Understanding Chest Pain: Causes, treatments and prevention

Chest Pain can have a variety of causes ranging from abdominal gas to heart attack. Thus, it’s difficult to determine the exact cause of Chest Pain on your own. Thus, if you are suffering from it, it is always a good idea to take a medical opinion. Read ahead to know more about this specific type of pain.

What is Chest Pain? 

The term ‘Chest Pain’ refers to pain anywhere in the chest. Depending on the cause, Chest Pain may also spread (radiate) to the neck, jaws, or arms. It could be a dull ache or a sharp stabbing pain, intermittent or continuous, and can last for a few minutes to a few hours. 

What causes Chest Pain? 

Chest Pain can indicate numerous underlying conditions. Some of them are listed below.

1. Heart and blood vessel-related

• Heart attack: In a heart attack, there is the death of the heart muscle tissues because of a block in the blood vessels that supply blood to the heart (coronary arteries). 

• Coronary artery disease: In this condition, cholesterol build-up clogs the coronary arteries and makes them narrow. This results in reduced blood supply to the heart muscles, which results in Chest Pain (angina).

• Aortic dissection: Aorta is the main artery that receives blood from the heart and supplies blood to the body. Aortic dissection is a life-threatening condition in which the inner layers of the blood vessels separate, and the blood enters between the layers. This eventually causes a rupture of the aorta. 

• Coronary artery dissection: Like the previous condition, here the coronary artery walls rupture and this compromises the blood supply to the heart. 

• Aortic aneurysm: When the blood in the aorta puts pressure on a weak part of the wall of the aorta, it may cause the wall to bulge and eventually rupture. 

2. Digestive-related 

• Gastroesophageal reflux disease/Acidity/Heartburn: When acid backflows from the stomach to the food pipe (oesophagus), you may feel a painful burning sensation in the chest. This is called heartburn. 

• Gastric ulcers: Factors such as unhealthy diet and infections can make the stomach lining more susceptible to injury by stomach acids. 

• Swallowing disorders: Dysfunction of the esophageal muscles may cause Chest Pain. 

• Gallbladder/pancreatic disorders: Diseases involving these organs may cause abdominal pain which radiates to the chest. 

3. Lung-related

• Pulmonary embolism: In this condition, a clot gets lodged in the pulmonary artery (the main blood vessels that carries blood to the lung for oxygenation). This is a life-threatening condition and needs emergency management.

• Lung collapse: Lung collapse usually occurs when there is an air leak in between the lungs. In this case, Chest Pain is usually very sharp, can last for hours and is accompanied by shortness of breath.

• Asthma: Difficulty in breathing in asthmatic patients is often accompanied by chest tightness. 

• Pneumonia: Infection in the lungs can cause pain in the chest and severe cough which can worsen the pain. 

4. Musculoskeletal related 

• Rib fracture: Rib fractures are extremely painful. Movement of ribs while breathing aggravates the pain. 

• Sprain in chest muscles: Excessive chest workout or heavy weightlifting might cause a pulled muscle or muscle injury in the chest. This causes sharp Chest Pain which is aggravated by movement. 

Symptoms that indicate possible causes of Chest Pain

The following characteristics of Chest Pain might help you guess the underlying cause. However, in case of Chest Pain, it is best to obtain a medical opinion. 

1. Digestive issues: If the pain starts after eating and you experience bloating and a bitter taste in the mouth, the Chest Pain may be Heartburn. 

2. Muscular issues: If the pain starts after a chest workout, chest injury or carrying heavy weights and reduces after some rest, then the cause might be chest muscle pull or injury. 

3. Lung-related issues: If you experience chest tightness or Chest Pain while breathing and have other symptoms like cough, yellow/green mucus and fever, you might have lung problems. 

4. Heart-related issues: If you have pain that radiates to the neck or arms, chest tightness and other symptoms like breathing difficulty, or sweating, then your Chest Pain might be due to a heart-related problem. 

Treatment for Chest Pain

The treatment for Chest Pain depends on the underlying conditions. 

Medications 

Depending on the aetiology, you might be given medications to:

• relax and widen the blood vessels (nitroglycerin)

• promote blood flow to the heart,  

• dissolve the clot (anticoagulants) 

• prevent clot formation (blood thinners) 

• prevent stomach acid production (antacids)

Surgery 

In case of blocked coronary arteries, either angioplasty or a bypass graft may be suggested depending on the severity of the condition. In case of coronary or aortic dissection, an emergency dissection repair is needed. 

Diagnosis of Chest Pain

The medical history and physical exam itself can help the physician understand the probable underlying cause. Based on your clinical examination findings, your doctor may refer you for one or more of the following tests. 

1. Electrocardiogram (ECG): To find out any abnormalities in the electrical activity of the heart.

2. Blood tests: To check for the levels of certain markers (proteins/enzymes) that indicate heart disease.

3. Chest X-Ray: To check for any pathology in the lungs and heart. 

4. CT scan: To check for any abnormalities in the structures present in the chest: heart, lungs, ribs, blood vessels etc. 

How can I prevent Chest Pain?

Chest Pain is a sign indicative of a variety of conditions. To prevent the underlying conditions as discussed above, the following measures should be taken.

1. Eat healthy: Consult a nutritionist for a diet plan that suits your health. 

2. Exercise: Exercise at least 5 days a week. 

3. Weight: Maintain a healthy weight.

4. Health issues: Manage any conditions like high blood pressure that you may have. Take medications and lifestyle measures to keep them in check.

5. Alcohol/smoking: Stay away from drugs, alcohol, and smoking> 

Frequently Asked Questions (FAQs)

Here are some common questions and answers related to Chest Pain.

I have Chest Pain, what should I do?

If your Chest Pain is severe and is not responding to pain medications or rest, it's best to seek immediate medical attention. If your Chest Pain goes after taking these measures but comes back again, you should get it checked once with your physician.

How to know if my Chest Pain is serious?

If Chest Pain persists for more than 5 minutes and does not respond to medications or rest, you should immediately seek medical attention. 

One of the life-threatening causes of Chest Pain is a heart attack. If you are having a heart attack, you would experience additional symptoms like sweating, shortness of breath, nausea and vomiting, dizziness etc.

Is angina and Chest Pain the same?

No. Chest Pain may have any cause as discussed above. However, angina refers to the Chest Pain that occurs when the heart muscles do not receive oxygen-rich blood.

How does pain in angina feel?

Patients have described squeezing, heaviness, or tightness in the chest. Chest Pain can be accompanied by shortness of breath, dizziness, sweating or nausea.

How do I manage heartburn at home?

You could take some over-the-counter drugs, such as antacids or H2 blockers, to relieve Heartburn. If these medications do not work for you, seek medical advice.

References

1. https://www.mayoclinic.org/diseases-conditions/chest-pain/diagnosis-treatment/drc-20370842

2. https://my.clevelandclinic.org/health/symptoms/21209-chest-pain#care-and-treatment

3. https://www.nhs.uk/conditions/chest-pain/

4. https://www.ncbi.nlm.nih.gov/books/NBK470557/

5. https://www.heart.org/en/health-topics/heart-attack/angina-chest-pain 

Disclaimer: The content on this page is generic and shared only for informational and explanatory purposes. Please consult a doctor before making any health-related decisions.

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