Understanding Chest Pain and its Possible Causes
Chest pain is a common complain being seen in the emergency room ever now and then. Its pain degree usually varies from person to person and also to one’s level of pain tolerance. Chest pain could also be associated with different symptoms like difficulty of breathing, diaphoresis, vomiting, palpitations and many more. It could also be aggravated by many factors, like with food intake, pain on movement, pain when exhausted or when walking a couple of blocks. Chest pain can represent a benign disease entity like a muscular strain or a life threatening one like a myocardial function. So let’s dig a little bit deeper and mention some disease entities presenting as chest pain.
Causes of Chest Pain
Musculoskeletal Strain – a strain in any of your chest muscles, may it be your pectoralis major or minor, can cause chest pain. It can present sometimes as chest heaviness and aggravated with moving. It could also mimic a cardiac event and sometimes could be misdiagnosed. This could be a dilemma sometimes, but going back to the patient could clear some differentials. If it’s a young patient, no comorbidities, then the diagnosis of a cardiac event is less likely compared to an old patient with comorbidities, then aside from a possible muscle strain, a cardiac event should be ruled out. It could be relieve by pain medications and relaxation of the muscle/s involved.
Costochondritis – is defined as inflammation of your costal cartilages which holds your ribs to your sternum. Pain in any of these cartilages could radiate it to your anterior chest and can present as chest pain. It is usually aggravated by movement and by deep breathing. It is usually pain free if you stay stationary and doing some shallow breathing. On physical examination of the anterior chest, a pin point tenderness on the anterior chest wall can be elicited if the patient is suffering from costochondritis. It is usually relieved with pain medications and rest.
Acid Reflux Disease – this chest pain of this disease entity is not cause by a mediastinal organ. Reflux disease usually present as chest pain, when the stomach cannot control anymore its acidic content, hence it has a tendency to go up via the esophagus hence presenting as chest pain. It type of chest pain is usually characterized as burning sensation and has a linear pattern of chest pain from the stomach going up. It is usually aggravated by hunger and is sometimes relieved with food intake. It could be treated with proton pump inhibitors like your omeprazole and rabeprazole, but if it persists, an upper endoscopy might be warranted to investigate the stomach.
Pneumonia – chest pain in pneumonia is characterized as pleuritic and is associated with productive cough. It phlegm is noted to be really sticky, chest pain can be a prominent symptom when the patient coughs out. Giving of antibiotics and phlegm softeners can help reduced chest pain. Once the pneumonia is resolved the patient can be chest pain free.
Myocardial Infarction – MI or commonly termed as a heart attack. Its main presentation is chest pain, usually associated with diaphoresis, cold clammy skin and difficulty of breathing. This usually presents as sudden onset chest pain, radiating to the back, shoulder or to the jaw. Patients suffering from myocardial infarction usually have 1 or more risk factors which are clues in clinching this diagnosis. Goals of treatment in myocardial infarction are to relieve chest pain right away, and prevent further infarction in the myocardium. If your face with a person with possible myocardial infarction, seek medical consult right away.
There are still many disease entities that could present with chest pain, but the 5 that I have mentioned are somewhat common causes of chest pain, and who knows you might encounter one in the coming days.