What Causes Chest Pain?

Chest pain, which ranges from a dull stinging pain to a short, sharp stabbing sensation, can sometimes radiate to the arm and neck. Chest pain can be a symptom of many diseases. In serious problems that may be caused by heart or lungs, the cause of chest pain should be determined exactly and urgent medical intervention should be performed.

What are the symptoms of chest pain?

We can divide the conditions that cause chest pain into two: heart-related and other reasons. Heart-related chest pain has typical characteristics and occurs due to situations that require urgent intervention.

• Heart-related chest pain: In this type of chest pain, patients experience discomfort in the chest. It causes pressure, burning, squeezing pain in the chest. Pain; It can spread to the jaw, arm, shoulders and back. Heart-related chest pain lasts longer than a few minutes and may wax and wane from time to time. The intensity of the pain increases with movement and activity and decreases with rest. Chest pain; It may be accompanied by shortness of breath, cold sweats, fatigue, exhaustion, nausea and vomiting. Chest pain that includes these typical heart-related features is called angina.
• Chest pain due to other causes: It may not always be possible to distinguish chest pain due to heart or other causes. However, pain types such as sour taste in the mouth, the feeling of eaten food coming back to the mouth, difficulty in swallowing, change in the severity of pain depending on the position of the body, pain that worsens with coughing and deep breathing, long-term pain, point pains indicate other problems rather than heart-related problems. .

What Causes Chest Pain?

There are many different problems that cause chest pain. Chest pain caused by different reasons has different characteristics.

Heart-related causes:

• Heart attack: It occurs when the coronary arteries feeding the heart are completely blocked. Blood flow to the heart stops, the heart cannot be fed and oxygenated. As a result, the cells in the heart muscle cannot perform their functions and die. Early intervention in heart attack aims to save heart muscle cells before they die. After the heart stops, tissues that are quickly affected by lack of oxygen, such as the brain, may be damaged. It is critical to immediately recognize patients who appear to be having a heart attack and provide emergency intervention.
• Angina: It occurs due to critical narrowing or temporary blockage of the coronary arteries and their branches that provide nutrition to the heart. Since the diameter of the blocked vessel decreases, the blood flow in this vessel decreases. Especially during exercise, failure to meet the heart’s increased oxygen needs due to decreased blood flow causes pain. Angina can progress to a heart attack if procedures such as angioplasty, which will prevent further blockage of the vessel or dilate the vessels, or open the blocked or narrowed vessel, are not performed.
• Aortic dissection (rupture): Dissection of the aorta, the main vessel that distributes blood from the heart to the body, is a serious, life-threatening condition. For some reasons, the structures that make up the vascular wall separate from each other and occur due to blood filling the separated areas and rupturing the vessel. It causes stabbing pain in the chest and back.
• Pericarditis: It occurs as a result of inflammation of the structure called pericardium that surrounds the heart. It causes a sharp chest pain that gets worse with breathing or lying down.

Chest pain may also occur due to disorders related to the digestive system:

• Heartburn, reflux: It is a burning pain felt behind the rib cage. It occurs when the acidic contents of the stomach leak back into the esophagus. Consuming foods such as coffee, carbonated drinks, and sour foods increases the burning sensation caused by reflux.
• Swallowing disorders: In swallowing disorders, which usually occur due to problems with the esophagus, patients have difficulty and feel pain while swallowing.
• Gallbladder and pancreas disorders: Inflammation in the gallbladder and pancreas can cause abdominal pain radiating towards the chest.

Problems with muscles and bones can cause chest pain:

• Costochondritis: It is due to inflammation of the cartilage in the rib cage.
• Painful muscles: Conditions such as fibromyalgia, which cause chronic and widespread pain, can cause constant pain in the muscles, including the chest muscles.
• Rib injuries: Chest pain may be observed in cases such as cracks, fractures, crushes, etc. in the rib bones.

In lung-related diseases, chest pain can be a symptom of:

• Pulmonary embolism: Clots that occur as a result of excessive blood clotting in the vessels block the vessels feeding the lungs, causing the blood supply to the lungs to stop. This may cause chest pain.
• Pleurisy: It occurs due to inflammation of the membrane surrounding the lung. As with pericarditis, it causes pain that worsens with breathing and coughing.
• Lung collapse (bankruptcy): It occurs as a result of the air inside the lung leaking between the lung and the ribs. It causes chest pain that starts suddenly and lasts for several hours, often accompanied by shortness of breath.
• Pulmonary hypertension: One of the symptoms of this condition, which occurs as a result of increased blood pressure in the blood vessels that carry blood to the lungs, may be chest pain.

Other causes of chest pain:

• Panic attack: Chest pain; When it is accompanied by rapid heartbeat, excessive sweating and nausea, one of the possible causes is panic attack.
• Shingles disease: It is a disease that occurs when the virus that causes chickenpox remains inactive in the body for many years and becomes reactivated in situations that reduce the body’s resistance, such as weakening of the immune system. It may lead to the formation of water-filled blisters on the face, back and hips and symptoms such as fever, headache and nausea.

How is Chest Pain Diagnosed and Treated?

If chest pain occurs suddenly and is suggestive of a heart attack, the patient should immediately contact the nearest health center. It is highly likely that heart-related chest pain is caused by a problem that can be life-threatening and requires urgent intervention. Answers to the doctor’s questions about the onset, type, severity and duration of pain are important in finding the cause of chest pain.

Methods such as ECG (electrocardiogram), which shows the electrical activity of the heart, blood tests, chest x-ray, echocardiogram, which is an imaging method to determine heart functions, MRI, which shows the structures of the heart and aorta, stress test, which determines how heart functions are during exercise, and angiogram, which shows clogged vessels, can determine the cause of chest pain. can be used to determine.

Treatment of chest pain varies depending on the condition causing the pain. In cases that occur due to blockage of the coronary arteries feeding the heart; Opening the blocked vein with medications, clot-busting medications, and blood thinners that prevent clotting may be used. In cases where the obstruction is more advanced, a stent is placed in the patient’s heart vessels through an intervention in the vein detected by angiography and the obstruction is removed. In patients where the occlusion affects many vessels, surgical repair (bypass) of the arteries using other vessels in the body may be considered.

In cases where chest pain is due to non-cardiac causes, such as reflux; Antacid drugs and stomach protectors can be used.

Chest pain caused by a panic attack can be treated with antianxiety medications.

Chest pain may be an indication of a serious condition. People who experience chest pain should definitely go to the nearest health center and get checked. Identifying the condition that causes chest pain and providing the necessary treatment prevents the recurrence of chest pain and prevents the emergence of problems more serious than chest pain. It should not be forgotten that conditions such as advanced age, diabetes, blood pressure and high cholesterol increase the risk of heart attack. People with one or more of these risk factors are advised to contact the nearest emergency center when they experience chest pain.