Evaluation of chest pain

"Evaluation of chest pain"

Chest pain could be as serious as myocardial infarction or just muscular pain 

Did you know that chest pain is one of the most important emergencies affecting the male population more than female around the world? It is the most common presenting complaint in emergency departments. In today's world people are so much engaged in multiple good and unhealthy activities that it's incidence rate is increasing every year, but it's necessary to evaluate chest pain thoroughly because all chest pains are not due to an unhealthy heart. 

  Whenever someone complains of chest pain, mostly people evaluate it as a heart attack or myocardial infarction (MI). Remember it can be as serious as myocardial infarction leading to coronary artery disease (CAD) or heart failure or it can be just a muscular pain...

   So always think first and rule out life-threatening conditions for an accurate diagnosis and a better prognosis.

Causes of chest pain

Few causes of chest pain are included here...

Cardiac 

• Coronary artery disease (CAD) such as angina, (MI)
• Aortic stenosis
• Pericarditis
• Cardiomyopathy

Pulmonary

•  Pneumonia
•  Pleuritis
•  Pneumothorax

Vascular

• Aortic dissection
• Pulmonary Embolism 

Musculoskeletal 

• Arthritis of shoulder or spine
• Cervical disc disease
• Costochondritis

Gastrointestinal

• Reflux esophagitis
• Peptic ulcer 
• Esophageal spasm

Other causes

• Emotional 
• Relationships
• Disorders of breast

Note: 

History is very important, ask weather its an acute ongoing pain, recurrent or episodic pain, or persistent pain even for days. 

We can differentiate the real cause of chest pain by examining presenting complain of the patient...

Signs & symptoms tells about the initiator. One should know how to differentiate each symptom from another for an accurate diagnosis...

So, if you or your loved ones have a complaint of chest pain and you can not understand it's cause, then you are reading the right blog...

Because in the next 5 minutes you are going to become a pro in the evaluation of chest pain. Here are signs and symptoms of every condition which leads to chest pain. You have to keep all these in mind to make an accurate diagnosis, because you can always believe diagnosis not the prognosis.

Chest pain a medical emergency

EVALUATION

Chest pain due to angina pectoris

Angina means discomfort, it is usually described as severe pain in chest, heaviness, pressure, squeezing or sensation of constriction in the chest, the pain often spreads towards the shoulder, arms, and neck which indicates inadequate blood supply to the heart. It may be described as aching or burning pain, difficulty in breathing, or even indigestion (gas problem).

Chest pain due to myocardial infarction

The pain of myocardial infarction is similar to angina in distribution but it is of greater intensity and longer duration. It may be accompanied by perspiration, nausea, and hypotension.

Chest pain due to pulmonary embolism

Pulmonary embolism, Infarction of the segment of the lung, or the chest wall (pleura) can cause sharp chest pain similar to myocardial infarction. It occurs when there is inadequate blood supply to one or both lungs causing shortness of breath (SOB) and rapid heart rate.

Chest pain due to musculoskeletal disorders

People often misinterpret muscle pain with chest pain and create a panic. Remember chest pain due to musculoskeletal disorder is always localized. Pain may be sharp lasting for a few seconds or it may be dull that persists for several hours or days. Local tenderness over the rib and costal cartilage is usually present.

Chest pain due to esophageal spasm

When chest pain is due to esophageal spasm, the patient will complain of squeezing pain in chest similar to (MI). In this case there will be a history of heartburn and food regurgitation which are important clues.

Chest pain due to emotional causes

Heartache, stress, breaking relationships often lead to chest pain. When the chest pain is due to emotional issues the patient will complain of chest discomfort in the form of chest tightness lasting for 30 minutes to an hour, pain in the left arm, It may be sharp and very brief located mostly near the left nipple.

Investigations for chest pain

To identify the cause of chest pain, theses investigations are widely used.

1. ECG
2. Echocardiogram
3. ETT (exercise tolerance test)
4. Cardiac enzymes (CK-MB, Troponin T or Troponin I)
5. CT scan
6. Blood test

We can easily identify the cause of chest pain by keeping these differences in mind. Always remember that all chest pains are not leading to heart failure. You can differentiate a chronic and acute case of chest pain by it...

"The medical study tells, that every pain, disease, or syndrome can be reduced by a healthy diet, exercise, and a healthy lifestyle." You just need to try it as in this world nothing is impossible, the word impossible itself says I'm possible!

Thank you for reading "Evaluation of chest pain" if you found this blog helpful, then help others by sharing it. keep on following "Doctor's Opinion" to get more information & knowledge leading to a healthy life.


Written by,
 Dr. Sara Zafar