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March Health Tip from Dr.
Koller
Chest pain is a common symptom that many adults of all ages may experience from time to time. There are a variety of etiologies of chest pain; some that can be associated with serious consequences and some that are rather innocent. Your general internal medicine primary care physician can evaluate you to determine the cause of the chest pain.
Diseases of the heart and the large blood vessels of the chest may not be the most common cause of chest pain, but they are the ones that receive the most attention. When evaluating you for chest pain, your doctor will probably want to rule out the possibility of heart disease. This evaluation may include a history, physical examination, and EKG, blood tests, and an exercise stress test.
The most common heart condition causing chest pain is coronary artery disease. Atherosclerosis causes occlusions in the coronary arteries. These are the arteries that provide the needed blood supply to the heart muscle. A heart attack is caused by a sudden blockage of an artery that causes death to heart muscle cells. This occurs when a thrombus, or clot forms in a coronary artery and interrupts needed blood supply.
The term angina refers to the symptoms that one experiences when the heart or a portion of the heart gets inadequate blood flow. This inadequate blood flow can be a result of an acute thrombus, or blood clot, in a coronary artery. It can also occur in the setting of increased demand for blood flow, as occurs in exercise, and the narrowed coronary artery can not provide the needed supply of blood to meet the demand of the stressed heart.
Chest pain can also be from an esophageal problem. The esophagus is the swallowing tube which allows food to travel into the stomach. Typically, this type of pain occurs after eating. Gastroesophageal reflux disease is the most common cause of chest pain referred from the esophagus.
Chest wall pain probably accounts for one third of all cases of chest pain. This can occur from rib fracture, fibromyalgia, shingles, costochondritis, or chest wall arthritis. Typically, this type of pain is exacerbated with palpation or touching the chest wall.
Lung problems such as pneumonia, pulmonary emboli, pleuritis, and pneumothorax can cause chest pain. Many of these cause the chest pain to be worse with a deep breath in.
Anxiety or panic disorders can cause chest pain. Many people who have anxiety and chest pain say they are under a considerable amount of stress.
If you get chest pain, it is a good idea to see your doctor so he or she can help guide you in coming to a determination of the cause of your pain. As described briefly above, there are a multitude of diseases or causes of chest pain. Some are benign, but some require swift attention.
For more information:
MU Health Sciences Library
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