Chest Pain: Causes, Diagnosis, and Treatment

Chest pain is a sudden sharp, piercing pain which often heralds the signs of a serious heart-related issue. Chest pain could vary depending on the intensity, duration, location and quality. Aside from heart attack which occurs due to blocked blood flow, chest pain could also be a cause of various other heart related disorders.

Symptoms that may occur in chest pain are:

• Cold Sweating
• Shortness of breath
• Burning, pressure or tightness in the chest
• Weakness or dizziness
• Vomiting
• Nausea
• Varied intensity and to and fro of pain
• Searing of crushing pain in shoulders, arms, neck, jaw and back

Experiencing a chest pain automatically takes a person on a ride to thoughts of Heart attack. Although it may be caused by less serious conditions as well. According to the National Centre for Health Studies, about 13% of all the cases that go to the emergency room are diagnosed with serious heart problems.

Some of the causes of chest pain include:

• Gastroesophageal Reflux Disease: It is when the contents of the stomach lifts up and moves into the throat. It causes a burning sensation in the throat and in the chest.
• Asthma: Asthma is a common breathing problem. The patient experiences inflammation in the airways. It can cause chest-pain too.
• Muscle Strain: Muscle inflammation around the ribs can cause continuous pain in the chest. If the pain remains and becomes worse with the activity, it can be muscle strain.
• Injured Ribs: Injury in the ribs such as breakage, fracture etc. can also lead to extreme pain in chest.
• Angina: Which occurs as a result of blocked blood vessels
• Pericarditis: Swelling of the pericardium sac membrane encircling the heart
• Myocarditis: Swelling of the myocardium heart muscle
• Cardiomyopathy: A disease of the heart that causes it to become enlarged
• Aortic dissection Tearing of the aorta
• Heartburn
• Esophagus disorders
• Pneumonia
• Blood clot
• Chronic pain
• The inflammation of the pancreas.

COVID-19 Symptoms: Chest pain is a possible symptoms of Coronavirus Disease (COVID-19) . The other common symptoms are dry cough, fever and shortness of breath.

On experiencing chest pain it is advised that you call for an ambulance or your health care provider. Explain the symptoms, your medical history and the medications that you may be already taking. At the outset you will be required to undergo physical assessment tests that involve doing:

• ECG (Electrocardiogram): This records a person heart electrical activity.
• Blood Test: It is done to measure the enzyme level in the body.
• Chest X-Ray: To examine the chest, heart and lungs
• MRI: It is used to check if there’s any damage to the heart or Aorta

On the basis of the results of these tests you will be required to undergo certain follow up tests such as:

• Echocardiogram: Sound waves are used to record the moving images of the heart to check its working or not!
• Computerized tomography (CT scan): CT scans to determine whether your chest pain is due to a heart attack
• Stress Test: It is done to check the functioning of the heart after exertion
• Angiogram: This is done to look for any blocks in arteries.

The duration of Chest Pain depends upon its type which means to which of the body organs it is associated. The conditions that occur usually with Chest Pain are angina pectoris and heart attack. In case of a heart attack, the pain usually lasts for more than 15 minutes, while it takes usually 5 to 10 minutes for the pain to subside in case of angina.

There are various treatments for chest pain like medication, surgery or a mixture of both. The way and type of treatment is opted according to the level of the pain. If the pain is because of heart problem, then the treatment include:

• Medications:

  Medications such as nitroglycerine (which is an artery relaxer, that enables the blood to flow more easily through these narrow spaces), aspirin,heparin drugs that help to bust clots (these drugs dissolve the clot that is inhibiting the blood flow to the heart), blood thinners, acid suppressing medications and antidepressants. Due to their working nature these drugs are known as anti-coagulants

• Surgical procedures:

  The surgical procedures include angioplasty, balloon and stent placement treatment. All of these methods open the blocked blood vessels after a narrow tube is inserted into the largest blood vessel in the groin region.

  Other procedures include bypass surgery (in case of a blocked artery this surgical method creates another route for the blood to flow), dissection repair (in case of aortic dissection, this method repairs the ruptured artery carrying the blood) and lung reinflation (this method inflates the lung by inserting a tube).

If the pain is caused by other factors, treatment include:

• Lung reinflation performed by a doctor done by inserting a chest tube
• Using antacids in case of acid reflux
• Anti-anxiety medications in case the pain is due to panic attacks.

The risk factors for causes of chest pain are:

• Elevated levels of Cholesterol
• Diabetes
• Smoking
• Physical Inactivity
• Obesity

Side effects of taking nitroglycerine include headache, rapid heartbeat, feeling of nausea and vomiting, skin rash and dizziness. Serious side effects include a rapid fall in blood pressure levels.

Angioplasty though effective in reducing the chances of a heart attack does involve some risks. For example people may experience continuous narrowing of the arteries. There is the risk of damaging your coronary arteries, to your kidney. There is risk of having a stroke while undergoing treatment.

There is risk of bleeding which may require you to take blood transfusion. There is the risk of blood clots as well as irregular heartbeat.

in case of bypass surgery you may experience reactions such as infection and bleeding at the site of the surgery, fever, stroke or even death and adverse reactions to anaesthesia.

There are certain post-treatment guidelines for chest pain. If you have undergone an angioplasty treatment for example, you need to take your medications regularly. Ensure to never stop taking your anti-clotting medicines before discussing with your doctor as these are extremely essential to keep the chances of heart attacks or strokes in check.

It is necessary that you go for a physical check-up that comprising of an ECG and some laboratory tests, a week after completing the treatment. You should avoid any high-impact exercises or lifting any heavy objects for at least a month after the treatment.

Adopting a healthy lifestyle and diet is also of utmost importance. Should you experience any pain in the chest or any side effects to the medications you are taking you should immediately go see your doctor.

Post an angioplasty treatment it takes about 4 days for the patient to resume normal activities. Avoid lifting heavy objects for at least 4 weeks after the treatment. You can resume your sexual activities at least 4 days after.

An angioplasty treatment in India for example could cost you about 2-4 lakh on an average. And if you’re a foreigner looking to treat yourself or anyone you know in India, the cost of angioplasty will be at least 50 % more as compared to an Indian treating himself/herself in India.

If you have undergone an angioplasty treatment then the effects of the treatment could last long enough to prevent the chances of a stroke or heart attack for a considerable period of time. However you may experience the narrowing of arteries once again. In certain cases where people adopt a healthy lifestyle then the results of the treatment may be permanent.

If you are looking for more natural or herbal options as opposed to medications to treat your chest pain problem then you need to exercise on a more or less regular basis to keep your heart healthy. You should immediately stop the habit of smoking (i.e., if you have it), have a more nutritious diet consisting of fresh onion and garlic, whole grains, fruits, vegetables, lean proteins and fish high in omega 3 fatty acids.

Summary: There could be many reasons for chest pain. It could be because of Asthma, Anxiety attacks, or acid reflux. But sometimes, chest pain can be an alarm for an upcoming fatal problem too.