Chest Pain

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Each year, six million adult patients in the U.S. see their doctor because of chest pain.

Causes of chest pain

Chest pain may be caused by a variety of factors that may include diseases such as coronary artery disease, gastro-intestinal pain such as acid reflux (“Hiatal Hernia”), pain from your lungs (pneumonia, or a collapsed lung), “costochondritis”, physical injuries or a host of other factors.

The evaluation of chest pain begins with a medical consultation that includes an examination. It includes looking for problems with:

If you are concerned about angina, try this Prediction Questionnaire.

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Symptoms of chest pain

Any pain in your body needs to be judged on its severity, location, type of pain, whether it radiates to a different location, and whether it is associated with other symptoms. Your doctor will begin by including the following questions:

1) How bad is your pain:

2. Where is your pain located?

  • Is your pain located in your front, back, side or just everywhere?
  • Can you point to exactly where this pain is located?

3. What type of pain do you have?

  • Is your pain dull,
  • Sharp (like a knife),
  • Like something is tearing inside,
  • A heavy feeling, or
  • Hard to describe?

4. Is there anything you do that makes this pain worse, or is your pain predictable with any type of activity?

  • Worse with Exercise,
  • Present at rest,
  • Worse with deep breathing,
  • Worse with a specific position, like leaning forward,
  • Worse with eating, swallowing or relieved by food,
  • Pressing on the painful area?

5. Are your Symptoms associated with:

  • Arm pain, jaw pain, back pain,
  • Coughing and/or difficulty breathing,
  • Coughing up blood,
  • Palpitations,
  • Nausea,
  • Excessive sweating,
  • Fever, and wheezing. 
  • High (or low) blood pressure,
  • Difficult or painful swallowing?

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Diagnosis of chest pain

The diagnosis is made by using all the tools modern medicine has to offer. Sometimes this means excluding major illnesses first such as angina or a heart attack. Sometimes it means that to make a diagnosis multiple observations and tests are necessary. Chest pain associated with anxiety may particularly difficult to diagnose, especially in a person with many other problems.

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Treatment of chest pain

Treatment for chest pain depends on the underlying cause. Musculoskeletal chest pain may be treated with rest, cold compresses, and non-steroidal anti-inflammatory (NSA) medications for pain. Angina requires treatment with medications that improve coronary blood flow. Chest pain due to pneumonia may require antibiotics.

Conclusion:

There are many causes of chest pain. The one that doctors worry about the most is cardiac because it has the potential to be life-threatening. Chest pain treatment depends on making a diagnosis and applying correct treatment to the underlying cause.

Please Seek emergency medical care if:

  • You have uncomfortable pressure, fullness or squeezing pain in your chest for longer than a few minutes
  • Your chest pain is accompanied by shortness of breath, sweating, nausea, dizziness or fainting
  • The pain radiates beyond your chest to one or both of your arms or your neck

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