Chest pain: Symptoms, Causes, Treatment

Chest pain can indicate a problem within the cardiovascular system. However, chest pain from the spine is common. It also occurs for other parts in the chest area. Even, problems from the abdomen may radiate to this area. 

The chest is the area of the body where the vital organs are located. The heart and lungs. The large blood vessels are related to blood circulation. The digestive tube passes through the chest. The rib cage protects the chest cavity area. Muscles, ribs, spine. Any part can hurt.

Chest pain can signal a problem with the spine, respiratory system, or cardiovascular system. Although the chest contains the esophagus, i.e. the food pipe, there are alsomuscles and ribs which do hurt. 

The overall variability and complexity requires attention.

In some cases, it is a symptom of a more serious disease. Sometimes it is also a life-threatening condition. Diagnosing it early improves the prospects for treatment, which can be life-saving.

Location and character of pain

People describe the pain mostly as chest pain located behind the breastbone, on the chest, under the breast. It can be in the middle, on the left side, or on the right side of the chest. It can hurt in a single point or across the whole chest. 

It is characterized by:

• pressure, feeling of heaviness in the chest, as if a stone in the chest, as if someone is sitting on the chest
• pressing
• burning
• stinging
• a vague sensation, general discomfort

Does it appear quickly and radiate to another part?

Chest pain can be acute, i.e. arising suddenly. Pain can also be chronic, which persists. It lasts minutes, or conversely hours or days. In some diseases, it is recurrent. It can radiate to the spine, to the abdomen, to the upper limbs, to the neck, to the temples, and to the head.

Movement, position, relief - related to the difficulty, isn't it?

Chest pain can be related to movement.

For example, it worsens when bending, turning or in a certain position (lying down, sitting, standing). It occurs with exertion, running, walking for longer periods or walking up stairs.

If a person does not tolerate, i.e. cannot endure, the pain in the lying position and complains of impaired breathing. Or, on the contrary, the pain forces him to walk, or forces a certain position? Is it relieved by position, by medication?

Is it accompanied by other symptoms? 

With chest pain, it is also important whether it is accompanied by other associated symptoms. Sometimes it can be present on its own, but in some cases, and in some diseases, there is more than one difficulty.

There may be symptoms such as:

• shortness of breath, feeling of lack of air
• heart palpitations
• restlessness, fear, anxiety, fear of death
• weakness, fatigue
• pallor
• sweating
• heaviness in the stomach, feeling like vomiting
• vomiting
• coughing
• weight loss
• heartburn

With concomitant discomforts, it is important when they began, how long they persist, whether they recur regularly with chest pain. Sometimes recurrent complaints change in character or intensity from past cases.

The description of the difficulty alone is not sufficient to make a diagnosis. The medical history must be supplemented by various examinations, for example, blood pressure, pulse, ECG, X-ray, CT, laboratory blood tests.

Diseases associated with chest pain

Depending on what kind of pain it is, in some cases it is possible to determine the preliminary cause. The exact diagnosis is based on several examinations. Difficulties with the spine are aggravated when some movement is made.

If the problem is the underdevelopment of the heart muscle, then changing the position or turning the trunk is of no importance and does not aggravate the pain. A general practitioner, neurologist, pulmonologist, cardiologist, orthopaedic surgeon and other specialist as appropriate work together to make a diagnosis.

Heart muscle infarction

It is an acute, i.e. sudden, insufficient blood flow to the heart muscle as a consequence of thrombosis or embolization of a cardiac, coronary, vessel, or when the oxygen supply to the cells is stopped or restricted, its gradual death occurs. 

Chest pain is also categorised into STEMI and NSTEMI.

Learn more: Heart muscle infarction

Typically, there is sharp pain behind the sternum in an area that is about the size of the clenched fist of a hand. The chest pain is located in the middle. However, it gradually shoots and radiates and radiates towards the left shoulder, arm, neck or lower jaw, but also between the shoulder blades, into the spine.

These symptoms describe a typically, bookish, manifesting myocardial infarction. Of course, acute myocardial infarction can also proceed differently. Its course is influenced by multiple factors, for example, which heart vessel is affected.

Sometimes it is asymptomatic, i.e. without any symptoms. Other times it is atypical, for example, in diabetes mellitus, i.e. diabetes, pain may not occur at all due to neuropathy. Another example of a heart attack may present with stomach heaviness, pallor, sweating, nausea (a feeling to vomit), even vomiting.

In the worst case, the first symptom of a heart attack is death.

TIP: Learn more about first aid during a myocardial infarction.

Angina pectoris and ischemia of the heart muscle

Similarly, pain that is located in the same place is angina pectoris. It is a symptom in coronary heart disease with a temporary or momentary insufficiency of blood supply to the heart. For example, as a result of increased exertion.

Stenocardia is pain of a stinging, pressing or burning nature. It is located behind the sternum. Stenocardia is taken from the Greek stenos, or constriction, and kardie, or heart.

It is typical for this pain to subside in times of rest and, conversely, to intensify in times of physical activity. This is called stable angina. The nature, intensity and location of the pain is the same, it does not change.

Unstable angina means that difficulties occur uncharacteristically. It varies in intensity and has different causes. It appears after minimal exertion, short walking, even at rest.

Aortic aneurysm or inflammation of the heart

If the pain is acute and shoots to the lower body, especially to the abdomen or to the shin at the back, it may be an aortic aneurysm. This is also a very serious and life-threatening condition. The pain is intense and even medication to relieve it does not help.

Read also: 
Aortic dissection
Aortic diseases
General information on aneurysms.

Pain in the region of the heart may indicate inflammation of the pericardial sac, i.e. the pericardium. Inflammation can affect different parts of the heart wall When it affects the inner lining, i.e. the endocardium, we speak of endocarditis, and the heart valves. When the heart muscle, i.e. the myocardium, is affected, it is referred to as myocarditis.

In addition to the cardiovascular causes mentioned above, chest pain can also manifest itself in the following:

• pulmonary embolism
• high blood pressure
• pulmonary hypertension
• pericardial tamponade
• tachycardia

Airway and chest pain

In addition to cardiovascular problems, pain in the sternum signals respiratory problems. If it is a stabbing pain that worsens when you breathe in or cough, it is usually an inflammatory disease or an infection related to the lower respiratory tract.

Pain in the chest area can be characterized by:

• inflammation of the trachea and bronchi, pain is felt when breathing, coughing
• pneumonia
• tuberculosis
• lung cancer
• pleurisy, pleurisy, chest pain when breathing, coughing, yawning
• pneumothorax, i.e. air in the pleural space
• fluid, blood in the pleural space
• inhalation of dust, dirt, foreign body into the lungs

The digestive system as one of the options

Many times the pain is also triggered by excessive production of gastric juices that have entered the esophagus. This condition is also known as heartburn, or pyrosis. This phenomenon is common if the person also has GERD, i.e. is gastroesophageal reflux disease.

But in this case, other symptoms are also present, not just pain in the chest or behind the sternum, for example, a feeling of bitterness, acidity in the mouth, especially after eating, or when lying down and at night. Radiating pain into the spine is common.

Other diseases to think about include spasming of the oesophagus, gastroduodenal ulcer disease, as well as gallbladder and pancreatic diseases. Sometimes pain can occur when bad swallowing or drinking hard alcohol.

Mental issues = cause of chest pain

The psyche, i.e. our mental state, can also be the cause of chest pain, especially extreme psychological stress, e.g. neurosis, depression, anxiety. A typical example is neurasthenia, also called neurocirculatory asthenia.

Musculoskeletal system, chest wall, muscles

If, for example, it is just a normal overload of muscle tissue, the person feels pain rather above the sternum in the area of soft tissues. Pain can come from the muscles and other soft structures from the intercostal spaces.

Muscles can also be affected by inflammation. Tietz syndrome is an inflammation that affects the cartilage of the ribs. Chest pain can come from the spinal area as a cause of vertebrogenic disorders.

Injury in the chest area causes intense stabbing pain. This is also the case due to a bruised or broken ribs. A more serious example is an injury causing intrusion of air into the pleural space, i.e. pneumothorax.

Other examples include herpes zoster, i.e. shingles, breast disease, such as inflammation, but also a more serious disease, e.g. a tumour of the mammary gland. If it is a long-term condition, an examination by a general practitioner with the possibility of observing other symptoms should be considered.

Professional examination and help should always be sought in the event of acute pain, which, for example, increases in severity, is of great intensity and causes a person serious breathing problems. Similarly, if the pain is accompanied by other symptoms that have appeared very quickly and acutely.

Chest pain can often be one of the symptoms of, for example, obesity, atherosclerosis, anaemia and other diseases that at first sight may have nothing to do with the chest.