Chest Pain

About Chest Pain

What it feels like: varies from a dull ache to tenderness, to a sharp, searing pain anywhere in the chest.

What can make it worse: swallowing, coughing, deep breathing, movement, cold weather, sexual intercourse, anxiety, eating.

What can make it better: food, antacids, nitroglycerin, rest, massage of the painful area.

Your Doctor Visit

What your doctor will ask you about: heart palpitations, anxiety, depression, light-headedness, numbness or tingling in your hands or around your mouth, fever, chills, sweating, coughing, coughing up blood or mucus, feeling short of breath, tenderness, trouble swallowing, nausea, vomiting, swelling or pain in the legs, changes in weight, pregnancy, smoking.

Your doctor will also want to know if you've ever had a stress test (usually an electrocardiogram [EKG] while exercising on a treadmill), or have been treated for heart trouble with medications or heart surgery.

Your doctor will want to know if you or anyone in your family has had any of these conditions: lung disease, asthma, chest surgery or injury, cardiovascular disease, high blood pressure, diabetes, elevated levels of cholesterol or fat in the blood, angina, phlebitis, emotional problems, obesity, congestive heart failure, heart attack, smoking.

Your doctor will want to know if you began feeling chest pain after chest injury or another specific event, or if the pain is frequently associated with eating, particular stressful events, or heavy exertion.

Your doctor will want to know if you’re taking any of these medications: oral contraceptives, diuretics (“water pills”), digitalis, bronchodilators, nitroglycerin, tranquilizers, sedatives, antacids, or blood pressure medications such as beta-blockers, calcium channel agents, and antiarrhythmics.

Your doctor will do a physical examination including the following: temperature, weight, blood pressure, pulse, listening to toyour chest with a stethoscope, listening to your heart with a stethoscope, examining your legs for tenderness, warmth, or swelling, electrocardiogram.

Your doctor may do the following blood tests: blood count, testing for heart enzymes.

WHAT CAN CAUSE CHEST PAIN, AND WHAT IS TYPICAL FOR EACH CAUSE? WHAT CAN CAUSE CHEST PAIN, AND WHAT IS TYPICAL FOR EACH CAUSE?

Cause: Chest wall  ache

What is it: Pain in the chest wall

Typical Symptoms: Tenderness in the chest wall, often worsening with movement or deep breathing, and possibly resulting from injury or a bout of violent coughing

 

Cause: Rib fracture

What is it: A crack in one of the ribs

Typical Symptoms: Tenderness over the fracture, often accompanied by the sound or sensation of grating and crackling

Cause: Neck pain

What is it: Pain in the neck that  radiates to the chest

Typical Symptoms: Chest or arm pain that worsens when moving or putting pressure on the neck

Cause: Heartburn

What is it: Also known as GERD  (Gastroesophageal Reflux Disease), the movement  of stomach acid up into  and through the  esophagus, which connects the throat to the stomach; can lead to the ulcer (see below)

Typical Symptoms:  Burning upper abdominal  pain, worse when lying flat  or bending over, particularly  soon after meals, relieved  by antacids or sitting  upright

Cause: Ulcer

What is it: Severe irritation of the  stomach or intestinal  lining

Typical Symptoms: Burning upper abdominal  pain that is worse when  lying down, sometimes relieved by antacids and made worse by aspirin or drugs such as ibuprofen

Cause: Cholecystitis

What is it: Gallstones

Typical Symptoms: Fever, right upper abdominal pain, sometimes pain in right shoulder, nausea, vomiting, chills, sometimes jaundice (skin taking on a yellowish appearance), dark urine

Cause: Arthritis/bursitis

What is it: Inflammation in or around the joints

Typical Symptoms: Tenderness in the shoulder,  ribs, or muscles, often in the lower chest, may result after prolonged coughing

Cause: Angina pectoris

What is it: Sudden spasms of chest  pain caused by lack of  oxygen to the heart  muscles

Typcal Symptoms: Chest pain behind the  breastbone, aggravated by  exertion and relieved by  rest; pain may radiate tothe left arm

Cause: Heart attack

What is it: Blockage in one of the  arteries feeding the heart, leading to the death of part  of the heart muscle

Typical Symptoms: Severe, often crushing pain  behind the breastbone,  sometimes with sweating,  nausea, or vomiting

Cause: Crescendo  angina (preinfarction angina)

What is it: A more severe form of   angina pectoris (see   above)

Typical Symptoms: Attacks of angina (see above) that occur more frequently, or become more severe over time

Cause: Pneumonia

What is it: An infection of the lungs

Typical Symptoms: Fever, chills, shaking, coughing up blood or mucus, sharp chest pain

Cause: Pneumothorax

What is it: “Collapsed lung”: an  accumulation of air  between the lungs and  chest wall

Typical Symptoms: Sudden onset of breathing  difficulties, sharp chest  pain

Cause: Pulmonary embolus

What is it: A blood clot blocking the   flow of blood to the lungs

Typical Symptoms: Sudden onset of breathing  difficulties, dull chest pain, sweating, light-headedness, apprehension, cough, coughing up blood, swelling or tenderness in the calves

Cause: Pleuritis

What is it: Inflammation of the outer  layer of the lungs

Typical Symptoms: Sharp pain anywhere in  the chest, often aggravated by deep breathing, coughing, or movement

Cause: Pericarditis

What is it: Inflammation of the sac  surrounding the heart

Typical Symptoms: Pain over the heart or  behind the breastbone,often aggravated by deep breathing, coughing, or movement

Cause: Dissecting  thoracic aortic  aneurysm

What is it: A tear of the aorta, the   largest blood vessel in   the body, which comes  directly out of the heart

Typical Symptoms: Searing chest pain that can  start between the shoulder  blades, abdominal pain

Cause: Lung tumor

What is it: Cancer of the lungs

Typical Symptoms:  Changes in coughing patterns, coughing up blood, chest ache, more common in smokers

Cause: Esophageal  spasm

What is it: A contraction of the   muscles in the esophagus

Typical Symptoms: Severe pain behind the breastbone that is often relieved by eating, difficulty swallowing

Cause: Esophageal  tear

What is it: A tearing of the muscles  in the esophagus

Typical Symptoms: Sudden and severe pain  behind the lower breastbone, vomiting, sweating, often a result of a neck wound

Cause: Esophageal  stricture

What is it: A constriction of the   esophagus, which  connects the throat to  the stomach, that doesn’t let food pass

Typical Symptoms: Chronic pain behind the  breastbone, food regurgitation, heartburn (see above)

Cause: Esophageal  cancer

What is it: Abnormal cell growth in   the esophagus