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Chest Pain: What is it? Am I having a heart attack?

Overview


Chest discomfort can take many forms, from a sudden stab to a gradual ache. Chest pain can feel crushing or searing at times. The discomfort may proceed up the neck, into the jaw, and then spread to the back or down one or both arms in certain situations.

Chest pain can be caused by a variety of issues. The most dangerous causes involve the heart or lungs. Because chest pain can signify a major problem, it’s critical to get medical attention right once.


Symptoms

Depending on what is causing the condition, chest pain can generate a variety of symptoms. Often, the problem has nothing to do with the heart – though there’s no way to determine without consulting a doctor.

Chest pain related to heart

Although chest pain is frequently connected with heart disease, many people who have heart disease report a vague discomfort that isn’t always characterised as pain. In general, chest pain caused by a heart attack or another heart disease may be described or connected with one or more of the following:

  • Chest pressure, fullness, burning, or tightness
  • Back, neck, jaw, shoulders, and one or both arms experience crushing or scorching pain.
  • Pain that lasts more than a few minutes, worsens with activity, disappears and reappears, or changes in intensity
  • Breathing difficulty
  • Sweating cold sweats
  • Weakness or dizziness
  • Vomiting or nausea

Different types of chest pain

It might be difficult to distinguish between heart-related and other types of chest pain. However, chest pain that is not caused by a heart disease is more commonly associated with:

  • A sour flavour or the feeling of food returning to your mouth
  • Having difficulty swallowing
  • Pain that improves or worsens as you move your body position
  • Pain that worsens when you cough or breathe deeply
  • Tenderness when pressing on your chest
  • Pain that lasts for several hours

Heartburn symptoms, such as a painful, burning sensation beneath the breastbone, can be caused by either heart or gastrointestinal disorders.

When should you see a doctor?

If you have new or unexplained chest discomfort or believe you are experiencing a heart attack, dial 911 or seek emergency medical attention right away. Don’t dismiss the signs of a heart attack. If you are unable to summon an ambulance or emergency vehicle, have a neighbor or a friend take you to the nearest hospital. Only drive yourself if you have no other choice.

Causes

There are numerous reasons of chest pain, all of which necessitate medical attention.

Causes of heart disease

The following are some examples of heart-related causes of chest pain:

  • A heart attack occurred. A heart attack is caused by a blockage of blood flow to the heart muscle, which is commonly caused by a blood clot.
  • Angina. Angina refers to chest pain produced by a lack of blood flow to the heart. This is frequently caused by the formation of thick plaques on the inner walls of the arteries carrying blood to the heart. These plaques narrow the arteries and impede blood circulation to the heart, especially during physical exercise.
  • Dissection of the aorta. This potentially fatal illness affects the major artery flowing from the heart (aorta). If the inner layers of this blood vessel separate, blood is squeezed between them, potentially rupturing the aorta.
  • The sac around the heart is inflamed (pericarditis). This illness is characterised by severe pain that worsens when breathing in or lying down.

Digestive causes

Chest pain can be caused by digestive system problems, such as:

  • Heartburn. This painful, burning sensation occurs behind the breastbone as stomach acid washes up into the tube that joins the throat to the stomach (esophagus).
  • Disorders of swallowing Esophageal disorders can make swallowing difficult and even painful.
  • Gallbladder or pancreatic issues Gallstones or gallbladder or pancreas inflammation can cause abdominal pain that extends to the chest.

Causes of Muscle and Bone

Some types of chest discomfort are caused by injuries or other abnormalities with the structures that make up the chest wall, such as:

  • Costochondritis. The rib cage cartilage, particularly the cartilage that connects the ribs to the breastbone, becomes inflamed and uncomfortable in this illness.
  • Muscle aches. Chronic pain syndromes, such as fibromyalgia, can induce muscle-related chest pain that persists.
  • Ribs were injured. Chest pain might be caused by a damaged or broken rib.

Causes of Lung Disease

Chest pain can be caused by a variety of lung illnesses, including:

  • pulmonary blood clot (pulmonary embolism). A blood clot that becomes lodged in a pulmonary artery can obstruct blood flow to lung tissue.
  • Inflammation of the pulmonary membrane (pleurisy). This illness might produce chest pain that gets worse when you cough or breath.
  • A lung had collapsed. The chest pain associated with a collapsed lung usually starts quickly and lasts for hours, and it is usually accompanied by shortness of breath. When air seeps into the area between the lung and the ribs, the lung collapses.
  • High blood pressure in the arteries of the lungs (pulmonary hypertension). This illness affects the arteries that deliver blood to the lungs, causing chest pain.

Other reasons

Chest pain can also be brought on by:

  • Anxiety attack You may be having a panic attack if you have periods of acute terror accompanied by chest pain, a rapid heartbeat, rapid breathing, excessive sweating, shortness of breath, nausea, dizziness, and a fear of death.
  • Shingles. Shingles, which is caused by a reactivation of the chickenpox virus, can cause pain and a band of blisters from the back to the chest wall.

Diagnosis

Chest pain is not usually indicative of a heart attack. But that’s what doctors in the emergency room normally look for first because it’s the most urgent threat to your life. They may also look for potentially fatal lung problems including a collapsed lung or a blood clot in the lung.

Immediate examinations

When examining chest pain, a health care professional may order the following tests:

  • Electrocardiogram (ECG or EKG) (ECG or EKG). This brief examination monitors the electrical activity of the heart. Sticky patches (electrodes) are applied to the chest, as well as the arms and legs on occasion. The electrodes are linked by wires to a computer, which shows the test findings. An ECG can reveal whether the heart is beating too quickly, too slowly, or not at all. The ECG may indicate that you have had or are experiencing a heart attack because wounded heart muscle does not conduct electrical signals in a usual pattern.
  • Blood tests are performed. Blood tests may be performed to look for elevated levels of particular proteins or enzymes found in cardiac muscle. Damage to heart cells caused by a heart attack may allow these proteins or enzymes to leak into the circulation over a period of hours.
  • X-ray of the chest A chest X-ray can reveal the status of the lungs as well as the size and form of the heart and main blood veins. A chest X-ray can also detect lung issues like pneumonia or a collapsed lung.
  • CT scan stands for computed tomography. A CT scan can detect a blood clot in the lung (pulmonary embolism) or an aortic dissection.

Testing /Follow-up

Depending on the results of the initial tests for chest discomfort, you may require more testing, which could include:

  • Echocardiogram. An echocardiography creates a video image of the heart in motion by using sound waves. To acquire clearer views of various areas of the heart, a tiny device may be introduced down the throat.
  • CT scan stands for computed tomography. CT scans of various types can be used to look for blockages in the heart arteries. A CT coronary angiography with dye can also be performed to look for blockages and other issues in the heart and lung arteries.
  • Stress Test These assess how the heart and blood arteries respond to effort, which can help determine whether chest pain is caused by a cardiac condition. There are various types of stress testing. While attached to an ECG, you may be asked to walk on a treadmill or cycle a stationary bike. Alternatively, you may be given an IV medication to stimulate the heart in a similar manner to exercise.
  • Coronary angiography (catheterization). This test assists doctors in detecting blockages in the cardiac arteries. A catheter is a long, thin, flexible tube that is placed into a blood artery, typically in the groyne or wrist, and guided to the heart. Dye is delivered to arteries in the heart via the catheter. The dye makes the arteries more visible on X-ray images and video.

Treatment

Treatment for chest pain differs based on the source of your symptoms.

Getting ready for your appointment
Call 911 or emergency medical assistance if you have severe chest pain, new or unexplained chest pain, or pressure that lasts more than a few moments.

If it’s not a heart attack, don’t waste time worrying about being embarrassed. Even if there is another cause for your chest pain, you should be evaluated as soon as possible.

Treatment for chest pain differs based on the source of your symptoms.

Medications

Among the medications used to treat some of the most common causes of chest discomfort are:

  • Artery relaxants Nitroglycerin, which is typically administered as a pill under the tongue, relaxes heart arteries, allowing blood to flow more readily through the restricted gaps. Some blood pressure medications relax and expand blood arteries as well.
  • Aspirin. If your chest pain is thought to be related to your heart, you will most likely be prescribed aspirin.
  • Thrombolytic medications. If you have a heart attack, you may be given these clot-busting medications. These break down the clot that is preventing blood from reaching the heart muscle.
  • Thinners of the blood If you have a clot in an artery that feeds your heart or lungs, you will most likely be given medications that inhibit blood clotting to prevent further clot formation.
  • Acid-reducing medicines If your chest pain is caused by stomach acid splashing into your oesophagus, your doctor may recommend medications that limit the quantity of acid in your stomach.
  • Antidepressants. If you have panic attacks, your doctor may prescribe antidepressants to help regulate your symptoms. Talk therapy, such as cognitive behavioural therapy, may also be suggested.

Surgical and non-surgical procedures

Some of the more dangerous causes of chest discomfort are treated with the following procedures:

  • Angioplasty and stent implantation Angioplasty is primarily done to relieve chest pain caused by a blockage in an artery that supplies the heart. A catheter with a balloon on the end is inserted into a big blood vessel, generally in the groyne, and guided to the obstruction. The balloon is inflated to expand the artery, then deflated and the catheter is removed. A tiny wire mesh tube (stent) is frequently inserted on the catheter’s balloon tip. When the stent is enlarged, it locks into place to keep the artery open.
  • Surgical bypass. During this operation, doctors use a blood vessel from another region of the body to provide an alternate path for blood to travel around the blocked artery.
  • Dissection repair in an emergency. You may require emergency surgery to repair an aortic dissection, a potentially fatal disorder in which the artery that connects the heart to the rest of the body ruptures.
  • Reinflation of the lungs. If you have a collapsed lung, your doctor may implant a tube into your chest to reinflate it.

What you are able to do


If feasible, transmit the following information to emergency medical personnel:

  • Symptoms. Describe your symptoms in full, noting when they began and anything that makes the discomfort worse or better.
  • Medical background. Have you ever had chest pain? What was the cause? Do you or any members of your immediate family have a history of heart disease or diabetes?
  • Medications. A list of all the medications and supplements you frequently use will be useful to emergency personnel. You might wish to make such a list ahead of time to keep in your wallet or purse.

Once you get at the hospital, your medical evaluation will most likely be expedited. Your health care practitioner may be able to rapidly assess if you are having a heart attack based on the results of an electrocardiogram (ECG) and blood tests, or give you another explanation for your symptoms. You’re bound to have a few questions at this stage. If you haven’t got the following information, you should inquire:

  • What could be the source of my chest pain?
  • Is there anything else that could be causing my symptoms or condition?
  • What types of exams do I require?
  • Do I need to be admitted to the hospital?
  • What treatments am I in desperate need of right now?
  • Are there any side effects to these treatments?
  • What are the next steps in my therapy and diagnosis?
  • I also have other medical issues. What impact might this have on my treatment?
  • Do I have to follow any rules after I return home?
  • Should I see a doctor?

Do not be afraid to ask any extra questions that come to mind during your medical evaluation.

What to anticipate from the doctor

A doctor who examines you for chest pain may inquire:

  • When did your symptoms first appear? Have they deteriorated with time?
  • Is your discomfort spreading to other areas of your body?
  • What phrases would you choose to express your anguish?
  • Do you experience any other symptoms than chest discomfort, such as difficulty breathing, dizziness, lightheadedness, or vomiting?
  • Do you suffer from high blood pressure? If yes, do you take any medication to treat it?
  • Do you or have you ever smoked? How much is it?
  • Do you drink alcohol or use caffeine? How much is it?
  • Do you experiment with illegal drugs such as cocaine?

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