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Causes of Chest Pain Other Than Heart Attack

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Causes of Chest Pain Other Than Heart Attack

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Chest pain is the common complaint encountered in the ER (emergency room) every day. When should we seek medical help for our chest pain? Read the article to know more.

Medically reviewed by

Dr. Preetha. J

Published At December 7, 2017
Reviewed AtNovember 10, 2022

Introduction:

When people get chest pain, most of them will panic about a severe problem with their heart. To what extent should you worry about it?

Chest pain appears in many forms, varying from a sharp stab to a dull ache, and crushing or burning. It can also vary in quality, intensity, duration, and location. In some instances, the pain from the chest can travel up the neck into the jaw and then to the back or down one or both arms. Before discussing the causes of chest pain, we have to be familiar with the general anatomy of the chest. Our chest is formed by skin, subcutaneous fatty layer, chest wall muscles, ribs, pleura (a layer that covers our lungs), lungs, esophagus, heart, and neurovascular components.

What Is a Heart Attack?

When the blood flow to the heart muscle gets blocked due to a blood clot, it can cause chest pain. It can cause compressing chest pain, dull aching, suffocating in nature, which usually radiates to the left shoulder, sometimes to the jaw, and causes epigastric pain. It is associated with risk factors such as smoking, diabetes, hypertension, high lipid profile, or family history. Seek medical advice immediately.

What Can Be the Common Causes of Chest Pain?

Chest pain can occur due to many reasons, but the two main groups of causes include:

  • Cardiac causes.
  • Non-cardiac causes.

Various problems can cause chest pain, but the pain caused by heart and lung problems is life-threatening, and it requires immediate medical intervention.

Cardiac Causes of Chest Pain:

Cardiac related causes of chest pain include:

  • Angina: When the heart muscles receive insufficient oxygen-rich blood, it is called angina, leading to chest pain. It is a more dangerous and life-threatening condition. It is usually caused due to blockage of the coronary arteries (blood vessels that supply blood to the heart) due to the accumulation of thick plaques on the inner walls of the arteries. These plaques in the arteries can cause them to narrow and restrict the blood supply to the heart, especially during physical activity.
  • Aortic Dissection: The inner layers of the aorta (the major artery leading from the heart), when separated, can be torn due to the forcing of blood between the layers. When blood rushes through the tear, it can cause the aorta to split, which is often deadly. It can cause severe pain radiating to the back, central, associated with uncontrolled hypertension. Seek medical advice immediately.
  • Pericarditis: The inflammation of the pericardium (sac or thin membrane around the heart) is called pericarditis. This condition can usually cause sharp pain over the center or left side of the chest while breathing in or lying down. The inflamed pericardium can cause persistent pain that increases with leaning forward, usually following an upper respiratory infection, but could be due to other severe kidney conditions. Seek medical advice if it is persistent to exclude more serious conditions.

Non-Cardiac Causes of Chest Pain:

1. Herpes Zoster: This pain can be burning in nature, and the pain will occur before the skin rash appears. It is associated with red skin vesicles grouped in one site, usually seen in elderly persons but also familiar in young people with stressful conditions. It is treated conservatively, but sometimes pain medications help.

2. Breast Abscesses in Females: A red, tender, swollen lesion seen in some lactating mothers. An elective outpatient clinic visit is required, and it is usually treated with antibiotics for a few days.

3. Gynecomastia: The swelling of the breast tissues in males due to hormonal imbalance in boys or men is called gynecomastia. It is a palpable tender disc under the nipple of males. It is more common in adolescents. An outpatient clinic visit is required in this case, and it is usually treated conservatively.

4. Musculoskeletal: It is a stabbing type of pain, very annoying, and is associated with tenderness, usually following trauma, abrupt, violent movement, uncomfortable sleeping position, or exposure to extreme cold weather. Treated conservatively, pain medications (systemic or local) could help to depend on the severity.

5. Pleurisy: The inflammation of the membrane covering the lungs can cause chest pain and can worsen when you inhale or cough. Pleurisy can cause a stabbing, localized pain that develops following a common cold or simple chest infection. Management is with some painkillers if needed.

6. Gastric Reflux: Central burning chest pain is seen after eating a meal, which is very common in obese people. Antacids relieve the pain, and so does changing your eating habits.

7. Pulmonary Embolism: When a blood clot gets stuck in a lung (pulmonary) artery, it can block blood flow to lung tissues, which may lead to chest pain.

8. Collapsed Lungs (Pneumothorax): When the air enters the pleural cavity (the space around the lungs), it can cause collapsed lungs. The pain in the chest can begin suddenly and last for hours, and cause difficulty in breathing.

9. Pulmonary Hypertension: This condition of high blood pressure in the lung arteries is called pulmonary hypertension. It can affect the arteries carrying blood to the lungs and produce chest pain.

10. Injured Ribs: Broken or bruised ribs can cause chest pain.

What Are the Other Conditions That Can Be Associated With Chest Pain?

  • Atherosclerosis.
  • Aortic stenosis.
  • Cardiomyopathy.
  • Cholecystitis.
  • Shingles.
  • Mitral valve problems.
  • GERD.
  • Scleroderma
  • Cocaine use.
  • Diabetes.
  • Spasm of the esophagus.
  • Polyarteritis nodosa.
  • Gastritis.
  • Hiatal hernia.
  • Hypercholesterolemia.
  • Hypertension.
  • Hyperthyroid.
  • Lupus.
  • Marfan syndrome.
  • Pott disease.

Conclusion:

It is not always chest pain related to a heart condition, although we should be aware of the following warning symptoms requiring a quick ER visit.

  • Compressing chest pain is associated with effort, radiating to the left shoulder or jaw.
  • Epigastric compressing pain associated with effort.
  • Severe tearing central chest pain radiating to the back.
  • Any chest pain associated with syncope, racing heartbeats, excessive sweating, or vomiting.
  • Any suspected chest pain in a patient with risk factors (diabetes, hypertension, smoking, high lipid profile, or family history of cardiovascular diseases).
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Dr. Mahmoud Ahmed Abdelrahman Abouibrahim
Dr. Mahmoud Ahmed Abdelrahman Abouibrahim

Internal Medicine

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cardiovascular disease riskherpes zosterchest paingynecomastiachest discomfort
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