Chest Pain: Symptoms and treatment you must know

If you have or not, you should know these. It may save your or others life

By Dr. Dipan Samanta, MBBS

In simple words, chest pain is the presence of pain anywhere in the chest. Making it more complex, chest pain can be caused by a variety of reasons ranging from heart issues, lung issues, even bone (cartilages) problems. Sometimes, nothing occurs in the chest but the pain is perceived to be coming from the chest. Like when you have heartburn or acidity in the stomach, there may be a burning sensation in the chest.

This article is intended to provide you with basic knowledge of chest pain and its type.

Firstly, I want to say you that chest pain can be from any part/organ which is present in the chest. In the chest, the organs/part of the organs found are:

• Heart and blood vessels (5 Foods That May give you High Blood Pressure)
• Lungs and respiratory canals
• Issues from coverings of Heart or Lungs
• Part of esophagus (food pipe, through which the food reaches stomach from mouth)
• Big arteries
• Diaphragm
• Cartilages (Rib cage)
• Breast ( in females well developed and prominent; in males rudimentary)
• Nerves present in the chest
• Muscles present in the chest
• Pain from organs of abdomen like pancreas, stomach, liver, gall bladder, etc
• Psychological
• Endocrine problems
• Lymphatics problems

The above list is little technical which is difficult to understand and interpret. Having said that, you can’t understand from where the chest pain is coming. But what you should do or the doctor may ask you is the nature of chest pain. Whether the chest pain is sharp, dull, burning, aching, stabbing, tight/squeezing/crushing, even variable. It is also crucial to inform the doctor the side of the pain. I mean to say right sided chest pain or left sided, or the whole chest pain. The description is quite important in the diagnosis of chest pain.

Most infection affects the chest including the upper respiratory tract. So, you can understand from all these descriptions, that, chest pain can be from a wide range of causes. Chest pain does not only mean heart issues, they can be due to many causes including breathing problem, bone problem, even gastric or digestive problem.

There is an idea in the general population that chest pain belongs only to elderly. But no, in reality, you can find people with chest pain belongs to different age groups. Even there may chest wall deformity or injury or chest muscle issues.

You should also correlate the pain with many aspects, like:

1. Is the pain related to the meal?
2. Is the pain always present or subsides?
3. How is the pain? Is it stabbing, throughout the chest, pointed, burning, etc?
4. When did the pain start and how long it lasts?
5. How many times in a day or at what particular time it occurs?
6. Does the pain move from one particular place to another?

If the pain is related to a meal (before or after) or hunger or after eating too much, it may be due to digestive system issue or may be due to diaphragm (the muscle that separates our chest cavity and abdominal cavity).

It is important for everyone to know that which type of pain occurs in which disease.

But I, being a doctor myself, strongly recommend you to have a check up, if you have chest pain.

1. Sharp pain starts in chest and later spreads to arms, shoulder, upper back, even back of the chest. This may be due to Coronary Artery Disease (CAD). It is very common to see mid aged people to elderly people may have chest pain and they squeeze their hands on the chest. This type of squeezing pain may be from heart attack (otherwise know as Myocardial Infarction. Tearing pain, like something is tearing inside the chest, can also be rooted to problems arising from blood vessels that are present inside the chest.

2. If the chest pain is related to meal taken. For example, if you are hungry, there is pain. Or if you have eaten too much you have chest pain. This type of pain occurs from digestive system, may be it can occur due to hyper-acidity. In the chest, the food pipe, through which the food goes and also your vomit comes, is present. This food pipe may tear or may have inflammation. In this case, additionally, you may have problem in swallowing.

3. The chest has skeletal muscle. If these muscles experiences injury, tear, attacked by any disease, can be painful.

4. Any issue arising from lungs like an infection (like tuberculosis; you should know how to protect from this), lung tissue diseases. The bag that contains the lungs may also have infection or tear. Even there may be fluid or blood accumulation between the walls of the bag and lungs. The air pipe, through which the air you breathe reaches the lungs, may get constricted (as in asthma) or may get torn, can be painful. There may be inflammation of the air pipe. But these cases will be accompanied by cough, breathing troubles, sputum expulsion, even blood vomiting.
5. There may be psychological problems also. Anxiety and depression evidently may lead to chest pain.

So what you can understand from this, is the chest pain can occur due to several causes and the doctor has to find the underlying cause by means of diagnostic tests.

If you have chest pain and you visit the doctor, you should report him/her about:

1. The Pain type
2. The time of day when the pain occurs
3. Digestive problem
4. Respiratory or breathing problem
5. Headache
6. Neck ache
7. Swollen feet.

There can be several tests that your doctor can give:

1. Electrocardiography or ECG show you the electrical activity of heart
2. Doppler Mode Ultrasound shows you the status or function of blood vessels.
3. Chest X-Ray reveals any structural problem like size, position, accumulation of fluid, etc, in the chest. It also shows the fracture of ribs. It also shows the lungs, their sizes and any abnormality if present.
4. Endoscopy reveals any tear, constriction, structural issues in the food pipe present in chest and also in abdomen.
5. Blood Tests show the status of the blood cells, several protein levels, etc. If anything happens anywhere in your body (including infection), the blood tests mostly come abnormal.

There are more and more tests available and new tests are coming. The above list is too short and the most common tests that can be given.

What You Can Do When There Is Chest Pain?

1. Sharp and severe pain in the left: You must go to a clinic/nursing home/hospital for this. Even a doctor does not have the machines or infrastructure to investigate and manage this.
2. Burning Sensation after meal: Take antacid like Aluminium Hydroxide or Magnesium Hydroxide. If this happens to you everyday, consider taking H2 blocker of Proton Pump Inhibitor (PPI) 15 minutes before the each meal.
3. If chest pain due to cold and cough, consider taking an antibiotic. Professional prescription is highly suggested.
4. If there is too much pain, for a primary management, you can also take aspirin. You can also read about Paracetamol.
5. If there is sputum coming out or blood, consider going to a physician without any delay.
6. Also you must take care of your weight. Weight Loss is one of the best preventive care for cardiovascular problems.

In every case, you must get to know if anything is wrong inside. So, you must give a visit to a physician. There is no alternative choice. But for the first management, you may do the above things.