Causes of chest pain explained

Causes of chest pain can be related to a variety of symptoms. Over six million people visit hospital emergency annually because of chest pain. 

Causes of chest pain can vary from life-threatening conditions to those that are relatively harmless. The most common causes of chest pain are musculoskeletal (30-50%) and gastrointestinal conditions (10-20%).

Pain due to coronary artery disease may radiate to the neck, jaw, and arms. Pleuritic pain typically worsens with respiration. Such pain is associated with several conditions of the heart and lungs.

Chest pain associated with body position or certain movements is possible of musculoskeletal origin, and so is a well-localized pain associated with tenderness on palpation (pushing on the spot).

Some of the severe Causes of Chest Pain are listed below.

The term angina pectoris or angina is used to describe chest pain or discomfort, often felt like a pressure or a squeezing sensation in the chest. The pain may radiate to the shoulders, arms, neck, jaw or the back region between the shoulder blades.

Typically, a patient with angina will experience no symptoms at rest. However, during exercise, the oxygen demands of the heart muscle will increase. If blood supply in a coronary artery is limited, usually because of an atherosclerotic plaque, angina will occur. 

Aortic dissection is a serious condition in which there is a tear in the inner layer of the aorta (the large blood vessel branching off the heart). Because blood can pass the tear, the inner and middle layers of the aorta to become separated, a condition called dissection. The blood-filled channel may rupture through the outer wall of the aorta causing fatal bleeding.

Patients with acute aortic dissection usually present with acute, severe, chest and back pain which is sharp and may have a ripping or tearing quality. The pain of aortic dissection is typically distinguished from the pain of ACS by its abrupt onset and maximal severity at onset. 

The term acute coronary syndrome covers a range of conditions associated with a sudden reduction in blood flow to the heart muscle. It includes conditions such as ST-segment elevation myocardial infarction (STEMI) and non-STEMI (NSTEMI). The underlying mechanism usually involves the rupture of an atherosclerotic plaque in a coronary artery with superimposed blood clotting (thrombosis), thereby blocking blood supply.

ACS and acute heart attack are one and the same and should always be treated as an emergency.

Patients with ACS typically experience pressure, fullness or tightness in the chest. Sometimes there is searing pain that may radiate to the back, neck, jaw, shoulders, and arms, particularly the left arm.

Stress cardiomyopathy, was first described 1990 in Japan. Although its symptoms mimic those of an acute heart attack, it is an entirely different disorder and is not caused by blocked coronary arteries.

Patients with stress cardiomyopathy experience sudden, intense chest pain precipitated by an emotionally stressful event. It could be the death of a loved one, breakup of a relationship, domestic abuse, arguments, devastating financial losses or a natural disaster.
The disorder is characterized by a severely decreased contraction of a part of the heart muscle. This may sometimes lead to heart failure, irregularities of heart rhythm and shock.

Pericarditis is an inflammation (swelling) of the pericardium, a thin membrane or sac surrounding the heart. In most cases, no specific cause is identified, although a viral infection usually presumed to be responsible.

The primary symptom may be a sudden, sharp and stabbing pain behind the sternum (breastbone). However, sometimes there may only be a dull ache.

The pain of pericarditis typically worsens when lying down or breathing in (pleuritic pain). It may often get better when sitting up and leaning forward.

Pericarditis is usually not a serious condition, and hospital admission is seldom required.

Please Note

If you or someone with you is having an emergency, get off your computer and call 911 immediately.

If you are having symptoms and don’t know the caused of chest pain and are unsure, don’t take a risk.  These symptoms are not a diagnosis or intended to be medical advice, but if you are unsure please call us or book an appointment now.