Chest Pain-Causes, Symptoms and Prevention

Chest pain is any sort of pain felt in the upper body, from shoulders down to ribs. It can be a symptom of many conditions and must be taken seriously. There are 10 main diseases where the chest pain is the main symptom. So, then how to know what is really causing your chest pain? Let’s know the various causing factors and symptoms of each one.

Causes of chest pain

• Heart Attack
• Angina
• Aortic Dissection
• Aortic aneurysm(enlargement of the aorta that can rupture)
• Pulmonary Embolism
• Spontaneous Pneumothorax
• Perforated Viscus
• Pericarditis
• Pneumonia
• GERD

Heart Attack

Causes

• Cocaine
• Diabetes
• Family history of heart attacks
• High cholesterol
• Hypertension
• Male gender
• Obesity
• One or more previous heart attacks
• Post-menopause
• Smoking

Symptoms and signs

• Abdominal discomfort
• Dizziness
• Heartburn
• Increased sweating
• Nausea
• Pain radiates to the left shoulder, the left arm, the jaw, the stomach, or the back.
• Pain in the mid to left side of the chest
• Shortness of breath
• Unexplained fatigue
• Vomiting

Investigations

• Electrocardiogram (ECG or EKG)
• Cardiac enzymes (blood test)

Angina

Causes

• Arrhythmia
• Coronary heart disease
• Exercise or physical exertion
• Mental stress

Symptoms

• Pain is triggered by physical activity and relieved by rest.
• Pain feels heavy, pressing or tight
• Breathlessness
• Nausea
• Sweating
• Pain spreads to the arm

Investigations

• Electrocardiogram(ECG or EKG)
• Cardiac enzymes (blood test)
• Stress test(TMT)
• Cardiac catheterization(Angiography)

Aortic Dissection

Causes

• Advanced age
• Cardiac catheterization
• Cocaine use
• Congenital heart disease
• connective-tissue diseases
• Pregnancy
• Uncontrolled high blood pressure

Symptoms

• Abdominal pain
• Angina-type pain
• Fainting
• Pain occurs suddenly
• Pain radiate to the back or between the shoulder blades.
• Ripping or tearing type
• Shortness of breath

Investigations

• Chest X-ray
• Transesophageal echocardiography
• CT-scan chest
• Angiography

Aortic Aneurysm

Causes

• Atherosclerosis
• Smoking
• Hypertension
• Advanced age
• Physical trauma to the chest or abdomen
• Inflammatory diseases, such as Takayasu’s arteritis
• Genetic connective tissue disorders, like Marfan Syndrome

Symptoms

• Deep, steady pain in the chest, back or abdomen.
• Difficulty in swallowing or breathing
• Shortness of breath
• Throbbing sensation near the navel
• Voice change

Investigations

• Echocardiogram
• Computed tomography (CT)
• Magnetic resonance imaging (MRI)
• Abdominal ultrasound

Pulmonary Embolism

Causes

• Arrhythmias
• Birth control pills
• Cancer
• Cigarette smoking
• Congestive heart failure
• Fracture(long bone of the legs)
• Heart attack
• History of blood clots
• Obesity
• Pregnancy
• Prolonged immobility
• Sedentary lifestyle

Symptoms

• Rapid breathing
• Sharp pain in the mid-chest( increases with deep breaths)
• Sudden onset of shortness of breath

Investigations

• Blood gases analysis
• Chest x-ray
• Ct scan-lungs
• ECG
• V/q scan ( (ventilation/perfusion) )

Spontaneous Pneumothorax

Causes

• AIDS-related pneumonia
• Cancer
• Crack cocaine
• Cystic fibrosis
• Emphysema
• Injury to the chest( trauma, as in a car wreck, bad fall, gunshot wound or stabbing, or in surgery)
• Marijuana
• Ruptured abnormal air sacs (sneeze or excessive coughing)
• Severe asthma

Symptoms

• Dizziness
• Faintness.
• Rapid heart rate
• Sharp chest pain
• Sudden onset of shortness of breath

Investigations

• Chest/Abdominal x-ray
• CT scan

Perforated Viscus

Causes

• AIDS
• Appendicitis
• Cancer
• Cholecystitis
• Cholelithiasis
• Irritation to the diaphragm
• Long-term steroid use
• Prolonged or forceful vomiting
• Swallowing a foreign body
• Untreated ulcers

Symptoms

• Sudden onset
• Severe abdominal, chest, and/or back pain
• Pain may increase with movement/ breathing
• Rigid abdominal wall during pain

Investigations

• Chest/Abdominal X-ray
• CT
• Blood tests

Pericarditis

Causes

• Bacterial infection
• Cancer
• Cardiac tamponade
• Certain medications
• Chronic renal failure
• Connective-tissue diseases
• Radiation treatment
• Viral infection

Symptoms

• Dysphagia
• Fever
• Pain is worsened by lying flat and improved by leaning forward
• Pain radiate to the left side of the back or shoulder
• Recent cold
• Sharp or stabbing pain in the mid-chest
• Shortness of breath

Investigations

• Serial ECGs
• Blood tests

Pneumonia

Causes

• Viral infections
• Bacterial infections
• Fungal infections of the lungs

Symptoms

• Chest pain during prolonged or forceful coughing
• Fever
• One-sided pain
• Shortness of breath
• Sputum production
• The pain worsened by the cough

Investigations

Chest x-ray

GERD

Causes

• Alcohol 
• Caffeine
• Calcium channel blockers
• Consumption of high-fat foods,
• Diabetes
• Estrogen, progesterone
• Infections( yeast, fungi, viruses, bacteria)
• Irritation from medications.
• Nicotine
• Nitrates
• Pregnancy
• Scleroderma

Symptoms

• Chest pressure
• Dull chest discomfort
• Dysphagia
• Excessive salivation
• Heartburn
• Hoarseness
• Nausea
• Pallor
• Persistent dry cough
• Profuse sweating
• Severe squeezing pain across the mid-chest
• Sore throat
• Sour or bitter taste in the mouth or throat

Investigations

• Barium studies
• Endoscopy

Treatment

According to doshas and symptoms the following herbs can be given-

• Charaka has mentioned hridaya maha Kashaya.

• Arjuna bark, Haridra, Pippali, Punarnava, Kutki, Pushkarmool, Bala, Shunti, Yasti madhu, Dashmool, Haratiki, Curcuma longa, Guggul, Amalaka, Jatamamsi, Pippalayadi choornam are used according to need.

• Panchakarma procedures, like vaman ,virechan, basti, shiroddhara, abyanga, swedan, are very beneficial.  

Prevention

• Allow stretching and movement of the legs if seated for a long time. Isometric contractions of the calves are helpful if getting out of the seat is not possible
• Avoid lying down right after eating
• Don’t smoke
• Eat nutritious, low-fat foods in moderate quantities.
• Effective handwashing and good hygiene
• Elevate the head of the bed
• Engage in physical activity or exercise for at least 30 minutes every day.
• Keep Blood sugar and Blood pressure in control
• Maintain a healthy weight. Holds good for all types of chest pain.
• Use alcohol in  moderation
• Do yoga on regular basis.