Chest Pain – is it heart-related?
Chest pain is a source of extreme concern for any middle aged or older person who is unfortunate enough to suffer from it. This short article attempts to explain in simple terms, the various different types of commonly encountered chest pain, and their possible diagnoses. It is intended for informational and educational purposes only. The reader should keep in mind that any type of chest pain could indicate a serious medical condition, and it is essential to immediately seek qualified medical attention if you suffer an onset of chest pain. The questions which are uppermost in the mind of the sufferer is ‘is this pain in my chest related to a serious heart condition?’ or worse still ‘am I about to suffer a massive heart attack?’ This is understandable as this distressing condition can indicate a potentially life threatening underlying condition which has a well deserved reputation for causing panic, as one of the first signs of the onset of a genuine heart attack. However, chest pain has many causes that produce differing types of symptoms, and so the initial feelings of dread may turn out to be unfounded. The main causes of chest pain can be divided into heart-related and non-heart related. As can be seen from the summary list below, there are many more non heart-related than heart related conditions that may be the cause of chest pain, although some are still serious:
- Duodenal Ulcer
- Chest wall pain (Tietzes syndrome)
- Bornholm Disease
- Lung Cancer
- Secondary cancer affecting the ribs
- Angina Pectoris
- Coronary Thrombosis
How to tell if your chest pain IS heart related
It is a common misconception that the pain of Angina and Heart Attack are the same. Angina pain is normally related to physical activity, and may present its symptoms after a predictable amount of physical activity. The pain may be variable, from mild to severe dependant on a number of different bodily factors, such as the body temperature, state of the digestive system and the psychological state of the patient. The pain associated with a heart attack on the other hand is usually a crushing, squeezing, agonising pain that leaves the sufferer with a dreaded feeling of impending death. The pain may also radiate to the back, up into the jaw or down the left arm. Pericarditis is the inflammation of the membrane surrounding the heart, and is usually accompanied by a fever, and pain behind the breastbone (sternum) which can spread to the shoulders. Additionally, localised movement usually accentuates Pericarditis pain.
Symptoms that may mimic a heart attack
These are often difficult enough for a physician to differentiate from the real thing, such that the average person would struggle to understand the relative seriousness of the risk that they represent. This is why a doctor should investigate the cause of all cases of chest pain. There are some clues though, that a chest pain may not be linked to a serious heart condition. Pleurisy for example causes a breathing related sharp stabbing type of pain as though one of the lungs had got stuck in a rib. The burning pain of reflux stomach acid in cases of heartburn may be recognised by the sufferer from previous experience and history of the condition. The Duodenal Ulcer may cause a chest pain between meals, and be relieved by the consumption of food. A physical injury or strain may cause a sharp stabbing pain in the chest, but can be immediately ruled out as being serious due to the known cause.
There are some other rarer conditions that may also cause symptoms of chest pains including some types of cancer, as mentioned above, but these are beyond the scope of this article. These will only become prospective causes following detailed medical investigation.
Possible treatments for chest pain
Many types of chest pain may at first seem related to heart problems. But often, after careful evaluation, doctors can distinguish the symptoms of non-cardiac chest pain from the pain caused by a heart condition. When you see the doctor he or she will check your blood pressure, take blood for a cholesterol test and do a diabetes test. Depending on the severity of the pain and the risk assessed by the doctor you may be prescribed low dose aspirin, and a drug such as Zetia to lower your cholesterol, and, possibly some other medication too. Almost certainly you will be referred for an exercise ECG which is a test where an electrical recording of your heart is taken while you exercise on a treadmill.