Chest Pain – The What, Why, and How

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Chest Pain may not always point towards a heart attack but must never be ignored. Whether mild or severe, a doctor should always be consulted for chest pain that persists for more than a few minutes.

When it comes to chest pain, the first thought to come to mind is a heart attack. However, this is the only cause for pain in the chest. Chest pain can vary from being a dull ache to stabbing pains. It also varies in terms of duration and location of the pain. In many cases, chest pain is caused by factors that are not very threatening. But, only a doctor can distinguish between dangerous chest pain and a not-so-dangerous chest pain. Hence, it is important never to ignore it.

Chest Pain

What is Chest Pain

Though it is termed as chest pain, this includes pain that is felt anywhere between the neck and upper abdomen. This pain may be focused on one spot or may radiate outwards. It appears in many forms and can be described as dull, sharp, a burning sensation, tightness or a crushing sensation. This type of pain may come and go or may persist.

What Causes Chest Pain:

Though it is typically associated with a heart attack, chest pain may be caused by many factors. Some of the most common causes of chest pain associated with the heart are:

  • Coronary Artery Disease:

This refers to a blockage in the blood vessels connected to the heart. The blockage reduces blood flow to the heart and causes chest pain known as angina.

  • Myocardial Infarction/ Heart Attack:

If the heart does not get sufficient blood supply, cells in the heart muscle may die, thus causing a heart attack. This can be defined as a severe pain that is not relieved by rest.

  • Myocarditis:

Inflammation of the heart muscle may also cause pain in the chest.

  • Pericarditis:

This refers to an infection or inflammation of the sac enveloping the heart. This type of pain may worsen while swallowing or lying on your back.

  • Hypertrophic cardiomyopathy:

This is a genetic condition that causes abnormally thick growth of the heart muscle. It can reduce blood flow to the heart and make it harder for the heart to pump blood.

Chest pain can also be caused by lung problems and gastrointestinal problems such as pneumonia, asthma, gastroesophageal reflux disease, peptic ulcers and a hiatal hernia.

Who is at Risk of Chest Pain

Risk factors for chest pain can be categorized as controllable and uncontrollable factors. Uncontrollable factors include:

  • Age – The risk of heart trouble increases with age.
  • Gender – Men have a higher risk of heart trouble as compared to women.
  • Family History – A family history of heart trouble increases a person’s risk of heart trouble.

An unhealthy lifestyle can increase a person’s risk of heart trouble that causes chest pain. Some of the controllable lifestyle risk factors are:

  • Smoking
  • High Cholesterol
  • Hypertension
  • Sedentary lifestyle
  • Stress
  • Obesity
  • Uncontrolled diabetes

Symptoms that May Occur with Chest Pain:

Chest pain caused by heart troubles may be accompanied by other symptoms. In many cases, the pain isn’t described as pain but more like a discomfort. Some of the symptoms that may accompany chest pain associated with a heart attack are:

  • Tightness in the chest
  • Pressure in the chest
  • Burning sensation
  • Searing pain that radiates outwards from the chest to the back, jaw, shoulder and neck
  • Pain that lasts for more than a few minutes
  • Pain that is aggravated by activity
  • Pain that comes and goes
  • Shortness of breath
  • Nausea
  • Dizziness
  • Cold sweat

If you notice any of these symptoms, consult a doctor immediately.

What Can You Do in an Emergency for Severe Chest Pain

It can often take a little time for medical help to arrive or for you to reach a hospital. Some of the things you can do to make the affected person more comfortable in the meantime are:

  • Give then a regular aspirin to chew on-

This reduces blood clotting and improves blood flow to the heart.

  • Begin CPR or chest compressions if the person is having a heart attack –

Make the patient lie on his back and kneel beside him. Interlock the fingers of both hands and with palms facing outwards and elbows straight, press down on the person’s chest. Aim to perform 100 chest compressions per minute.

How is Chest Pain Diagnosed

The first thing doctors will check when a patient complains of chest pain is a heart attack and other fatal conditions such as a clot in the lungs or a collapsed lung. Some of the tests the doctor may need to diagnose chest pain include an Electrocardiogram (ECG), blood tests, a chest X-ray and a Computerized tomography (CT scan). Depending on the results of these tests, further tests such as an Echocardiogram, stress tests and Coronary catheterization (angiogram) may be needed. These tests will help identify the cause of chest pain and determine the best form of treatment for it.

Treatment of Chest Pain:

Treatment for chest pain depends on the factors triggering it. This usually takes the form of medication and surgery.

Medications:

Medication is usually the first form of treatment for chest pain unless a serious condition is identified. Many different types of medications may be prescribed including blood thinners, artery relaxers, thrombolytic medicines and acid-suppressing medications.

Surgical Procedures:

Surgery is often recommended in cases where chest pain is caused by a blockage in the arteries. This may be either an angioplasty and stent placement or a bypass surgery. In cases where chest pain is caused by the rupturing of an artery that supplies blood to the heart, a dissection repair surgery may be needed.

Prevention of Heart Trouble


Living a healthy lifestyle can reduce the risk of heart trouble considerably. If you smoke – stop. Eat a healthy well- balanced diet that is low in cholesterol. Exercising for at least an hour every day can help improve heart health and can help you deal with stress. If you are diabetic, this can also help regulate blood sugar levels.

If you wish to know more about chest pain, find out if you have heart problems, or even need a second opinion, you can now book an appointment with an experienced cardiologist without stepping out of your home. In fact, you can also have the consultation in the comfort of your home. Book an appointment now through Medlife e-consult and get that second opinion, or to get answers to any queries you may have on chest pain from our experienced cardiologists.

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FAQs:

  • Can stress cause chest pain?
    Yes, stress can trigger chest pain. If there is an underlying heart condition, stress can aggravate it and worsen chest pain.
  • How can you differentiate between chest pain caused by a heart attack and heartburn?
    One of the main differences between chest pain caused by a heart attack and heartburn is that the latter tends to be worse after eating and when lying down. This type of pain is also usually not accompanied by other symptoms such as breathlessness and cold sweats.
  • Can chest pain recur after treatment for a heart attack?
    Having a heart attack increases the risk for heart attacks in the future. Hence, chest pain can recur and must never be ignored.
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