pain is heart related or non-heart related, consultation of Physician is necessary.

Chest pain diagnosis

How is the cause of chest pain diagnosed?
  • The following tests are done to know the cause of chest pain.

1. Questioning the patient about chest pain - History taking in Chest pain

  • Knowing the risk factors of a person can be extremely useful in understanding or controlling the serious causes of chest pain .
  • For example, it is not very common among people who are under 30 years of age.
  • Whereas people who already have a wrong habit or disease, such as blood pressure, smoking, sugar or someone in the family has already had a heart attack, there is a higher risk of heart attack.
  • In addition, if the patient's chest pain spreads to the neck, back, left arm, or jaw, then this pain can usually be heart related.

Nature of pain 

  • Along with the pain, there is also a complaint of sweating.
  • Chest pressure is felt along with chest pain .
  • If the nature of pain is like squeezing, then this pain can be especially heart related.
  • But heart related pain can occur without these symptoms.
  • If the pain increases or decreases due to moving or turning, or increases by pressing or is intensified by deep breathing, then it is more likely that such pain is non-heart related.
  • But it cannot be completely fragmented that pain is not heart related.
  • Just by history taking, it cannot be said with complete confidence that pain is heart related or non heart related.
  • For this, physical tests and medical tests are required.

2. Physical Examination in Chest pain

  • Caution and concentration are required during patient's history taking and physical examination.
Results from physical examination conducted with caution and concentration are helpful in identifying some dangerous causes of disease and chest pain.
Like:-
  • Abnormal heartbeat
  • More than two beats
  • Sweating too much
  • Blood pressure too high or too low
  • Rapid or slow heartbeat
  • Abnormal sound
  • Pressing or rubbing the chest by the patient with the palm or fist of his hands
  • Presence of restlessness
  • Loss of consciousness
  1. All these results or indications are found in physical examination, which indicate that chest pain can be heart related.
  2. However, all these signs do not confirm that chest pain is related to the heart. Medical examination is required to confirm this.
  3. In the diagnosis of chest pain (finding out the cause), it is most important to remove the causes of chest pain which are the most fatal.
  • Such as a heart attack, rupture of the large blood vessel of the heart, rupture of the food pipe,hemothorax, etc.
  • The origin of pain can be determined by dismissing or confirming the most serious causes.

3. Medical diagnostic test - Chest pain related test

  • According to the nature of chest pain , several types of tests can be done -

१. Electrocardiogram (ECG)

  • This is the first test done to diagnose a heart attack .
  • In this, the electrical activity of your heart is recorded on a paper.
  • Muscles of the injured heart do not normally conduct electrical impulses.
  • The ECG can show whether a heart attack has occurred or is in progress.

2. X-ray of Chest

  • Through this , the non-heart related causes of chest pain are known -
  • Like - infection in lungs, filling of water around lungs, TB Etc.
  • Apart from this, the size of the heart is also seen through chest X-rays.

३.Echocardiography

  • This test proves to be very important in such patients who already have a heart related disease.
  • Apart from this, it is a very special investigation to dismiss or confirm some of the causes of chest pain.

4. Ultrasonogarphy (USG)

  • In chest pain , especially pain that spreads from the upper part of the stomach to the chest, abdominal sonography proves to be very important.
  • Some causes of chest pain can be found by sonography -
  • Such as gallbladder and pancreatic stones and inflammation in them.
  • Apart from this, sonography also shows the filling of water around the lungs.

5. Coronary Angiography (CAG)

  • This is a test in which X-rays are used to look at the blood vessels of your heart.
  • Tests are usually done to see if there is any obstruction or decrease in the blood flow of the heart, and how much is it (in percentage).

6. Blood Tests

A.  Cardiac enzymes

TroponinI and T - Troponin I and T

  • If there is damage to the heart muscle, these special enzymes releases.
  • Excess of these enzymes in the blood is a sign of heart attack or angina.

CK-MB  (creatine kinase myocardial band) 

  • This enzyme also found in the blood more than a quantity is a sign of heart attack or angina.
NOTE - CKMB is also found in high levels in asthma and musculoskeletal damage in addition to heart related disease.

Apart from this, complete blood count, liver function test, pancreatic enzymes are also   important in the diagnosis of heart attack .

How to avoid chest pain - Prevention of Chest pain

Is it possible to avoid chest pain?
1.Lifestyle - It is possible to prevent heart and non-heart related chest pains by making changes in lifestyle such as-
  • Reduce the use of saturated food ( Saturated Fat),Such as red meat, fried food, pastries and cakes etc.
  • Use Fiber-rich foods.
  • Reduce the use of salt in food.
  • Workout daily for at least 30 minutes.
  • Do not smoke
  • Keeping yourself stress free
" Prevention is better than cure (PREVENTION IS BETTER THAN CURE) "
ALSO READ - What to eat and what not to eat after a heart attack

Treatment of chest pain - Chest pain treatment

What is the treatment of chest pain?
  • Your doctor can treat your chest pain with medications, surgery or a combination of both. Treatment depends on the cause and severity of the pain.

Treatment of heart related chest pain - Treatment of cardiac chest pain

A.Medical Treatment- Treatment with medicines

  • Your doctor will give you medicines that dilate the arteries of the heart so that the blood can flow easily into the dilated arteries, such as -Nigtoglycerine, this medicine may ask the doctor to keep you under the tongue.
  • Apart from this, there are other blood pressure medicines that work to dilate the arteries.

Blood thinners

If your doctor feels that the pain is heart related, then he will give you medicines that keep the blood thin, such medicines are called Blood Thinner.
  • By keeping the blood thin, these drugs prevent various types of cells present in the blood from sticking together or increase their freezing time.
  • These drugs are also called antiplatelet drugs, some examples such as Asprin and Clopidogrel.

Blood clot busters

If you have a heart attack, the doctor will treat you with medicines that work to break the blockage in the arteries.
  • These drugs are called thrombolytic drugs and this procedure is called thrombolysis .
  • Thrombolysis requires admission to the Intensive Care unit (ICCU or ICU) of the hospital.
Apart from this, those risk factors are treated due to which the chances of having a heart attack are increased, such as -
  • High blood pressure
  • Uncontrolled diabetes
  • High Cholesterol level in blood etc.
Do Read: Causes, symptoms, prevention and treatment of heart attack
ALSO READ: What to eat and what not to eat after a heart attack

B. Surgical - Surgical Treatment Heart attack

1. Angioplasty

  • This is a major heart related surgery in which the blood flow is regularized by putting a spring (stent) in the blocked artery.

2.Bypass Surgery

  • In this operation, taking blood vessel from the other part of the body and attaching it to the blocked artery.

3 Aortic Dissection Repair 

  • Aortic dissection requires emergency repair, otherwise it can prove to be fatal.
Also Read :-1.Chest pain in English

Non cardiac chest pain treatment - treatment of non-heart related chest pain

The doctor will treat you according to the cause of pain like-
  • If the pain is due to acidity then the doctor will start your treatment with ANTACIDS.
  • If you have pain due to stress then the doctor will start your treatment with anti anxiety drugs.
  • Similarly, the pain related to the lungs, gall bladder and pancreatic are treated according to its cause.

Summary –

  • Chest pain is very common in today's lifestyle.
  • Treatment of most pains are possible, but proper diagnosis requires proper identification of the disease.
  • People should consult a doctor for the diagnosis of chest pain, especially when the pain is spread to the left arm, neck, jaw along with chest pain and the patient is also feeling restless and sweating.
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