Tuesday, November 5, 2013

What can cause pain in your chest?

How many times have you scared because of pain in the chest? This symptom is very unpleasant and brings the fear of a heart attack. I must stress the fact that any kind of pain in the chest, particularly behind the breastbone, very serious symptom and requires a medical examination.

Chest pain may be associated with a whole range of causes, such as heart disease, digestive problems or lung disease. Pain in the chest may also be musculosceletal origin. Sometimes the chest pain of psychogenic nature.




There are extremely dangerous conditions that must be excluded in the diagnosis of chest pain. These are: myocardial infarction, angina pectoris, and aortic (cracking) of the aorta.

Angina pectoris is a common disease, especially in smokers of tobacco and obesity. It occurs due to changes in coronary blood vessels. These are the blood vessels that supply exclusively our hearts. It may be the result of small thrombosis in coronary blood vessels or pain occurs due to contraction (vasoconstriction) of blood vessels. Angina pectoris, especially variant that occurs at rest, it can cause a myocardial infarction, or heart attack. The pain of angina usually occurs in the form of tightness or pressure behind the breastbone. Sometimes spreads to the left arm and the chin. Anginal pain often accompanied by dizziness, sweating, nausea, high blood pressure. The people of angina pectoris often referred to as predinfarkt. Angina pectoris is diagnosed ergonomics. After the exercise test, the decision on coronary angiography.

There are several factors that may provoke angina pains. These are mental stress, physical exertion, cold weather, a large meal. The pain of angina usually stop at nitroglycerin and lasts up to 15 minutes.
People who know they have angina must bring your nitroglycerin.
If the pain does not stop at nitroglycerin, you should contact the emergency room!


Heart attack or myocardial infarction is caused by spasm or blockage of the coronary arteries, where stops the flow of blood and oxygen to the heart. Condition in which the heart does not have enough oxygen for their needs is called ischemia. If ischemia is caused long lasting changes, or lesions and necrosis of cardiac muscle. Heart attack accompanied severe pain behind the breastbone, which never ceases to nitroglycerin. It is sometimes accompanied by nausea and vomiting, especially when be said of the myocardial wall of the lower rate.
In our work, for fear of a specific patient's decision situations in which the patient is quiet, no panic on his back and complaining of severe pain behind the breastbone. Patients with myocardial infarction are usually silent and worried about his condition. First you need to test the ECG.
In most cases, the ECG shows changes in terms of myocardial infarction, but there are forms of stroke in whom there is no change in the ECG tape.
There is also a heart attack without pain or "silent heart attack", which usually occurs in patients with long-standing diabetes.
The pain of a heart attack is usually localized behind the sternum and has a classic pattern of spread. can go to the left arm, neck, stomach, jaw, and back. sometimes occurs and hiccups.
Pain comes with the feeling of breath, choking, fear, excitement, restlessness.
If it is a very extensive myocardial then there is hemodynamic instability, cold sweat, and blood pressure immeasurable.
A heart attack is fatal mainly due to malignant arrhythmias that accompany it.

Sometimes a heart attack discovered a few years later, when the ECG treadmill or ultrasound of the heart scar register and hypokinesis of the heart wall.

Valvular heart disease (mitral valve prolapse, aortic stenosis, mitral insufficiency) can also cause chest pain, but humanity changes usually follow choking, especially intense when lying on a flat surface.

Inflammation of the lining of the heart or pericarditis may also be the cause of chest pain. Intensifies during deep breathing, coughing, lying on his back. This pain is reduced when bending over and sitting.High risk for inflammation of the lining of the heart making the water around heart failure and pericardial effusion. A large amount of fluid in the pericardium, or pericardial tamponade napkin can cause death.

Particularly dangerous and extremely painful condition is aortic dissection. The aorta is the largest blood vessel arising from the heart. Aortic aneurysm is a pathological enlargement, and the weakening of the wall longitudinal aorte. Aorta often shoot in places aneurysm. This is a medical emergency, which quickly leads to tamponade and death if an emergency surgical procedure does not fix. The pain of dissection is tearing, extremely strong, spreading to the back, neck, arms, does not change when you change the position of the body. Very soon nastuopa cardiogenic shock, and death and it is time to help very shortly.


A common cause of chest pain are digestive problems, such as a hernia of the stomach (hiatus hernia), acid reflux from the stomach into the esophagus (GERD). This pain is usually associated with heavy meal, followed by heartburn and acid reflux. Taking medications that reduce the production of stomach acid, the pain is reduced. Previously, of course, necessary to exclude a heart attack. Hernia of the stomach may also cause disturbances in heart rhythm.

Inflammation of the esophagus or esophagitis may cause pain in the chest. It occurs frequently in alcoholics. Muscle spasm of the esophagus can also cause pain behind the breastbone.

Sometimes the cause of chest pain may be lung and pleura (the pleura). The most common diseases are cancer, metastasis, inflammation, adhesions (adhesions), thromboembolism or pulmonary infarction.The pain of pleurisy, or inflammation of the pleura increases in breathing and coughing, reduced lying on the affected side. Adhesions hurt the changing times. The pain of pleurisy is a sharp, piercing and character.


Diseases that are localized in the chest wall, may also be the cause of chest pain. These are osteoporosis, scoliosis, neuromuscular disease, fractures of the ribs, komresija nerves, forced standing, sitting, computer work, stretching the muscles in excessive physical exertion. The intensity of the pain varies in pressure.

Shingles can cause pain in one half of the chest.

In a previous article describes the most common causes of pain in the chest. The occurrence of pain in the chest, it is necessary to rule out serious conditions such as myocardial infarction and aortic dissection.
First search to make the EKG, cardiac necrosis markers and echocardiography.
After these  searches cardiologist decides about medications and additional diagnostic methods. 

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