Cardiac pain: Angina
Chest pain of any intensity should never be ignored. It should promptly be recognized, investigated and treated. The cardiac and vascular causes of chest pain can be fatal and so need to be promptly treated.
Chest pain can be due to a variety of reasons. It can be due to causes related to the heart, the lungs, food-pipe, spine and muscles.
Let us learn about how to differentiate between some of them!
Some of the causes of chest pain are:
- Cardiac pain: is also called Angina. It is caused by blockages in the heart blood vessels due to cholesterol deposition. The pain is classical in nature and easy to recognize. Most of the time it is described as heaviness in chest (compression or a tight feeling). Some of patient may have burning pain in chest. It increases on exercise. It decreases at rest. This is caused by blockages in the arteries which progress slowly over months and so called stable. The pain in this condition is called Stable Angina. They are confirmed by a test in which one exercises and the ECGs are monitored. The test is called treadmill stress test. Sometimes, the blockage gets complicated due to blood clot formation. This causes total occlusion of the artery and is riskier. The pain here is severe in intensity, sudden in onset and even at rest. It does not subside with routine medicines. It is called Unstable Angina. The condition is diagnosed by ECGs and blood tests. If not promptly treated, patients may progress to have a heart attack.
- Lung pain: The covering layer of the lungs produces pain which is sharp and increases on deep breathing. This pain can be due to infection or other causes which need to be investigated. The lung tissues normally do not cause pain but can cause cough and breathlessness. Most of the time it is diagnosed by an X-ray of the chest and can be promptly treated.
- Food-pipe/ Esophageal pain: This is caused by increased acidity and mild erosion of the food-pipe. The pain here is burning type, normally increases on an empty stomach. It is normally associated with belching and sour eructations. The test preferred is a Scopy of the upper gut where in a tube with a small camera is passed into the food-pipe to diagnose the problem. It is easily treated with antacids and drugs to reduce acid secretion.
- Spine problems: Here, the pain is dull or sharp but always localized to the spine. It originates from the spine and most of the time radiates to the sides. Movement of the spine makes the pain worst. An X-ray or MRI of the spine may be necessary to assess the severity of the problem. Most of the time the pain subsides with medical treatment. It is relieved with analgesics and muscle relaxants.
- Muscular pain: These are normally associated with soreness of the muscle and dull aching in nature. They are easy to recognize and so easily treatable with analgesic and some exercises.
These are the common causes of chest pain. One needs to be cautious when it is in the center of the chest and associated with breathlessness.
The take home message is: DO NOT IGNORE CHEST PAIN! SEEK MEDICAL ATTENTION IMMEDIATELY!