Chest Pain

GENERAL INFORMATION:

What is chest pain? Chest pain is any discomfort between your abdomen (belly) and your neck. The discomfort may stay in your chest. It may radiate (move or travel) to other places, such as your shoulder or back. Your discomfort may feel like tightness, burning, or pressure in your chest. Your chest pain may be sharp or dull. The discomfort may range from mild to severe. You may have other symptoms with your chest pain, such as nausea (upset stomach) or vomiting (throwing up).

What causes chest pain? There are many things that can cause chest pain. Also, certain things may trigger your chest pain to start, such as eating a spicy meal. Your chest pain may even come and go for no reason that you know of. Some chest pain may return often and be bothersome to you, but it may not be dangerous. However, some chest pain may be a sign of a serious (very bad) health condition. You may not know what is causing your chest pain until you are seen at a hospital or clinic. Some causes of chest pain include the following.

• Blood or circulation problems: High blood pressure or anemia (iron-poor blood) may cause chest pain. Another cause may be an aneurysm, which is a weak part in an artery (blood vessel) wall. Aneurysms can be serious, even life threatening. Atherosclerosis or "hardening of the arteries," may cause chest pain. Atherosclerosis is a disease that causes fatty deposits to narrow arteries in your body, and increase your risk of blood clots.
  
  
• Anxiety, depression, or panic attacks: Panic attacks may cause chest pain that feels like you have a serious health problem, even though it is not life threatening. Hyperventilation (breathing too fast) can also cause bad chest pain. People who have depression (feeling sad most or all of the time) may have chest pain or heaviness.
  
  
• Bone, nerve, or muscle problems: Examples include arthritis and other inflammation (swelling) problems, hard coughing, and overdoing exercise. Herpes zoster (shingles) can cause chest pain. Injuries, such as after a car accident or a blow to the chest may also cause chest pain.
  
  
• Heart (cardiac) problems: Chest pain because of a heart problem may be serious (life threatening) and requires emergency medical care. Only a medical caregiver can say for sure if your chest pain is caused by a heart problem or not.
  
  
  • Almost any heart problem can cause chest pain. For example, heart valve problems, heart rhythm problems, heart enlargement, and heart failure can cause chest pain.
    
    
  • Angina is chest pain that happens when the heart does not get enough oxygen to do its work. You may have angina because of atherosclerosis or other heart problems. If the heart goes too long without enough oxygen, part of the heart muscle may die. This is called a myocardial infarction, "MI", or a heart attack. Angina can be a warning sign that you may be at risk for a heart attack.
  
  
• Lung problems: Examples include infections (such as bronchitis), or inflammation (swelling) in or around a lung. A blood clot in a lung or lung diseases may cause chest pain. Breathing in smoke or fumes can cause chest pain.
  
  
• Digestive tract problems: Acid reflux, ulcers, or other stomach and esophagus (food pipe) problems may cause chest pain. Problems with too much gas in your stomach or intestines, or other digestion problems may cause chest pain. Gallbladder or pancreas problems may also cause chest pain.
  
  
• Other problems: Taking illegal (street) drugs, such as cocaine, or misusing certain medicines may cause chest pain. Certain diseases such as lupus may cause chest pain. Tumors (growths) in your chest or abdomen may cause chest pain. Problems with almost any organ in your chest or abdomen may cause chest pain.

What are signs that my chest pain may be serious? It is often hard to tell what is causing your chest pain. Even caregivers may have trouble finding the cause without doing tests. Chest pain may sometimes be caused by life threatening health problems.

• Never try to drive yourself to the hospital if you have signs of a serious health problem. Call 9-1-1 or 0 for an ambulance right away if you have chest pain with any of the following symptoms:
  
  
  • Any new chest pain that is severe, or that lasts for 15 minutes or longer.
    
    
  • Feeling lightheaded, dizzy, weak, or faint.
    
    
  • Sudden sweating for no reason that you know of.
    
    
  • Nausea or vomiting.
    
    
  • New or worsening trouble breathing.
    
    
  • New or worsening trouble with thinking clearly or speaking.
    
    
  • Any new numbness, tingling, or loss of movement in any part of your body.
    
    
  • Coughing up blood.
  
  
• What you need to know about heart attacks:
  
  
  • The signs and symptoms of a heart attack may start slowly, or they may happen suddenly. The most common sign of a heart attack is chest pain, tightness, or pressure. The discomfort may feel crushing, tight, or heavy. The discomfort may range from mild to severe. It may spread to the neck, jaw, shoulders, back, or arm. You may feel like you are having indigestion or burning under the breast bone in your upper chest. Other signs may include sweating, nausea, vomiting, or trouble breathing. Your skin may be pale, cool, or "clammy". You may feel lightheaded or weak.
    
    
  • Some people having a heart attack may not have typical chest pain or pressure. Those most likely to have unusual symptoms when having a heart attack are women and people who have diabetes. Their discomfort may be in an unusual place, such as the right arm or lower back. Sometimes symptoms like sweating, shortness of breath, dizziness, or nausea may be the only sign of a problem. Some people who are having a heart attack have no obvious symptoms at all. This is called a "silent" heart attack.
    
    
  • A common problem with some people having a heart attack is denial. This is when the person does not admit to themselves or others that they are having symptoms of a heart attack. Unfortunately, this denial may cause the person to put off seeking medical help. This delay in treatment can be dangerous, even life threatening.

What may be done about my chest pain? Caregivers may do tests to learn what is causing your chest pain. You may have a test called an electrocardiogram to check your heart. Blood tests and a chest x-ray may also be done. You may need tests to check your esophagus, stomach, or other organs. You may be given medicine to decrease your chest pain. You may need to go into the hospital for tests and treatment. Other tests and treatments depend on what may be causing your pain.

How can I help my caregiver find out what is causing my chest pain? Keep a diary or a calendar of your chest pain. Bring this with you every time you see your caregiver. Some things to keep track of include:

• __ What does the discomfort feel like? For example, is it dull, sharp, stabbing, squeezing, crushing, or heavy? Is it mild, moderate, or severe?
  
  
• __ Where is the discomfort? Is it only in one place, or does it travel (radiate) to somewhere else, such as to your arm?
  
  
• __ How often does your chest discomfort happen?
  
  
• __ How long does the discomfort last?
  
  
• __ What were you doing when the discomfort started? Did it start during exercise, after a heavy meal, or when you were upset? Did it wake you from sleep?
  
  
• __ Does anything make the discomfort worse? Does coughing, bending over, or taking a deep breath make it worse?
  
  
• __ What helps the discomfort go away? Did it go away when you rested? Did taking nitroglycerin, an antacid, or an over-the-counter pain reliever help?

Wellness hints: Live a healthy lifestyle by not smoking, and by losing weight if you are overweight. Eat foods low in salt and fat, but high in fiber (roughage). Foods high in fiber include vegetables, whole grains, and fruits. Exercise three or more times a week if your caregiver says it is OK. Learn to control the amount of stress that you feel. Other lifestyle changes you may need depend on what is causing your chest pain.

CARE AGREEMENT:

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

Copyright © 2008 Thomson Healthcare Inc. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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