Chest Pain: Reason, Diagnosis & Treatment

Chest pain is discomfort or pain anywhere from a person’s neck to the upper part of the abdomen.

Chest Pain Reason

When you have chest pain, your first thought may be that you’re having a heart attack. While chest pain is a well-established sign of a heart attack, it can also be caused by many other less serious conditions. About 13 percent of all emergency room (ER) visits for chest pain result in a diagnosis of a serious heart-related problem, according to the National Center for Health Studies (NCHS).

Although there are many causes of chest pain, the two large groups of causes are cardiac-related problems and non-cardiac causes. Cardiac chest pain is caused by an imbalance between the blood supply to the heart and oxygen needs of the heart muscle. Cardiac chest pain is most commonly a result of atherosclerosis (leading to fixed narrowing of coronary arteries), but also can be caused by coronary spasms that narrow the arteries intermittently. Cardiac chest pain is also referred to as angina or angina pectoris.

Non-cardiac chest pain has many causes, ranging from infections and muscle or bone problems to conditions such as lung tumors, lung collapse, chest trauma, upper abdominal pain, and gastric reflux. Although some of the non-cardiac causes of chest pain may require emergency care (for examples, lung collapse and severe chest trauma), most do not.

Heart-related causes of chest pain

The following are heart-related causes of chest pain:

  • heart attack, which is a blockage of blood flow to the heart
  • angina, which is chest pain caused by blockages in the blood vessels leading to your heart
  • pericarditis, which is an inflammation of the sac around the heart
  • myocarditis, which is an inflammation of the heart muscle
  • cardiomyopathy, which is a disease of the heart muscle
  • aortic dissection, which is a rare condition involving a tear of the aorta, the large vessel that comes off of the heart

Gastrointestinal causes of chest pain

The following are gastrointestinal causes of chest pain:

  • acid reflux, or heartburn
  • swallowing problemsrelated to disorders of the esophagus
  • gallstones
  • inflammation of the gallbladderor pancreas

Lung-related causes of chest pain

The following are lung-related causes of chest pain:

  • pneumonia
  • viral bronchitis
  • pneumothorax, which is a leak of air from your lung into your chest
  • a blood clot, or pulmonary embolus
  • bronchospasm, or constriction of your air passages; this commonly occurs in people who have asthma and related disorders such as chronic obstructive pulmonary disease(COPD)

Muscle- or bone-related causes of chest pain

The following are causes of chest pain related to the muscles or bones:

  • bruised or broken ribs
  • sore muscles from exertion or chronic pain syndromes
  • compression fracturescausing pressure on a nerve

Other causes

Shingles can cause chest pain. You may develop pain along your back or chest before the shingles rash becomes apparent. Panic attacks can also cause chest pain.

SOME BASIC FAQ Related to the Chest Pain

When to See a Doctor for Chest Pain?

If your chest pain is intermittent or you have problems swallowing or have a fever and/or chills, you should seek urgent evaluation by a medical caregiver.

When Is Chest Pain a Medical Emergency?

Some types of chest pain require emergency medical evaluation. This includes chest pain that:

Comes on suddenly
Has the characteristics of pressure, squeezing, and/or tightness underneath your sternum or in your left chest
Radiates to your jaw, left arm, and/or back
Is accompanied by shortness of breath, nausea, dizziness, rapid heart rate, or a very low heart rate, sweating, pale skin color, and/or mental status changes such as confusion

How is chest pain diagnosed?

Your doctor may order tests to help diagnose or eliminate heart-related problems as a cause of your chest pain. These may include:

an electrocardiogram (ECG or EKG), which records your heart’s electrical activity
blood tests to measure enzyme levels
a chest X-ray to examine your heart, lungs, and blood vessels
an echocardiogram, which uses sound waves to record moving images of the heart
an MRI to look for damage to the heart or aorta
stress tests to measure your heart function after exertion
an angiogram to look for blockages in specific arteries

Chest Pain Treatment

Treatments for heart-related causes of chest pain include:

medications, including nitroglycerin and other medications that open partially closed arteries, clot-busting drugs, or blood thinners
cardiac catheterization, which may involve using balloons or stents to open blocked arteries
surgical repair of the arteries, which is also known as coronary artery bypass grafting or bypass surgery
Treatments for other causes of chest pain include:

lung re-inflation for a collapsed lung, which your doctor will perform by inserting a chest tube or related device
antacids or certain procedures for acid reflux and heartburn
anti-anxiety medications for chest pain related to panic attacks