chest pain? know more...

There is little correlation between the severity of chest pain and the seriousness
of its cause.
POTENTIALLY SERIOUS CAUSES

MYOCARDIAL ISCHEMIA Angina Pectoris Substernal pressure,
squeezing,constriction, with radiation typically to left arm; usually on exertion,
especially after meals or with emotional arousal. Characteristically relieved by
rest and nitroglycerin.
Acute Myocardial Infarction Similar to angina but usually
more severe,of longer duration (
30 min),and not immediately relieved by
rest or nitroglycerin. S3 and S4 common.
PULMONARY EMBOLISM May be substernal or lateral,
pleuritic in nature,and associated with hemoptysis, tachycardia, and
hypoxemia.
AORTIC DISSECTION Very severe,in center of chest, a
“ripping” quality,radiates to back, not affected by changes in position. May be
associated with weak or absent peripheral pulses.
MEDIASTINAL EMPHYSEMA Sharp,intense,localized to substernal
region; often associated with audible crepitus.
ACUTE PERICARDITIS Usually steady,crushing, substernal;
often has pleuritic component aggravated by cough,deep inspiration,
supine position,and relieved by sitting upright; one-, two-, or three-component
pericardial friction rub often audible.
PLEURISY Due to inflammation; less commonly tumor and pneumothorax.
Usually unilateral,knifelike,superficial, aggravated by cough and respiration.


LESS SERIOUS CAUSES

COSTOCHONDRAL PAIN In anterior chest,usually sharply localized,
may be brief and darting or a persistent dull ache. Can be reproduced by pressure
on costochondral and/or chondrosternal junctions. In Tietze’s syndrome (costochondritis),
joints are swollen,red, and tender.
CHEST WALL PAIN Due to strain of muscles or ligaments from excessive
exercise or rib fracture from trauma; accompanied by local tenderness.
ESOPHAGEAL PAIN Deep thoracic discomfort; may be accompanied
by dysphagia and regurgitation.
EMOTIONAL DISORDERS Prolonged ache or dartlike,brief,flashing
pain; associated with fatigue,emotional strain.

OTHER CAUSES
(1) Cervical disk; (2) osteoarthritis of cervical or thoracic spine; (3) abdominal
disorders: peptic ulcer,hiatus hernia, pancreatitis,biliary colic; (4) tracheobronchitis,
pneumonia; (5) diseases of the breast (inflammation, tumor); (6)
intercostal neuritis (herpes zoster).