chest pain

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chest pain

Etymology: AS, cest, box; L, poena, punishment
a physical complaint that requires immediate diagnosis and evaluation. Chest pain may be symptomatic of cardiac disease, such as angina pectoris, myocardial infarction, aortic stenosis, or pericarditis, or of pulmonary disease, such as pleurisy, pneumonia, or pulmonary embolism or infarction. The source of chest pain may also be musculoskeletal, gastrointestinal, or psychogenic. The use of illegal drugs such as cocaine may also cause chest pain. Over 90% of severe chest pain in adults is caused by coronary disease, spinal root compression, or psychological disturbance. Because of its association with life-threatening heart disease, chest pain causes extreme anxiety, which tends to mask other symptoms that would aid in diagnosis and treatment. Reassuring the person being examined assists in proper diagnosis. Evaluation of chest pain requires determining the quality of the pain-dull, sharp, or crushing, locating the site of the pain-in the center or side of the chest, and determining how long the pain has persisted, how it has developed, and whether it has occurred in the past. The patient is asked to describe the spread of pain to other parts of the body and to identify such factors as exertion, emotional distress, movement, eating, or deep breathing that aggravate or relieve the pain. If the pain is reproducible by palpation during physical examination, it is unlikely to be cardiac in origin. Specific cardiovascular conditions associated with chest pain are myocardial infarction, angina pectoris, pericarditis, and a dissecting aneurysm of the thoracic aorta. Musculoskeletal conditions include rib fractures, swelling of the rib cartilage, and muscle strain. GI conditions associated with chest pain include esophagitis, peptic ulcers, hiatal hernia, gastritis, cholecystitis, and pancreatitis.

chest pain

A general term for any dull, aching pain in the thorax, usually referring to that of acute onset, which is often regarded as being myocardial in origin unless proven otherwise

chest pain

Discomfort felt in the upper abdomen, thorax, neck, or shoulders. Chest pain is one of the most common potentially serious complaints offered by patients in emergency departments, hospitals, outpatient settings, and physicians' offices. A broad array of diseases and conditions may cause it, including (but not limited to) angina pectoris or myocardial infarction; anxiety and hyperventilation; aortic dissection; costochondritis or injured ribs; cough, pneumonia, pleurisy, pneumothorax, or pulmonary emboli; esophageal diseases, such as reflux or esophagitis; gastritis, duodenitis, or peptic ulcer; and stones in the biliary tree.
See also: pain

Patient discussion about chest pain

Q. I was in the ER because of a chest pain and the doctor there said its costochondritis. What does it mean? I am a 42 years old man. Last night i went to the ER because of a chest pain. The doctors there did many test and in the end they said its costochondritis. What does it mean? Can someone elaborate about the risk factors that can cause this symptom?

A. It seems that you are suffering from a traumatic injury to the skeleton that is near the heart which is called costochondritis. It can be a result of a simple trauma to the area or (as in my case, I am a rower) due to repetitive use of the muscles of the thorax and arms

Q. I still have chest pain after 5 angioplasties/stents. Does anybody else still have that much angina?

A. my uncle had the same problem. went through several catheterization at several different cardiologist (some are well known), but couldn't get this annoying pain off his chest. the weird part was that it didn't even reacted to effort. but eventually (i don't remember the stent amount) one of the cardiologist solved the problem. so don't give up and continue searching the cause!

Q. What is the differential diagnosis of chest pain in a 35 year old woman? I am a 35 years old woman. I suffer from chest pain for about 24 hours. I just came back from a trip to Europe, and i feel really bad. I smoke and I take anti contraceptive and i know that I am at a risk for pulmonary embolism or costochondritis. Cat it be something else?

A. The differential diagnosis of chest pain is very wide.
It can start in costochondritis if u carried a lot of luggage or might be pulmonary embolism if you didn't move from the chair all the flight. But it can also be a sign for an acute coronary syndrome (even at the age of 35) or a pericarditis. To be sure you need to consult with your GP.

More discussions about chest pain
References in periodicals archive ?
Sometimes non-traditional heart attack symptoms, such as shortness of breath or a cold sweat, occur along with chest pain.
Chest pain contributes approximately six million annual visits to emergency departments in the United States, making chest pain the second most common complaint7-9.
Striking temporally dynamic ECG changes associated with recurrent chest pain in a case of myopericarditis.
To study psychosocial factors in relation to depressive, anxiety and somatic symptoms in patient with 1st episode of chest pain attending to medicine department for consultation.
But at that time one expert commented that proof of the clinical utility of a high-sensitivity troponin assay for emergency chest pain patients needed validation in a well-designed, prospective trial.
Psychosocial and developmental antecedents of chest pain in young adults.
If the patient is stable, obtain a history of the onset and evolution of the chest pain, especially its location, quality, duration, and aggravating or alleviating factors.
Patients without chest pain had fewer symptoms overall but their ACS was not less severe.
KEY WORDS: Chest pain, acute myocardial infarction, Precordial chest pain.
The message that I really want to get across is that if you experience chest pain, it is serious and one should immediately reach the emergency and not waste time going to a general practitioner," warned the Emirati specialist.
Chest pain with exertion occurred in 1,222 (33%) of the cases.
Women, especially younger women, are more likely than men to show up at the hospital with no chest pain or discomfort after having a heart attack -- and they are also more likely to die than men of the same age, according to a U.