Chest Pain: Causes and Characteristics

Chest pain can manifest in different ways, ranging from sharp, stabbing sensations to dull aches. It can be caused by a variety of conditions, some more serious than others. Here’s a breakdown of the common causes and characteristics of chest pain:

1. Cardiac (Heart-related) Causes for chest pain:

A) Angina:

Pain Characteristics: Tight, squeezing, or pressure-like pain.
Location: Center or left side of the chest, can radiate to the arms, neck, jaw, or back.
Associated Symptoms: Shortness of breath, sweating, dizziness, or nausea.
Cause: Reduced blood flow to the heart muscle (often due to coronary artery disease).
Triggers: Physical exertion, stress, cold weather, or heavy meals.

B) Myocardial Infarction (Heart Attack):

Pain Characteristics: Severe, crushing, or heavy pain.
Location: Center of the chest, radiating to the arms, jaw, neck, or back.
Associated Symptoms: Sweating, nausea, vomiting, dizziness, shortness of breath, fatigue, and palpitations.
Cause: Blockage of one or more coronary arteries, leading to damage of the heart muscle.
Urgency: This is a medical emergency.

C) Pericarditis:

Pain Characteristics: Sharp, stabbing pain that worsens when lying down or breathing deeply.
Location: Center or left side of the chest.
Associated Symptoms: Fever, weakness, or fatigue.
Cause: Inflammation of the pericardium (the sac around the heart).

D) Aortic Dissection:

Pain Characteristics: Sudden, severe tearing or ripping pain.
Location: Pain may radiate to the back.
Associated Symptoms: Sweating, fainting, or trouble speaking.
Cause: Tear in the aorta’s inner layer.
Urgency: Life-threatening emergency.

2. Non-Cardiac Causes:

A) Gastroesophageal Reflux Disease (GERD):

Pain Characteristics: Burning pain, often after eating or lying down.
Location: Behind the breastbone, may radiate up to the throat.
Associated Symptoms: Acid taste in the mouth, regurgitation, and difficulty swallowing.

B) Muscle Strain:

Pain Characteristics: Tender, aching, or sharp pain.
Location: Usually on one side of the chest, worsens with movement or palpation.
Cause: Overuse or injury to the chest muscles, rib cage, or intercostal muscles.

C) Costochondritis:

Pain Characteristics: Sharp, stabbing pain.
Location: Usually localized to the breastbone (sternum) and worsens with pressure.
Cause: Inflammation of the cartilage that connects the ribs to the breastbone.

D) Pulmonary Embolism:

Pain Characteristics: Sharp, stabbing pain that worsens with deep breaths.
Location: May be on one side of the chest.
Associated Symptoms: Shortness of breath, rapid heart rate, coughing up blood, or fainting.
Cause: Blood clot in the lungs.
Urgency: Medical emergency.

E) Pneumothorax (Collapsed Lung):

Pain Characteristics: Sudden, sharp pain.
Location: Usually on one side of the chest.
Associated Symptoms: Shortness of breath, rapid breathing, or rapid heart rate.
Cause: Air trapped between the lung and chest wall.

F) Anxiety or Panic Attack:

Pain Characteristics: Tightness, chest discomfort, or pressure.
Location: Center or left side of the chest.
Associated Symptoms: Rapid heartbeat, shortness of breath, dizziness, sweating, and feelings of impending doom.
Cause: Intense anxiety or stress.

3. Other Causes:

Shingles: Pain can occur in the chest if the herpes zoster virus affects the nerves in that area, and it is typically followed by a rash.
Esophageal Spasm: A sudden, painful contraction of the esophagus can cause chest pain similar to that of a heart attack.

When to Seek Emergency Care:

Chest pain should always be taken seriously. Seek emergency medical attention if:

The pain is severe or sudden.
It’s accompanied by shortness of breath, sweating, nausea, fainting, or a sense of doom.
You have a history of heart disease, or you’re at risk for a heart attack.

Understanding the specific characteristics and associated symptoms of chest pain is crucial for determining whether it requires urgent medical attention.

Salam Salloum

Consultant Cardiologist, Specialist In Cardiac Imaging, Heart Failure, And Valve Disease. Dr. Salloum has been working in the field of cardiovascular medicine for over 20 years between cardiac surgery, cardiac intensive care, and cardiology. In 2016 he was appointed as a consultant cardiologist with a special interest Heart Failure, Valve Disease, Cardiac Imaging (Cardiac CT, Cardiac MRI, Echocardiogram, and Stress Echocardiogram), along with General cardiology (angina, hypertension, and palpitations). Dr. Salloum received his training to be a Cardiology Doctor in prestigious UK University Hospitals. He did over 2 years at Southampton University Hospital training in cardiac intensive care and post-cardiac surgery care. He did 18 months at Papworth Hospital – Cambridge spending 1 year in cardiac surgery and 6 months in advanced heart failure training including pre and post-heart transplant care. The general cardiology, echo, stress echo and cardiac CT trainings all were gained through training programme at Oxford University Hospital (John Radcliffe Hospital) where he spent over 3 years. Dr. Salloum then took over 2 years of fellowship training at The Royal Brompton Hospital – London to obtain a level 3 EACVI Accreditation in cardiac MRI. He also has the British, European, and American Board Certifications in Echocardiography. Dr. Salloum has performed over 5000 Dobutamine Stress Echo (DSE) to assess ischaemia and valve disease. He reported over 3000 cardiac MRI studies assessing ischaemia, heart structure, valve diseases, aortopathies, and different types of cardiac cardiomyopathy conditions. He also reported over 2000 cardiac CTs assessing cornary calcifications, and coronary artery diseases non-invasively. All expertise aside, Dr. Salloum’s real goal is to help those who need it. He decided becoming a virtual doctor and offering both general and cardiology services online would be the best way to do so. He committed himself to be able to offer the best advice to anyone who asks as well as provide more in-depth consultative services through the phone, internet and face to face. So rest assured, no matter what kind of issues you have faced, whether it is pre-operative, post-operative or you have been experiencing some sort of cardiovascular symptoms you feel you need to ask a doctor or cardiologist about, The UK-Cardiologist will do the absolute best to help you through this troubling time through the virtual clinic and online services. Dr. Salloum will pass this experience on to everyone who needs to ask a cardiologist anything online. Qualifications: M.D. MRCP UK. CMR Level 3 EACVI: Cardaic MRI. CTCA SCCT II: Cardiac CT. NBE: Natioanl Board of Echocardiogram (USA). Member of: RCP: Royal College of Physicians. ESC: European Society of Cardiology. ASE: American Society of Echocardiography. EACVI: European Asscoiation of CardioVascular Imaging. MDDUS and AoN: Meidcal Indemnity Insurances. Subspecialties: Cardiac Imging. Herart Failure. Valve Disease. Stress tests. Special interests in the following cardiac conditions: Acute Coronary Syndrome (ACS) Angina Aortic Valve Degeneration Aortic Valve Disease Aortic Valve Regurgitation Aortic Valve Stenosis Atrial fibrillation Atrial flutter Beathlessness Crdiomyopathy Crdiovascular Disease Chest Pain Cngestive Heart Failure Cronary Artery Disease Heart Failure Heart Murmurs Heart Valve Problems High Blood Pressure Hypertension (High Blood Pressure) Conditions Non-Invasive Heart Imaging Oedema Palpitations Pericarditis Postural Orthostatic Tachycardia Syndrome (POTS) Supraventricular Tachycardia (SVT) Takotsubo Syndrome Valvular Heart Disease Investigations: 24 Hour Blood Pressure Monitor Bubble Contrast Echocardiography CT Coronary Angiogram Calcium Coronary Score Cardiac CT Cardiac Imaging Cardiac MRI Cardiac Screening Dobutamine Stress Echocardiogram ECG (Electrocardiogram) ECG Holter Monitor Ehocardiogram (Cardiac Ultrasound) Exercise Stress Test Heart Health Check Heart Scan Sress Echocardiogram Transthoracic Echocardiogram (TTE) Languages: English Arabic

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