Important Things You Should Know About Chest Pain

My parents are here with me in Malaysia for holiday for a month. Last Tuesday night while he was finishing his dinner, he stopped eating because he felt like he swallowed 1 tiny fish bone. Then my mother immediately asked him to drink more water and eat banana to bring down the bone that stuck to his throat. However, after for a while he said that pain goes down somewhere between his chest.

My father had a mild stroke 1 year ago and now he is doing ok. He can pronounce the word properly though it fells like it is difficult for him to speak. He can now do jogging slowly though he walks slow.

So yesterday, he said that pain is getting stronger that everytime the pain strikes the becomes breathless. So i send to him to the clinic. His blood pressure is ok for his age 130/80 but the doctor said that his heart is under stress and squezzing that's why he is having chest pain. Whether due to his long walking every morning in the park, his food intake and or skipping his hypertension medication. However, is given some medication for pain and heartburn. After 2 days, there would be another test like ECG to determine if he needs a heart specialist. Right now with the medication, the pain is lesser though the discomfort feeling is still there sometimes and hoping he would be better today or tomorrow.

So to ease some worries and help understand my father illness, i browsed some articles related to chest pain. I would like to share this to you all hoping this would help you in case you may experience the same.

What is Chest Pain?
It is often used to describe any pain, pressure, squeezing, choking, numbness or any other discomfort in the chest, neck, or upper abdomen, and is often associated with pain in the jaw, head, or arms. It can last from less than a second to days or weeks, can occur frequently or rarely, and can occur sporadically or predictably. With such a broad definition, you can see why the term “chest pain” is itself of little help to doctors.

Chest pain is one of the most frightening symptoms a person can have. It is sometimes difficult even for a doctor or other medical professional to tell what is causing chest pain and whether it is life-threatening.

• Any part of the chest can be the cause of the pain including the heart, lungs, esophagus, muscle, bone, and skin.
  
• Because of the complex nerve distribution in the body, chest pain may actually originate from another part of the body.
• The stomach or other organs in the belly (abdomen), for example, can cause chest pain.

Causes of Chest Pain (Potentially life-threatening)

A. Cardiopulmonary

• Acute coronary syndrome
  • Unstable Angina Pectoris - Angina is chest pain related to an imbalance between the oxygen demand of the heart and the amount of oxygen delivered via the blood. It is caused by blockage or narrowing of the blood vessels that supply blood to the heart. Angina is different from a heart attack in that the arteries are not completely blocked, and it causes little or no permanent damage to the heart. "Stable" angina occurs repetitively and predictably while exercising and goes away with rest. "Unstable" angina results in unusual and unpredictable pain not relieved totally by rest, or pain that actually occurs at rest.
  • Myocardial infarction ("heart attack") - A heart attack occurs when blood flow to the arteries that supply the heart (coronary arteries) becomes blocked. With decreased blood flow, the muscle of the heart does not receive enough oxygen. This can cause damage, deterioration, and death of the heart muscle.
• Aortic dissection - The aorta is the main artery that supplies blood to the vital organs of the body, such as the brain, heart, kidneys, lungs, and intestines. Dissection means a tear in the inner lining of the aorta. This can cause massive internal bleeding and interrupt blood flow to the vital organs.
• Pericarditis - This is an inflammation of the pericardium, which is the sac that covers the heart.
• Pulmonary embolism - A pulmonary embolus is a blood clot in one of the major blood vessels that supplies the lungs. It is a potentially life-threatening cause of chest pain but is not associated with the heart.
  
• Pneumonia - Pneumonia is an infection of the lung tissue. Chest pain occurs because of inflammation to the lining of the lungs.
• Hemothorax
• Pneumothorax and Tension pneumothorax: Pneumothorax often called a collapsed lung, this condition occurs when air enters the saclike space between the chest wall and the lung tissue. Normally, negative pressure in the chest cavity allows the lungs to expand. When a spontaneous pneumothorax occurs, air enters the chest cavity. When the pressure balance is lost, the lung is unable to re-expand. This cuts off the normal oxygen supply in the body.
• Arrhythmia - atrial fibrillation and a number of other arrhythmias can cause chest pain.

Other causes

• Cardiopulmonary
  
  • Stable Angina Pectoris - this can be treated medically and although it warrants investigation, it is not an emergency in its strictest sense
  • Pleurisy - an inflammation which can cause painful respiration
• Upper gastrointestinal ailments
  • Gastroesophageal reflux disease (GERD) and other causes of heartburn - occurs when acidic digestive juices flow backward from the stomach into the esophagus. The resulting heartburn is sometimes experienced as chest pain.
  • Hiatus hernia (which may not accompany GERD)
  • Achalasia, nutcracker esophagus and other neuromuscular disorders of the esophagus
  • Functional dyspepsia
• Problems of chest wall structures
  • Costochondritis or Tietze's syndrome - a benign and harmless form of osteochondritis often mistaken for heart disease. This is an inflammation of the cartilage between the ribs. Pain is typically located in the mid-chest, with intermittently dull and sharp pain that may be increased with deep breaths, movement, and deep touch.
  • Spinal nerve problem
  • Fibromyalgia
  • Chest wall problems
  • Breast conditions
  • Herpes zoster - Also known as shingles, this is a reactivation of the viral infection that causes chickenpox. With shingles, a rash occurs, usually only on one small part of the body. The pain, often very severe, is usually confined to the area of the rash. The pain may precede the rash by 4-7 days. Risk factors include any condition in which the immune system is compromised, such as advanced age, HIV, or cancer. Herpes zoster is highly contagious to people who have not had chickenpox or have not been vaccinated against chickenpox for the five days before and the five days after the appearance of the rash.
• Psychological
  • Panic attack
  • Anxiety
  • Clinical depression
  • Somatization disorder
  • Hypochondria
• Others
  • Hyperventilation syndrome often presents with chest pain and a tingling sensation of the fingertips and around the mouth
  • Da costa's syndrome
  • Bornholm disease - a viral disease that can mimic many other conditions
  • Precordial catch syndrome - another benign and harmless form of a sharp, localised chest pain often mistaken for heart disease
  • Carbon Monoxide Poisoning
  • Sarcoidosis
  • Lead Poisoning
  • High abdominal pain may also mimick chest pain.

Chest Pain Treatment at Home:

Heart Attack
If you suspect that you or someone you are with may be having a heart attack, call 911 for emergency services or go to the nearest hospital emergency department.

• While waiting for the ambulance, have the patient chew two baby aspirin or at least half of a regular aspirin - at least 160 mg. There is no evidence that taking more than this helps more, and the patient could have unwanted side effects if they take too much.
  
• It is important to chew the aspirin before swallowing it because chewing decreases the time the medicine takes to have an effect.
  
• Chewing an aspirin in the early stages of a heart attack may reduce the risk of death and it may also reduce the severity of the attack.

Angina
If the patient has had angina and has nitroglycerin tablets available, have the patient place one under the tongue. This may aid in increasing blood flow to blocked or narrowed arteries.

• If the chest pain continues in the next five minutes, take another tablet under the tongue.
  
• If, after three nitroglycerin tablets, the patient does not have relief of the chest pain, immediately call 911 or go to the nearest emergency department.

Esophagus
If the pain is from acid reflux (GERD), it may be relieved with antacids. Even if the patient's pain goes away after taking an antacid, do not assume they are not having a heart attack. The patient should still be evaluated in a hospital emergency department.

Prevention
Prevention is always better than cure.

• Don't smoke.
  
• Maintain a healthy weight.
  
• Eat nutritious, low-fat foods in moderate quantities.
  
• If you drink alcohol, use alcohol moderately.
  
• Engage in physical activity or exercise for at least 30 minutes every day.
  
• Control high blood pressure and high cholesterol.
  
• If you have diabetes, control your blood sugar every day.

For Acid reflux (GERD) can be prevented to a certain extent in most people:

• Avoid foods and other substances that bring on or worsen symptoms, especially fatty foods
  
• Stop smoking
  
• Use alcohol in moderation, if at all
  
• Avoid eating large meals
  
• Avoid eating for three hours before bedtime
  
• Avoid lying down right after eating
  
• Elevate the head of your bed

More information on chest pain causes and symptoms.

Recommended eBooks:

Stop Heartburn Fast!
Heart Attack Survivor: a field Guide
Panic or Anxiety Attack: Treatment and Symptoms
Panic Away Official Site -Treat Panic Attacks and Anxiety
Your Heart Needs the Mediterranean Diet - Emilia Klapp
Cholesterol and the French Paradox
Stop Smoking! Quit Smoking Forever With Quit Smoking Success Plan