Chest pain; always a sign of impending doom?

Pain is a good thing! It’s what we do about the pain that matters. Pain is a warning sign that something abnormal is happening in our bodies; poor posture, infection, heart attack and many others.

Whenever you experience chest pain do not die from FEAR of a heart attack but instead seek urgent professional care. It may not even be a life-threatening cause.

Chest pain is probably the number one pain that sends shivers down the spine of most people; healthcare professionals and laymen alike. We often equate chest pain to a heart attack or heart problem but several other conditions that may have nothing to do with the heart may also cause chest pain. It is important however to seek professional care so that life-threatening conditions such as heart attack and lung conditions such as clots in the lung (pulmonary embolism) and a collapsed lung can be investigated for and managed without delay if the need arises.

Pain that is crushing or burning. Pain that may travel to a jaw or along an arm or moves to the back. A dull ache or sharp stab. Pain worsened by position or pain brought on by exertion or pressing on the chest. Pain worsened by certain foods. All these may describe chest pain.

PRESENTATION OF HEART-RELATED CHEST PAIN

• Pressure, fullness or tightness in your chest

• Nausea or vomiting

• Dizziness or weakness

• Cold sweats

• Shortness of breath

• Pain that gets worse with activity

• Crushing pain that radiates to your back, neck, jaw, shoulders and especially the left arm.

COMMON PRESENTATION OF CHEST PAIN NOT DUE TO A HEART CONDITION

• Trouble swallowing

• Pain that gets better or worse when you change your body position

• Pain that intensifies when you breathe deeply or cough.

• Tenderness when you push on your chest

• A sour taste or a sensation of food re-entering your mouth.

• However burning sensation behind the breast bone may originate from the stomach or heart

MY PICK OF CAUSES OF CHEST PAIN

• Heart Attack

• Angina

• Aortic Dissection (inner layers of a major artery separate forcing blood in between the layers and may cause the blood vessel to rupture.

• Heart Burn (reflux)

• Problems of the gallbladder and pancreas.

• Sore muscles

• Injured ribs and inflammed cartilage

• Pulmonary Embolism

• Collapsed Lung

• Pulmonary Hypertension

• Stress/Anxiety/Panic Attack

COMMON TESTS TO DETERMINE THE CAUSE

Several tests may be carried out after the health professional has asked you questions to determine the likely causes and also examined you.

• ECG – determines abnormal electrical activity of the heart.

• Blood tests to determine levels of enzymes associated with damaged heart muscle

• Chest X-ray; helps determine conditions of the heart and lungs including lung infection and collapsed lung.

• CT Scan to look for a blood clot in the lung or an artery about to rupture.

• Echocardiography; shows an image of the heart and how it’s functioning.

• Stress Tests; using exercising or a drug to stimulate the heat and determine how it responds to exertion.

The list is endless.

MANAGEMENT OF CHEST PAIN

From the earlier list of causes we can imagine that there may be several ways of managing chest pain depending on the cause and may include: Medication, Surgical Interventions and Psychotherapy.

• Aspirin; often given in heart-related chest pain. Talk to your doctor about keeping emergency soluble aspirin at home or at work.

• Nitroglycerin that relaxes arteries and ease flow of blood through narrowed arteries.

• Blood thinners are given when you have clot(s) and the aim is to prevent new clots from forming

• Antidepressants/Anxiolytics etc. in cases of panic attacks and anxiety etc. BUT in most cases psychotherapy is also required

• Acid-reducing medication; used when the cause is acid from the stomach moving upwards.

• Bypass-Surgery to create new path for a blocked blood vessel to the heart

• A Stent to keep a blood vessel to the heart open

• Repair of a dissecting artery

• Re-inflating a collapsed lung by putting a tube in the chest to drain.

Not all chest pain is heart or lung related. Not all chest pain is life-threatening but all chest pain require a professional evaluation because it is better to check and know it won’t kill than to wait and lose a life.

AS ALWAYS LAUGH OFTEN, WALK AND PRAY EVERYDAY AND REMEMBER IT’S A PRICELESS GIFT TO KNOW YOUR NUMBERS (blood sugar, blood pressure, blood cholesterol, BMI)

Dr. Kojo Cobba Essel

Moms’ Health Club/Health Essentials

(dressel@healthclubsgh.com)

*Dr Essel is a medical doctor, holds an MBA and is ISSA certified in exercise therapy and fitness nutrition.

Thought for the week – “although chest pain is commonly attributed to heart disease, many people with heart disease say they experience a vague discomfort for which PAIN doesn’t seem to be an adequate description”

References:

• www.mayoclinic.org (Mayo Clinic Staff)