Chest pain: symptoms, causes and when to see your doctor

Chest pain can be identified as a dull aching sensation, pressure on the chest or sharp pain. If you experience these symptoms, it's important to seek immediate medical attention. Identifying the cause is the next step to effective treatment. Find out more here.

Chest pain is one of the main reasons why people go to the emergency room. You may experience a dull aching sensation, pressure on the chest, sharp or stabbing pain. The intensity, duration, location and quality of chest pain are different for each sufferer. 

Chest pain can be caused by a number of factors ranging from serious heart conditions to less deadly causes.

Chest pain symptoms

Chest pain can be caused by several different factors, so you need to know what signs to look for to distinguish whether or not it's associated with your heart. The symptoms below can help your doctor determine if it's a heart problem.

♦ Dizziness
♦ Chest pressure
♦ Shortness of breath
♦ Nausea
♦ Pain on exertion

Women, in particular, have reported unusual symptoms. Chest pain in women can be accompanied by back, jaw and neck pain, dizziness, nausea and abdominal pain. Cold sweats are also common symptoms of heart attacks when accompanied by chest pain, particularly in men. 

Symptoms that indicate chest pain is not heart-related include:

♦ Chest pain after eating
♦ Fever
♦ Pain accompanied by a rash
♦ A bitter taste in the mouth
♦ Aches and chills
♦ Chest pain on coughing

Causes of chest pain

It's common to think that chest pain is a sign of a heart attack, and while this may be the case, there are other reasons why you may experience chest pain. 

Only 13% of emergency room visits for chest pain result in a cardiac diagnosis. Understanding the cardiac causes of chest pain is important for an accurate diagnosis and treatment plan. 

Abnormal heart rhythms: When your heart beats too fast or too slow, you suffer from arrhythmia . These abnormal heart rhythms aren't usually life-threatening, but they do require medical attention if they're caused by an underlying heart condition or disease. 

Angina: This is a type of chest pain that is caused by reduced blood flow to the heart and is a symptom of coronary artery disease and presents as a crushing pain in the middle of the chest.

Atherosclerosis: The accumulation of fatty deposits known as plaques causes atherosclerosis. These plaques block arteries and disrupt blood flow and blood pressure. Arteries can be damaged and even burst if left untreated, and your heart can be deprived of essential oxygen. 

Cardiac tamponade: This condition is marked by the accumulation of fluid in the pericardial space and requires immediate medical attention. Complications such as pulmonary edema, shock and even death can occur without prompt treatment.

♦ Pulmonary heart : When blood pressure is high in the pulmonary arteries, this condition can develop. This is also known as right heart failure, as the right ventricle swells too much and can't pump blood efficiently. Eventually, the left ventricle fails.

Heart attack: the blood supply that supplies the heart with oxygen is cut off, causing heart tissue and muscles to die. This requires immediate medical attention, as urgent care may be required. Left untreated, heart attacks can lead to heart failure. 

Hypertension: Hypertension doesn't always present symptoms, but when your heart has to work under pressure for a long time, chest pain can occur along with other serious conditions. Untreated hypertension can cause serious damage to your arteries and eventually to your heart.

Hypertensive heart disease: This is a group of heart diseases caused by high blood pressure. When the heart works under increased pressure, several serious problems can occur, such as thickening of the heart muscles, heart failure and coronary artery disease. Chest pain can be the first sign of a problem. 

Hypertrophic cardiomyopathy: This is a condition in which the heart muscle (myocardium) becomes thicker than normal and disrupts regular blood flow. This can develop slowly or suddenly and, in most cases, people can live a normal life. 

Ischemic cardiomyopathy: This occurs when your heart is weakened after a heart attack or coronary artery disease. As a result, your left ventricle enlarges and weakens, preventing it from pumping blood efficiently. The end result without treatment will be heart failure.

Myocarditis: Also known as viral heart disease , myocarditis is caused by a viral infection. The virus attacks your heart muscle, causing inflammation and disrupting the heart's electrical signaling. Inflammation weakens the heart, and the inability to signal properly increases the risk of abnormal heart rhythms and heart failure. 

Pericarditis: Pericarditis is characterised by acute chest pain, aggravated by deep breathing. The pain is the result of inflamed pericardial muscle walls surrounding the heart. When the inflamed muscle rubs against the ribs in the chest cavity, pain is the result. Pericarditis is chronic but also rare. 

Pulmonary embolism: This is a blood clot that forms in your lungs, causing restricted airflow and reduced oxygen levels in the blood. This affects the lungs as well as other organs, including the heart. Although not directly related to the heart, a pulmonary embolism is a serious condition requiring immediate medical attention, and chest pain is a common symptom to watch out for.

Other common causes of chest pain are related to the lungs and digestive system. 

Gastrointestinal causes: acid reflux, gallstones, esophageal disorders and inflammation of the pancreas.

Lung-related causes: pneumonia, blood clot, viral bronchitis, pneumothorax (air leakage from the lungs) and bronchospasm (airway constriction common in asthma and COPD).

Diagnosing chest pain 

If you experience chest pain, it is important to seek medical attention immediately, in case the cause is cardiac and severe. 

If your chest pain is new and unexplained, it is always advisable to consult a doctor immediately. Your doctor will need to know how long you've been experiencing the pain, as well as its severity and location. Your medical history, along with a list of current medications, is also important to share. 

The doctor will probably also perform some tests to determine the cause of the chest pain.

♦ ECG (electrocardiogram) will record the electrical activity of your heart
♦ Chest X-ray to examine your lungs, heart and blood vessels
♦ MRI to check for damage to the aorta or heart
♦ Blood tests to assess enzyme levels
♦ Stress tests to measure heart function after exercise
♦ Angiograms to specifically look for blocked arteries

Treatment of chest pain

The cause of your chest pain will be treated according to the underlying cause. In most cases, medication and non-invasive measures are used, or a combination of both. 

Chest pain linked to lung problems can be treated by re-inflating a collapsed lung. Antacids are used to treat chest pain caused by acid reflux, and anxiety-reducing medications can help in anxiety-related cases. 

Treatment of cardiac causes of chest pain includes:

♦ Drugs such as anticoagulants, blood thinners and nitroglycerin, which open partially closed arteries.

♦ Cardiac catheterisation uses balloons and stents to open blocked arteries.

♦ Surgery may also be needed to repair damaged arteries. Coronary artery bypass surgery is the most common procedure performed for heart-related chest pain. 

Natural treatment of chest pain

Some underlying causes of chest pain will require medical attention and even surgery. There are also natural treatments that can reduce the risk of chest pain and help relieve symptoms. If you are at risk of heart disease, these natural ingredients can help protect your heart.

Chromium: Chest pain is a symptom of a heart attack. Conditions such as atherosclerosis and high blood pressure increase the risk of heart attack. High blood pressure and high cholesterol can be treated naturally with chromium.

Niacin: Also known as vitamin B3, niacin is essential for heart health. Niacin works to naturally lower cholesterol, reduce blood pressure and stabilize blood sugar levels. High blood pressure, cholesterol and blood sugar all increase the risk of heart disease, of which chest pain is a major symptom.

Chilli extract:This fruit extract has been proven to improve circulation and enhance blood vessel health. High blood pressure causes chest pain and can be a sign of poor blood vessel circulation. By promoting healthy blood vessels, capsicum extract ensures that heart tissue receives the nutrients it needs, reducing your risk of heart disease.

Red yeast rice: The key compound in red yeast rice, monacolin K, is the same ingredient found in cholesterol-lowering drugs. Red yeast rice is a natural and more economical way to treat high cholesterol and prevent heart disease.

When to see your doctor

Since the causes of chest pain can vary from mild to more severe, the results will also vary. Chest pain is usually caused by gastrointestinal problems such as acid reflux, as well as anxiety. 

If there is a more potentially life-threatening heart condition, the outlook depends on how quickly the pain is treated. You should seek immediate medical attention for any sharp chest pain or sharp pain in the left side of your chest cavity, so that heart problems can be treated immediately. 

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