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Chest Pain: 11 Causes, Symptoms And Treatment Options
Chest pain may indicate a number of health conditions.
Heart AttackCoronary artery disease (CAD), which occurs when blood flow to the arteries is compromised by a narrowing and hardening of the arteries, can cause a myocardial infarction (heart attack), and chest pain is one of many potential symptoms of this medical event. "Chest discomfort due to CAD is usually diffuse (widespread) and difficult to localize," explains Dr. Jean. "It's also worse with exertion or emotional stress and relieved by rest."
PericarditisPericarditis occurs when the pericardium, a two-layer structure of tissue that surrounds and protects the heart, becomes inflamed due to an infection, a heart attack, certain medications, heart surgery or an injury or medical condition. The pericardium holds the heart in place and helps it function appropriately, and if it becomes inflamed, it may rub against the heart.
Pericarditis commonly causes chest pain similar to that of a heart attack, says Alexandra Kharazi, M.D., a cardiothoracic surgeon at CVTS Medical Group Inc. In San Diego and author of The Heart of Fear, a book about her experiences as a surgeon.
AnginaAngina occurs when the heart isn't getting the blood volume it needs, often resulting in chest discomfort or pain. As well as feeling pain in the chest, some people with angina experience pain in other parts of the body, such as the shoulder, neck, jaw, arms or back, as well as sensations like pressure or squeezing in the chest similar to indigestion. Angina becomes serious when symptoms don't dissipate when a person is resting, an indication that they need urgent care.
Aortic Dissection or RuptureAn aortic dissection occurs when a tear in the wall of the aorta, the heart's main artery, gets bigger. As the tear grows, blood starts to flow between the layers of the wall of the blood vessel. The tear can also inhibit blood flow to important branches of the aorta, potentially leading to additional symptoms like stroke, abdominal pain or leg pain and weakness, according to experts. Chest pain experienced during an aortic dissection or rupture is usually sharp and sudden and may have a stabbing or ripping quality. The discomfort usually occurs below a person's breast bone initially but often moves into the back or shoulder blades.
Heart Valve DiseaseHeart valve disease occurs when the valves in the heart stop working properly because they're damaged or because of an underlying health condition. While many people with heart valve disease don't experience symptoms, some may experience chest pain and heart palpitations, as well as fatigue, lightheadedness and shortness of breath.
Pulmonary EmbolismA pulmonary embolism occurs when a blood clot from another part of the body breaks loose and enters the lungs, where it blocks blood flow and inhibits oxygen flow through the body. Chest pain caused by a pulmonary embolism can mimic that of a heart attack, and the condition can be fatal. Certain populations are at a higher risk of developing a pulmonary embolism, including anyone with a prior history of the condition, people who are inactive for long periods of time and those with certain medical conditions, such as heart disease, COVID-19, lupus, interstitial lung disease and some cancers. Smoking, pregnancy, and medications containing estrogen can also increase a person's risk.
Gastroesophageal RefluxGastroesophageal reflux, also known as acid reflux or GER, occurs when the contents of a person's stomach rise into their throat, causing heartburn and indigestion that may manifest as chest pain. Acid reflux is usually temporary but may become gastroesophageal reflux disease (GERD), a chronic condition.
AsthmaAsthma is a disease that causes intermittent airway inflammation, potentially leading to chest tightness or pain, breathlessness, wheezing and coughing.
Musculoskeletal Pain or CostochondritisSometimes chest pain can stem from the muscles and structures of the chest. For instance, costochondritis occurs when the cartilage between a person's ribs and their sternum becomes inflamed, leading to chest pain. Musculoskeletal chest pain may also stem from the body's muscles or bones, referred pain from other areas of the body or traumatic injuries to the chest, such as broken ribs.
Anxiety or StressA number of anxiety and stress conditions can result in chest pain. Generalized anxiety disorder, panic disorder and social anxiety disorder can all cause a feeling of chest pain, often as a result of stress or navigating stressful situations.
Chest InfectionsA wide range of infections may cause chest pain, including pneumococcal disease and acute bronchitis. These conditions are usually accompanied by other symptoms, such as coughs, fevers and difficulty breathing. COVID-19 may also lead to chest pain in some cases.
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Common Causes Of Chest Pain
One of the most common sites of pain anywhere in the body is chest pain, and ironically it is one of the problems we have never discussed on this page. Chest pain is the reason for some of the most frequent visits to the emergency room in many countries around the world and it is estimated to affect 20 to 40 percent of the general population. Sometimes, the pain itself is mild and the sufferer may not even complain about it but sometimes, it is so severe that the person could feel that death is imminent. In this week's essay, we shall look at the various causes of this phenomenon and discuss the different modes of managing it. As a rule, chest pain can arise from an infection in the lungs where it may be called pneumonia or pneumonitis, a heart attack, an injury to the ribs, a muscle strain or even a panic attack. We shall begin to discuss these potential causes of chest pain in the subsequent paragraphs and take cognizance of the fact that a topic of this nature is too wide to be adequately discussed in a single essay. With that in mind, we may be compelled to do a follow-up on this initial bit depending on how much ground we can cover this week. This is no doubt, a very important topic and over the last several months, many readers have posed numerous questions related to the issue of chest pain. Part of the motivation to write this essay today is based on those questions.
One of the most common of these chest conditions is tuberculosis, a chronic infection that affects the lungs most and which we have previously discussed on this page about ten years ago. It can cause a bad cough which may become productive of sputum or blood and also cause chest pain. There may also be associated night sweats, fever and weight loss. Considering how this disease used to be in the past when many people died from it, it is largely curable these days with the deployment of the appropriate antibiotics. This aspect of the disease is known as pulmonary tuberculosis in recognition of the fact that the lungs are where it is often to be found. Another common cause of chest pain is the common breathing disorder known as bronchial asthma. We have also previously discussed this problem and recognized that it is characterized by inflammation in the airways leading to its clogging up with mucus. These events then lead to a tightness in the chest, coughing, wheezing, chest pain and shortness of breath. In the same way, pneumonia often leads to chest pain, fever, cough and shortness of breath. Coughing may bring up phlegm which could be yellow, milky, greenish, or contain blood. Breathing is usually shallow and fast and there is an associated low energy level with easy tiredness and loss of appetite. Chest pain may not be obvious in those children who are less than 5 years of age and cannot appropriately describe their symptoms.
At the extremes of age, like infants and in those above 70 years of age, pneumonitis which is often a more generalized kind of lung infection can also lead to chest pain in addition to the other features already mentioned. These seniors may also develop some degree of confusion as well as the amount of oxygen supply to the brain becomes less than optimal. This picture is quite similar to that seen in association with pulmonary embolism. This results when a blood clot becomes trapped within the artery feeding blood to the lungs. As a result, chest pain easily becomes one of the earliest symptoms. There will be back pain also. This is often a life-threatening emergency situation during which the patient feels lightheaded, and experiences dizziness and pain and swelling in the legs. The person may cough out blood and the sputum is often frothy. Sweating is profuse and death often ensues when there is no emergency treatment. As a valuable addition, lest we forget, it is important to include covid-19 here as a potential cause of chest pain. Two of my close friends who were recently on international flights developed unrelenting cough and were subsequently found to be positive for the virus. Such people may experience difficulty with breathing, persistent pressure or pain in the chest and some difficulty with staying awake. Among chest conditions that often lead to pain is a problem called pleurisy in which the membrane covering the lungs becomes inflamed. In this situation, there is a sharp chest or shoulder pain that worsens with breathing, coughing and sneezing. While the pain is often described as sharp, it can also be dull and persistent.
Similarly, a lung collapse caused by a pneumothorax can often lead to chest pain. This happens when air builds up in a space between the lungs and the ribs thereby causing the lungs to collapse. Such a patient will experience some difficulty with breathing, a faster breathing rate, shortness of breath an obvious swelling in one side of the chest. There develops a certain kind of chest pain which can radiate to the shoulder. When the chest is examined with a stethoscope, the breath sounds on that side of the chest are noticed to be reduced and somewhat distant. Besides all these causes related to lung infections, similar pain may be caused in individuals who suffer from panic attacks. Such people may suffer from a rapid heartbeat, fear, sweating and dizziness and an urge to vomit. There may be associated fear and chest pain can often develop. In addition, such a person is often seen to be trembling and shaking. In some cases, these features can resemble a heart attack and that even tends to worsen the sense of terror associated with the situation. For these kinds of patients, who are often women, medications to relieve anxiety may be prescribed in addition to deploying the relevant kind of psychotherapy. Lastly, another chest condition that leads to pain is called costochondritis which is an inflammation of the cartilage in the ribs. The pain can start suddenly and get worse during the course of exercising, lying down, coughing or sneezing.
In the same way, an inflammation of the tendons and muscles around the ribs can lead to persistent chest pain. Usually, if the pain worsens with any form of physical activity, it may be due to a muscle strain. This occurs a lot in active young children and teenagers. We should add here that injuries to the ribs either from bruises, blunt trauma and fractures will usually cause chest pain. The patient may have heard an obvious crack at the time of the injury or felt a sharp chest pain. The cause of such pain is usually obvious. The associated factors are an inability to breathe in deeply and abnormal movement seen on the chest wall. Lastly, there is significant pain and discomfort in the chest which sometimes extents to the back. It is important to recognize the fact that problems within the heart can often lead to chest pain and one of these problems has to do with a heart attack which we discussed on this page about 6 years ago. Usually, there is pain in the jaw, neck and chest which may extent to the back. There may be pain in the arms and shoulders and there is often associated difficulty with breathing. Also among common heart conditions is the development of angina which usually feels like a squeezing pain or pressure on the chest. This condition occurs when there is inadequate supply of blood to a segment of the heart with the implication, of course, that not enough oxygen is being supplied. Somebody like that may also feel pain in the back, neck, arms and jaw. In the concluding part of this important topic, we shall be examining those factors within the abdomen that can also cause chest pain.
What Causes A Heavy Feeling In The Chest?
Tightness or heaviness in the chest can result from various mental and physical health conditions, including stress, anxiety, and lung complications. It can also be a sign of a heart attack.
People often associate a heavy feeling in the chest with heart problems, but this discomfort can be a sign of anxiety or depression.
A feeling of heaviness is one way that a person may describe chest pain or discomfort. Other sensations that a person with chest pain may experience include:
This article explores 13 causes of a heavy feeling in the chest and ways to treat them.
Anxiety can cause a number of physical symptoms, including a heavy feeling in the chest.
Anxiety disorder is a mental health condition that causes a person to feel worried, apprehensive, and tense. It can also cause many physical symptoms.
Experiencing anxiety can lead to a heavy or tight feeling in the chest. Other physical symptoms of anxiety include:
A panic attack involves experiencing many of these symptoms at once. Panic attack symptoms feel intense and overwhelming.
If a person has not had a panic attack before, they may mistake their symptoms for those of a heart attack.
Experiencing a panic attack can make a person feel like they are in physical danger, but these attacks are not physically harmful. Symptoms usually pass after 10–20 minutes.
If a person has panic attacks often, they may have a type of anxiety disorder called panic disorder.
Depression is another psychological cause of a heavy feeling in the chest. A 2017 study found a link between having depression and experiencing recurrent chest pain.
A person with depression may experience physical symptoms because depression affects how people feel pain. One theory is that this is because depression affects the neurotransmitters that govern both pain and mood.
People with depression may also experience chest heaviness due to an increase in perceived stress.
Unexplained aches and pains accompanied by feeling low, hopeless, guilty, or worthless may be a sign of depression.
Chest pain may result from intercostal muscle strain, which can happen when a person overstretches and pulls the muscle that holds the ribs in place.
Straining the intercostal muscles may put pressure on the ribs and cause a heavy feeling in the chest.
Gastroesophageal reflux disease (GERD) is a digestive disorder that can cause chest pain.
GERD occurs when stomach acid comes back up into a person's throat. As well as chest pain, it may cause:
Pericarditis pain may get worse if a person lies down.
Pericarditis is a heart problem that may cause chest pain.
The pericardium is the name of the layers of tissue surrounding the heart. Pericarditis occurs when the pericardium becomes infected and swells.
When swollen, the pericardium may rub against the heart, causing chest pain. The pain typically gets better when a person sits upright and worse when they lie down.
Angina can cause a feeling of pressure in the chest. It happens when the heart muscle does not get enough blood, and it is a symptom of coronary artery disease.
As well as chest pain, angina may cause pain in the:
Chest discomfort is one symptom of a heart attack. During a heart attack, a person's chest may feel:
Other heart attack symptoms include:
A heart attack is a medical emergency, so anyone who suspects that they are having one should seek immediate medical care.
Pneumonia can cause chest pain that worsens when a person coughs or breathes deeply.
It is a complication of the flu and other respiratory infections. Other symptoms of pneumonia include:
A partial or completely collapsed lung may cause a person's chest to feel heavy and painful.
Known as pneumothorax, a collapsed lung happens when air collects in the space between the lungs and chest wall. Pneumothorax can occur on its own or as a complication of lung disease.
As well as chest pain, a person with a collapsed lung may experience shortness of breath.
A pulmonary embolism requires immediate medical treatment.
A heavy or painful feeling in the chest may be a sign of a pulmonary embolism. This is when a blockage occurs in the pulmonary artery, or the artery in the lung.
The blockage is usually a blood clot, but in rare cases, it can be made up of other substances, such as fat.
The blockage will cause other symptoms, such as:
A pulmonary embolism is a medical emergency and can be life-threatening without treatment.
If a person has pain where their breastbone meets their ribs, they may have costochondritis.
Also known as chest wall pain, costochondritis occurs when the cartilage between the rib and the breastbone becomes inflamed. The pain may feel worse when a person touches the area.
A buildup of cholesterol or bilirubin can form masses, known as gallstones, in the gallbladder.
Gallstones do not always cause symptoms, but if they block a person's bile ducts, they can cause chest pain. Doctors refer to this as a gallbladder attack.
A person usually feels gallbladder attack pain in the upper right abdomen. The pain is often sharp and sudden, but it can feel like dull, heavy cramping.
Sudden chest pain may result from an aortic dissection.
The aorta is the main artery that comes from the heart. An aortic dissection occurs when the wall of the aorta tears.
This is a medical emergency and requires immediate treatment.
The treatment for a heavy-feeling chest varies, depending on the cause. We explore treatments for the mental and physical causes of chest pain below.
Treating psychological causesWhen chest heaviness or tightness is a symptom of anxiety or depression, it is important to get help for the underlying condition.
People can often manage depression and anxiety through a combination of medication and talk therapy.
Lifestyle changes and stress-management techniques can also help. These include:
Each of the following causes of chest heaviness or pain may have a different treatment:
People who have anxiety or depression may recognize a heavy feeling in the chest as a symptom of their condition. In this case, it is not usually necessary to see a doctor every time symptoms occur.
However, as chest heaviness and pain have many causes, it is best to see a doctor when new symptoms happen for the first time.
Anyone experiencing sudden, unexplained, severe chest pain should contact emergency services.
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