Chest pain is a complex complaint that immediately brings heart attack to mind for many people, but can arise from a wide variety of causes. It can be a symptom of serious conditions such as heart failure, angina, or heart attack, as well as less dangerous conditions such as digestive system problems (reflux), musculoskeletal pain, or panic attacks. Not every chest pain means the same thing, and the character, duration, and accompanying symptoms of this pain provide critical clues to understanding the underlying cause.
When you feel chest pain, especially if it starts suddenly, is severe, and is accompanied by sweating, shortness of breath, nausea, or jaw-arm pain, it could be a heart attack. In such a situation, you should apply to the emergency room without wasting time.
What is chest pain?
Chest pain is a general term that covers complaints such as discomfort, pressure, tightness, or burning sensation felt between the chest cage and the neck and upper abdominal region. Chest pain can have different meanings depending on where and how it is felt. For example, heart-related pain usually manifests with a feeling of pressure in the middle of the chest, while muscle pain can be sharper and more localized.
What causes chest pain?
The cause of chest pain can originate from very different organs and systems. Cardiovascular diseases, lung problems, musculoskeletal system problems, and stomach problems are among the most common causes. Each cause has its own specific characteristics. To understand the source of pain, it is very important to know the accompanying symptoms.
Heart-related chest pain causes
Although heart and vascular diseases constitute the most serious causes of chest pain, they only cover 15-20% of cases. Heart diseases that cause chest pain include coronary artery diseases (angina and heart attack), heart muscle diseases (cardiomyopathies), heart membrane inflammation (pericarditis), valve diseases, arrhythmias, and large vessel diseases (aortic aneurysm, aortic dissection). Any condition that reduces the heart’s blood pumping capacity, disrupts the integrity of vessels, or causes inflammation in heart tissue can lead to pain in the chest area. This pain sometimes occurs during exertion, sometimes develops suddenly at rest and may require emergency intervention.
Lung-related chest pain causes
Diseases of the lungs and respiratory tract can also cause chest pain. Pneumonia, pleural inflammation (pleuritis), blood clot to the lung vessel (pulmonary embolism), lung collapse (pneumothorax), bronchitis, COPD exacerbations, and lung tumors fall into this group. These conditions usually affect respiratory movements, increasing pain during deep breathing or coughing. Especially causes such as embolism and pneumothorax require urgent diagnosis and treatment.
Digestive system-related chest pain causes
Sometimes the source of chest pain is problems in the stomach, esophagus, or bile ducts. Reflux disease, esophageal inflammation, esophageal spasm, stomach ulcer, gallstones, and pancreatitis are included in this group. These diseases cause pain to be felt in the chest due to their proximity to the chest cage. Increase after meals, worsening in lying position, acid reflux, or pain radiating to the upper abdomen suggests digestive system-related causes.
Musculoskeletal system-related chest pain causes
Muscles, rib bones, and cartilage structures in the chest wall can cause pain due to strain, fibromyalgia, trauma (injury), or inflammation. Muscle strains, rib fractures, rib cartilage inflammation (costochondritis), and blows to the chest wall fall into this group. Such pain usually concentrates at a specific point, increases with touch or movement, and may be related to breathing.
Psychological chest pain causes
Panic attacks, anxiety disorders, and intense stress are non-physical causes of chest pain. Psychologically-sourced pain can sometimes be severe enough to mimic a heart attack. Chest tightness, feeling unable to breathe, palpitations, sweating, and fear of death are common in these situations. Although there is no underlying physical illness, symptoms are real and can seriously affect a person’s quality of life.
What causes chest cage pain?
Chest cage pain more often indicates problems related to the musculoskeletal system, ribs, or cartilage tissue. The most common causes include costochondritis, muscle strain, and rib injuries. It can especially occur after strenuous movements, heavy lifting, coughing, or trauma. Pain is usually at a specific point and increases when touched. However, if there is severe pain after trauma or symptoms such as difficulty breathing, the possibility of rib fractures or pleural involvement should not be forgotten.
What are the symptoms of chest pain?
The character, location, and timing of chest pain are very important for understanding its cause. Below, you can find the symptoms that chest pain can present with according to its most common causes.
Heart-related chest pain symptoms
When there is a problem with your heart, pain is usually felt right in the middle of your chest. This pain is described as pressure, tightness, or crushing and sometimes gives a feeling like “an elephant sitting on my chest.” It can radiate to your left arm, jaw, neck, or back. It usually starts during physical exertion and decreases with rest. Pain due to coronary artery blockage may be relieved with nitrate group sublingual medications. During a heart attack, pain may not subside with rest and may last longer than 20 minutes.
Lung-related chest pain symptoms
Pain originating from your lungs or respiratory tract is usually felt in a sharp, stabbing manner. Taking deep breaths, coughing, or sneezing can intensify this pain. Sometimes lying on your side may provide relief. Additional complaints such as shortness of breath, cough, and fever may accompany the picture. In conditions such as pleural inflammation or embolism, pain may change shape when position is changed.
Musculoskeletal-related chest pain symptoms
Pain originating from your muscles, ribs, or joints is more superficial and localized. Pain may increase when you press with your hand or touch. Daily movements, heavy lifting, or sleeping in the wrong position can trigger these pains. When you rest or don’t strain the area, complaints usually subside.
Digestive system-related chest pain symptoms
Problems with the stomach, esophagus, or gallbladder can also cause pain in the chest area. Such pain is usually in the form of burning, stinging, or pressure. It may start after eating or increase with hunger. Relief can be achieved with antacid use. Digestive system complaints such as acid reflux, bloating, or difficulty swallowing may accompany pain.
Psychological and stress-related chest pain symptoms
Chest pain that occurs during intense stress, anxiety, or panic attacks can give a feeling very similar to real heart pain. Tightness or pressure is usually seen together with palpitations, sweating, trembling, and shortness of breath. During a panic attack, an intense feeling of fear and the thought “I’m dying” may be experienced. Insomnia, excessive caffeine consumption, or traumatic events can trigger this condition.
Hyperventilation
Breathing rapidly and shallowly during stressful or anxious situations disrupts the oxygen-carbon dioxide balance in your body. This condition can lead to a feeling of tightness in the chest area, numbness in hands and feet, dizziness, and drowsiness. Hyperventilation is usually seen together with panic attacks or intense anxiety.
What is good for chest pain?
The method that will be good for chest pain varies according to the cause of the pain. In emergency situations such as heart attack or embolism, no method applied at home is sufficient. In such a situation, it is necessary to call emergency services without wasting time. Dietary arrangements and acid-reducing medications may be beneficial for stomach-related pain, while rest and simple painkillers may be beneficial for musculoskeletal-related pain. However, trying treatment without knowing the cause of chest pain is dangerous.
Since chest pain can originate from different organ systems, it is first necessary to make the correct diagnosis.
- In heart diseases, especially in cases of suspected angina or heart attack, the most correct approach is to apply to the hospital urgently.
- In digestive system-related pain such as reflux and gastritis, not overloading after meals, avoiding fatty and spicy foods, and stopping eating 2-3 hours before bedtime are beneficial.
- In musculoskeletal-related pain, rest, hot-cold application, and light exercises can provide relief.
- In anxiety-related pain, deep breathing techniques, relaxation exercises, and professional psychological support when necessary are important.
Methods that are good for chest pain can be applied not only when pain starts but also before it starts. Healthy lifestyle habits reduce the risk of heart, lung, and digestive system diseases that can lead to chest pain. For this, it is important to quit smoking, exercise regularly, eat healthily, manage stress, have regular health check-ups, and maintain a healthy weight.
How does chest pain go away?
Chest pain can only go away when the cause is correctly determined and appropriate treatment is applied. Although pain may sometimes result from simple muscle strain, there may also be life-threatening causes such as heart attack or pulmonary embolism. Heart and vascular-related pain is usually controlled with medical or surgical intervention. Antibiotics can be used for lung infections, acid-suppressing drugs for reflux, and physiotherapy and painkillers for musculoskeletal problems.
Heart-related chest pain treatment
In conditions such as heart attack or angina, treatment is done urgently. Interventions to open vascular blockages, clot-dissolving drugs, vasodilator treatments, and drugs that support heart function can be applied.
Lung-related chest pain treatment
In conditions such as pneumonia, pulmonary embolism, or pleural inflammation, infection-fighting drugs, clot-dissolving treatments, or respiratory support may be needed.
Stomach and esophagus-related chest pain treatment
Antacids and dietary regulation help with digestion-related pain. Antacid tablets neutralize stomach acid and provide quick relief. H2 receptor blockers ranitidine and famotidine reduce acid production. Proton pump inhibitors omeprazole and lansoprazole provide strong acid suppression.
Dietary changes provide long-term solutions. Small and frequent meals reduce stomach load. Avoid spicy, fatty, acidic foods. Do not lie down for 2-3 hours after eating. Sleep with your head elevated.
Musculoskeletal system-related chest pain treatment
Hot-cold application and light stretching are effective for muscle-related pain. Cold compress for the first 24-48 hours reduces inflammation. Apply at 15-20 minute intervals. Subsequently, hot compress provides muscle relaxation. Light stretching exercises increase muscle flexibility. Anti-inflammatory drugs ibuprofen and diclofenac reduce pain and inflammation.
Psychological causes-related chest pain treatment
In chest pain due to panic attacks and anxiety, psychotherapy, stress management techniques, and drug treatment when necessary can be beneficial.
When should you consult a doctor?
Sudden onset, severe chest pain felt as tightness or pressure and radiating to the neck, jaw, shoulder, or arm is an emergency. Additionally, if symptoms such as shortness of breath, sweating, nausea, dizziness, fainting are accompanying, emergency medical help is needed.
Even if your chest pain is mild, you should definitely consult a doctor in the following situations:
- Pain that occurs with exertion and subsides with rest
- Chest pain lasting for days or recurring
- Pain accompanied by infection symptoms such as fever, cough, sputum
- Chest pain occurring after trauma
- If you have previously been diagnosed with heart, lung, or stomach disease and your pain has newly started
Reference: https://pmc.ncbi.nlm.nih.gov/articles/PMC1124107/
