What is Chest Pain?
Chest pain is a condition affecting the area between the neck and the abdomen.
There are a number of reasons why we might get chest pain. Some of them are minor and some are life threatening.
Chest pain is one of the most common reasons why people visit the emergency room at the hospital. This is rightly so as chest pain may indicate a serious problem. (1)
The pain could be short sharp stabs or could feel like it is crushing or burning.
Causes
The chest contains the lungs, diaphragm, heart and part of the aorta. The aorta is the main artery of the body. It supplies oxygen rich blood to the circulatory system.
It also contains the trachea which supplies air to the lungs. The esophagus is also in the chest which allows food to pass from the mouth to the stomach.
These major organs are protected by the ribcage.
Many of the the organs in the chest can cause pain. We will now detail some of causes related to the various organs.
Heart Related Pain
There are many reasons why the heart can cause pain. The main ones are: heart attack, angina, rupture of the aorta and inflammation of the sac around your heart.
Heart Attack
The heart is a muscle. A heart attack happens when the blood flow through the heart becomes blocked. This could be because of a blood clot. The flow of blood to heart stops and it begins to die.
This causes pain in the chest. It can last a few minutes or come and go. The pain can also travel down your arms or across your back. It is sometimes mistaken for indigestion. (2)
Angina
Angina occurs when your heart does not get enough oxygen rich blood. It is usually a symptom of coronary heart disease.
Coronary heart disease means that there is a build up of a substance called plaque in the arteries. This reduces blood flow. The result is a lack of oxygen to the heart.
This scenario leads to chest pain. It feels like pressure or squeezing. Like a heart attack it also can travel along your arms or shoulders and feel like indigestion. (3)
Aortic Dissection
An aortic dissection or tear in the aorta is a very serious condition and it can also be fatal. The aorta is a large blood vessel which branches off the heart. It carries oxygenated blood.
When it tears, blood flows through causing the inner and outer layers of the aorta to separate.
This causes a pain in the chest which can be sudden and severe. (4)
Pericarditis
The sac around your heart is called the pericardium. It has two layers which hold the heart in place and help it work. The fluid in this sac can become inflamed and make it rub against the heart.
This causes pain that can feel like a heart attack. (5)
Lung Related Pain
The lungs are responsible for exchanging gases when we breathe. They supply oxygen to the body and take away carbon dioxide that we don’t need. (6)
Pain from the lungs when you breathe can indicate a number of issues. These include: pneumonia, bronchitis, pneumothorax or collapsed lung and pulmonary embolism or a blood clot.
Pneumonia
Pneumonia is a respiratory infection. There can be many causes, although it’s usually as a result of a bacterial or viral infection.
It leads to pain in the chest when you breathe deeply or cough. This pain is described as sharp or stabbing. (7)
Bronchitis
Bronchitis is inflammation of the airways into your lungs. It can be caused by a virus or breathing in something that irritates them. It makes your chest feel tight. (8)
Pneumothorax
A pneumothorax or collapsed lung happens when air finds its way into the chest wall or from a tear in the lung. It stops the lung from remaining inflated.
It can be caused by lung disease, an injury from playing sport or an accident. Further causes can be breathing with a ventilator, or changes in air pressure when scuba diving or mountain climbing. The cause is sometimes unknown.
The pain from this is usually sudden and in one side of your lung. You might also feel like you can’t breathe easily. (9)
Pulmonary Embolism
This is a blockage due to a blood clot in an artery leading to the lungs. The clot may form elsewhere in the body and travel to the lungs. It is a serious condition that can be life threatening if the clot is large.
It can damage your lungs due to lack of blood flow. Damage to other major organs occur due to a lack of oxygen.
This causes chest pain and a sudden shortness of breath. (10)
Muscle or Bone Related Pain
There are many muscles and bones in the chest. Ribs may be bruised or broken if you have an accident or a fall. Muscles can ache or tear if you exercise too hard.
There is a condition that can cause pain or tenderness in cartilage around the breastbone. This is called costochondritis and is due to inflammation in that area. (11)
Panic Attack
Panic attacks can be a cause of chest pain. When you have a panic attack you hyperventilate or breathe in and out too rapidly. This causes the blood vessels to contract which results in the pain. (12)
Heartburn or Indigestion
Although heartburn originates in the stomach, pain is often felt in the chest. It gives you an unpleasant burning sensation. (13)
Shingles
Shingles is a viral disease. It is caused by the same virus as chickenpox. It most commonly occurs in the chest or torso area.
It produces an itchy rash with blisters. Before this rash appears you feel a bit run down and tired. If it is in the chest you also feel a stinging or burning pain in the area. (14)
Symptoms
There are many different reasons why you may experience chest pain. Some can be serious issues as your heart and lungs are in the chest. Whatever the reason it is important to seek medical help quickly.
It may be difficult to tell without medical help what the cause of the pain is. It can often be nothing to do with your heart or lungs.
We will break the symptoms down into two categories: heart related symptoms and non heart related symptoms. (15)
Heart Related Symptoms
Not everyone feels extreme pain as a result of a heart problem. It can be as simple as feeling discomfort in the chest area that you would not describe as painful.
There are varying levels and types of pain that you can feel.
These include pressure, burning, fullness or tightness in your chest. There could be a crushing or searing pain that travels from your chest to your back, arms, shoulders neck or jaw.
This pain can be excruciating or mild. It may come and go. You can feel more pain if you start doing something active. The pain usually lasts for more than a few minutes.
There are other symptoms that can accompany the pain. They include shortness of breath, cold sweats, dizziness, nausea and vomiting.
Non Heart Related Symptoms
Chest pain is not always related to the heart. As we have already seen there are other causes of chest pain.
Indications the pain is due a cause other than the heart include pain that gets worse when you breathe deeply or cough.
Pain can get better or worse when you move around.
Sometimes it might be a feeling of tenderness when you press on the area. It can be a persistent pain that lasts a long time.
Accompanying the pain you could have a sour taste in your mouth. It also may be hard to swallow.
Other Considerations
The symptoms of heartburn and indigestion are quite similar to those associated with heart problems. It is a painful burning sensation behind your breastbone.
Diagnosis
It’s important you seek immediate help if you think you may be having a heart attack. Especially if you have a new or unexplained pain that lasts for more than a few moments.
Your physician will ask many questions which may help them determine the cause of the pain. (16)
You should be ready to tell them any symptoms you have. Tell them about any medication you may be taking. Also let them know about any medical conditions you have or treatments you are receiving.
There are a number of diagnostic tests available. These include blood tests and various scans and x-rays.
Blood tests can detect whether a heart attack has happened.
An echocardiogram can measure the electrical impulses from the heart. It will indicate if you have had a heart attack.
A chest x-ray can help identify heart and lung issues.
CT scans can pick up blood clots.
There are other follow up tests that can be carried out if necessary to determine the exact cause of the pain.
FAQ
What is chest pain? Chest pain is any pain that happens between the neck and abdomen area. It may be mild or severe. It can happen unexpectedly and be unexplained. Dependent on the cause it can pass quickly or last a long time.
What area covers the chest ? It is the area which lies between your neck and lower rib cage or abdomen. It includes two main vital organs of your body, the heart and lungs.
What causes chest pain? There are many causes of chest pain. More serious ones involve the heart and the lungs. Less concerning are shingles, muscle strain, indigestion and panic attacks.
How do doctors test for chest pain? A doctor will carry out an initial physical examination. They may ask lots of questions. Dependent on what they find, they may order diagnostic tests. These can help determine the cause of the pain.
When should you go to the doctors with chest pain? Any unexplained new pain that lasts more than a few minutes should be treated as an emergency. Also if the pain is so severe that you cannot carry on with daily life then seek medical help. With other types of pain, if they persist see your doctor.
Can you prevent chest pain? This will depend on the cause of the pain. Following a healthy diet and exercise plan can help prevent a lot of heart related problems. If you smoke you should quit as this will also help. (17)
What can you do to relieve chest pain? Many of the causes of chest pain require medical intervention. You can find herbal remedies like peppermint tea that can help the pain from indigestion. (18)
Is chest pain life threatening? In some cases yes. This is why it’s important to seek medical advice if you are unsure what is causing your pain. There are times when the emergency room is the only option.
Summary
Chest pain has many different causes and can present a multitude of symptoms.
It can be as a result of a serious issue with the heart or lungs. It may be a more minor issue like indigestion or muscle strain.
The type of pain can also be minor or severe.
Chest pain is one of the most common reasons that people head for the emergency room.
What’s clear is that diagnosis of chest pain is important to rule out any life threatening conditions.