UK Cardiologist – Dr. Salam Salloum

Chest Pain: Causes and Characteristics

Chest pain

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:

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.

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