Chest Pain
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Chest Pain

Chest Pain

Chest pain is felt in the upper part of your body from your neck to your belly. You may feel pain, pressure, or tightness. Your heart and lungs are common sources of pain. You can also have pain from your chest muscles or the tendons and nerves in your chest. Your chest pain may be caused by a serious health problem or by something not as serious.
Your doctor may use tests to record your heartbeats, use x-rays, or take your blood pressure to understand your chest pain. Treatment will depend on what is causing your chest pain.

What are the causes?

Some of the problems related to your heart include:

  • Heart attack. This is a blockage of blood supply to part of the heart.
  • Angina. This is similar to a heart attack, but without long-lasting heart damage.

  • Arrhythmia. This is abnormal heartbeats.
  • Pericarditis. This is irritation of the sac around the heart.

Some of the problems that may not be related to your heart include:

  • Digestive problems like ulcers, indigestion, gastric reflux, gallstones
  • Lung problems like collapsed lung, blood clots, asthma, pneumonia
  • Rib injuries or muscle pain
  • Panic attack
  • Pinched nerve
  • Shingles

What are the main signs?

  • Chest pain of any type should be checked by a doctor.
  • Signs that may show a more serious cause of chest pain are:
    • Squeezing or tightness in the chest which may spread to the back, neck, jaw, shoulders, or arms
    • Shortness of breath
    • Sweating
    • Dizziness
    • Upset stomach, nausea, or throwing up
    • Weakness
    • Feeling faint
  • If you have chest pain with any of these signs, call for emergency help.

How does the doctor diagnose this health problem?

Your doctor will do an exam. The doctor may ask you questions about your pain. Your doctor may order:

  • Lab tests
  • Chest x-ray
  • Electrocardiogram (ECG)

  • Echocardiogram
  • Stress test
  • Nuclear heart scanning
  • Computed tomography (CT)
  • Heart cath or catheterization

How does the doctor treat this health problem?

Your treatment will depend on what is causing the pain. Many times, drugs may be given to treat the problem. Any chest pain could be serious. More serious problems can be treated by opening the vessel in your heart with a balloon or a metal straw called a stent. You may need surgery to replace the vessels in your heart. Always talk to your doctor about chest pain.

What lifestyle changes are needed?

Once your doctor finds the cause of your chest pain, you may be asked to make changes to your diet, activity, weight, and drugs you take. These changes will depend on the cause of your pain.

What drugs may be needed?

  • Thin the blood
  • Dissolve a blood clot
  • Lower cholesterol
  • Lessen the work of your heart
  • Correct or prevent an abnormal heartbeat
  • Lower your blood pressure
  • Increase blood flow to the heart muscle
  • Relax the heart and help avoid spasms in the arteries

 

If chest pain is caused by a something other than your heart, the doctor may order drugs to:

  • Help with pain
  • Treat stomach problems
  • Help with breathing
  • Help you relax
  • Control coughing

What problems could happen?

If the pain is due to a serious problem with the heart or lungs, the following things could happen:

  • Heart attack with long-lasting damage to the heart
  • Abnormal heartbeat that is too fast, too slow, or irregular
  • The heart stops beating. This is cardiac arrest. If not promptly treated, it can result in death.

What can be done to prevent this health problem?

  • If you smoke, stop.
  • Keep a healthy weight. If you are too heavy, lose weight
  • Keep blood pressure, cholesterol, and high blood sugar (diabetes) under control.
  • Exercise at least 3 to 4 times a week.
  • Eat lots of fiber, fruits, starches, and vegetables and stay away from foods that are high in fats.

When do I need to call the doctor?

Activate the emergency medical system right away if you have signs of a heart attack. Call 911 in the United States or Canada. The sooner treatment begins, the better your chances for recovery. Call for emergency help right away if you have:

  • Signs of heart attack:
    • Chest pain
    • Trouble breathing
    • Fast heartbeat
    • Feeling dizzy
  • Not had chest pain before and it does not go away with rest after 5 minutes. Do not drive yourself to the hospital or have someone drive you. The emergency rescue people can begin to treat you the minute they arrive.


If your doctor has given you nitroglycerin for heart pain, sit or lie down.

  • Place a pill under your tongue and allow it to dissolve. If your mouth is dry, take a small sip of water.
  • Wait 5 minutes and if the chest pain does not go away, call for help and put a second nitro pill under your tongue.
  • Sometimes, your doctor will tell you to take a third pill after another 5 minutes.

Where can I learn more?

American Heart Association
http://www.heart.org/HEARTORG/Conditions/HeartAttack/AboutHeartAttacks/About-Heart-Attacks_UCM_002038_Article.jsp

American Heart Association
http://www.heart.org/HEARTORG/Conditions/HeartAttack/SymptomsDiagnosisofHeartAttack/Angina-ChestPain_UCM_450308_Article.jsp

FamilyDoctor.org
http://familydoctor.org/familydoctor/en/diseases-conditions/angina.printerview.all.html

NHS Choices
https://www.nhs.uk/conditions/chest-pain/

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