Chest Pain-Causes, Symptoms and Prevention

Chest pain is any sort of pain felt in 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 chest pain is the main symptom. So, then how to know what is really causing the pain in your chest? Let’s know the various causing factors and symptoms of each one.

  1. Heart Attack
  2. Angina
  3. Aortic Dissection
  4. Aortic aneurysm(enlargement of the aorta that can rupture)
  5. Pulmonary Embolism
  6. Spontaneous Pneumothorax
  7. Perforated Viscus
  8. Pericarditis
  9. Pneumonia
  10. GERD

Heart Attack

Causes of Heart Attack

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

    Symptoms of Heart Attack
  • Abdominal discomfort
  • Dizziness
  • Heartburn
  • Increased sweating
  • Nausea
  • Pain radiating 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 of Angina

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

Symptoms of Angina

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

Investigations

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

Aortic Dissection

Causes of Aortic Dissection

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

Symptoms of Aortic Dissection

  • 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 of Aortic Aneurysm

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

Symptoms of Aortic Aneurysm

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

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

Pulmonary Embolism

Causes of Pulmonary Embolism

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

Symptoms of Pulmonary Embolism

  • 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 of Spontaneous Pneumothorax

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

Investigations

  • Chest/Abdominal x-ray
  • CT scan

Perforated Viscus

Causes of Perforated Viscus

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

Symptoms of Perforated Viscus

  • 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 of Pericarditis

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

Symptoms of Pericarditis

  • 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 of Pneumonia

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

Symptoms of Pneumonia

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

Investigations

Chest x-ray

GERD

Causes of GERD

  • 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 of GERD

  • 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

Chest pain 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, hrid dhara, abyanga, swedan, are very beneficial.

Prevention

  • Allow stretching and movement of the legs if seated for 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  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.
  • Use alcohol in  moderation
  • Do yoga on regular basis

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