Reasons for Chest Pain/Discomfort

Chest pain is one of the most common reasons for which patients present for medical attention at either an emergency Department or an OPD.

Chest pain could be of cardiac or non cardiac origin.


Hereby we are detailing you with few of the common causes of chest pain and their symptoms, which will help you get a gross idea about the etiology of chest pain.:-

  1. CARDIAC : Feeling of pressure, tightness, squeezing, heaviness, burning ; behind the sternum( mid chest); often radiation to neck, jaw, shoulder or arms rarely epigastric region. (Please see the diagram below).
  2. PULMONARY: Pain is located on one side usually, often localized, has associated features as dyspnea (difficulty in breathing after exertion), cough, fever.
  3. GASTROINTESTINAL: Burning, pressure, tightness, aching or colicky in nature. Associated features include worsening after meals & lying down, relived by antacids.
  4. MUSCULAR/MUSCULOSKELETAL/NEUROMUSCULAR: Aching ,may have numbness (as in case of cervical disk ) localized to area of strain / trauma, Heavy lifting weight or injury present; usually prolonged with sharp and burning nature along with dermatomal distribution (as in herpes zoster).
  5. PSYCHOLOGICAL : Followed by some stressful or emotional event; often patient express feeling of tightness in chest with dyspnea along with a feeling of panic or doom!

Please note-
NOT ALL CHEST PAINS are cardiac (Heart) in origin

  • The symptoms sometimes can be confusing , hence when you visit the emergency department your doctor will suggest you to get an ECG done along with a blood test (for cardiac enzymes —Trop T & CPK).
  • Also sometimes the changes in pain of cardiac onset, ECG changes appear after 6-8 hours, so even if your first ECG is normal and your physician is suspicious; he will suggest a repeat ECG after 6 hours and keep the patient for observation.
  • So next time someone near you has chest pain you can start first line treatment right away on your way to Emergency department.

 

Basic treatment should comprise of –


1 Antacid – eg. Pantop/ Lanzol / Rablet – if pain seems to be due to gastritis (Acidity)
2 Aspirin – if pain seems to be of cardiac origin
3 BP medications – if patient is a known hypertensive under treatment
4 Pain killers – tab Calpol/ tab Ultracet(if it will be a muscular pain)

 

 

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