Chest pain, to be classified as such, must be located in the anterior area of the human body’s trunk. Precisely, it must be felt in some area between the neck and the abdomen. Also, some describe it as pain, others as discomfort. It can also be interpreted as pressure on the chest.
This pain can arise from any structure found in the chest. It can be pain originating in an organ, such as the esophagus, or in the chest wall, from the muscles, ribs or nerves. Furthermore, it is possible that it radiates, spreading the pain to the neck, upper limbs or even the face.
Sometimes chest pain starts with a pain in the spine and is felt first in the back. This will depend on the punctual origin of the disease that generates the pain. In any case, to be considered from the chest, it must manifest in front of the body.
It’s a pain that people fear very much. Unconsciously, it is always associated with a heart problem; therefore, fear. Approximately 5% of emergency room visits are attributed to chest pain. In pediatrics, it is less frequent, accounting for less than 1% of emergency consultations at this age.
Organic causes of chest pain
Chest pain is usually divided into two large groups: cardiac and non-cardiac origin. This allows clinicians to quickly differentiate between pain that requires urgent attention, and pain that can be managed less quickly.
In this sense, we will first enumerate the causes of cardiac chest pain and then some groups of structures that can cause non-cardiac pain.
- Ischemic disease: chest pain is the fundamental sign of angina pectoris and myocardial infarction. It is a very intense pain, disabling, with a feeling of pressure. Furthermore, it is located in the cardiac area and radiates to the upper limbs and neck. It represents an absolute urgency.
- Aortic Rupture: Although the aorta artery has a thick wall that supports high pressure, it can rupture. Furthermore, it is an uncommon clinical situation called aortic dissection and causes severe pain. It also requires urgent attention.
- Pericarditis: The membrane that covers the heart is called the pericardium. Under various circumstances, it can accumulate fluid and become inflamed, producing pericarditis. In addition, pericarditis is manifested by chest pain that can be intermittent and often changes with position.
pulmonary chest pain
- Pneumonia: Infection of the lungs with microbial agents causes chest pain. The pain can be continuous and intensify with a cough or breathing movement. Still, it is usually a pain on one side, coinciding with the infected area.
- Pulmonary embolism: The arteries and veins of the respiratory system can become clogged with clots in a condition called pulmonary embolism. In short, these clots can form in the lung itself or come, through circulation, from other parts of the body. It’s an extremely urgent situation too.
- Pneumothorax: Just as the heart is surrounded by the pericardium, the lungs are surrounded by the pleura. If the virtual space that forms the pleura fills with air, it is called a pneumothorax. It is very painful, in addition to being accompanied by symptoms such as dyspnea.
- Pleuritis: The pleura is susceptible to inflammation, called pleuritis. As in pericarditis, pain is intermittent and can vary with changes in posture.
Pain originating in the digestive tract
- Esophageal spasm: the esophagus travels through the center of the chest to communicate between the mouth and the stomach. As it is a hollow organ, whose wall is muscular, it can suffer spasms. In spasm, the esophagus closes in on itself, producing pain in the chest, as well as blocking the passage of food.
- Gastritis: Even though the stomach is lower down, gastritis and dyspepsia sometimes manifest the pain above in the chest. Gastritis does not only present pain, as well as usually accompanying digestive signs such as belching, reflux and nausea. Chest pain from gastroesophageal reflux is felt as a painful tie in the center of the chest.
- Gallstones: if the gallbladder presents stones, even if the pain is normal abdominal, it can reverberate in the chest. According to the anatomical position of the gallbladder and the position of the bile stones, some patients perceive colic pain in the right lung region and even in the right shoulder.
Other causes of chest pain
As we said before, in addition to the chest and abdomen organs, other structures and other situations can generate pain in the chest. It will always be necessary to rule out the most serious sources of pain before moving on to diagnosing other causes that can be treated less urgently.
Among these causes we have, for example:
- Causes of psychogenic origin: the panic attack, for example, in which the pain has a psychological rather than anatomical origin. There is a feeling of pressure and discomfort in the chest that does not originate from any organ or its malfunction.
- Costochondritis: This is inflammation of the cartilage that joins the ribs to the sternum. It can arise from effort or trauma, although not always. However, its treatment is very easy with anti-inflammatory drugs and local ice placement.
- Myalgias: the intercostal muscles that form the chest wall can hurt, either from strains, stretches, bruises from trauma, as well as inflammation. In general, treatment is also conducted primarily with anti-inflammatory drugs.
- Neuritis: The nerves that run through the ribs can become inflamed and cause pain in the chest. A classic example is herpes zoster, in which a viral infection manifests as an intense, burning pain that travels along the path of the affected nerve.