Chest pain. CHEST PAIN OVERVIEWIt is hard to know what to do when you feel pain or discomfort in the chest. Is it a heart attack or another, less serious problem? Because chest pain can be a sign of a heart attack, if the pain is due to heart disease, it is important to seek help and get treatment as quickly as possible. The important causes, typical signs and symptoms, diagnostic tests, and initial treatment of chest pain will be reviewed here. CHEST PAIN CAUSESChest pain generally originates from one of the organs in the chest (heart, lung, or esophagus) or from the components of the chest wall (skin, muscle, or bone). Occasionally, organs close to the chest, such as the gall bladder or stomach, may cause chest pain. Pain in the chest may also be the result of neck pain that is referred to the chest, called referred pain. Angina — All organs and tissues in the body require oxygen and nutrients carried in the blood. The heart pumps oxygen and nutrient- rich blood through a huge network of arteries throughout the body, which includes vessels that supply blood to the heart muscle. These vessels, called coronary arteries, lie on the surface of the heart and branch into smaller vessels located within the muscle (figure 1). In people with coronary heart disease (CHD), the coronary arteries become clogged with fatty deposits (figure 2). The deposits, called plaques, cause the coronary arteries to narrow and may prevent a normal amount of oxygen- rich blood from reaching the heart muscle. This is called cardiac ischemia. Angina develops if the demand for oxygen exceeds the amount of oxygen delivered to the heart muscle by the coronary arteries. Heart attack — A heart attack, or myocardial infarction (MI), occurs when the surface covering of a fatty plaque ruptures. A blood clot (thrombus) can form on the plaque, which can partially or completely block the artery. This blockage slows or blocks blood flow to the area of heart muscle fed by that artery. If this continues for more than 1. During a heart attack, the patient may feel a discomfort that is similar to an episode of ischemia (angina), although more prolonged and intense. Describing chest pain — Chest pain caused by angina or a heart attack may be similar to or different from chest pain caused by other conditions. Depending upon the cause, chest pain can have varying qualities (sharp, dull, burning), can be located in one or several areas (middle of the chest, upper or left chest, back, arms, jaw, neck, or the entire chest area), pain may worsen with activity and improve with rest, and there may be other associated symptoms (sweating, nausea, rapid heart rate, shortness of breath). A person may describe their pain as squeezing, tightness, pressure, constriction, strangling, burning, heart burn, fullness in the chest, band- like sensation, knot in the center of the chest, ache, heavy weight on chest (like an . In some cases, the discomfort cannot be described, but the patient may describe the pain by placing a fist in the center of the chest, known as the . The patient may actually have difficulty describing the exact location of the pain. Cardiac pain often involves the center of the chest or upper abdomen. If the pain is felt only on the right or left side, and not in the center of the chest, it is less likely to be cardiac ischemia. If the patient is able to point with a finger to one area of pain, it is unlikely to be caused by cardiac ischemia. This may include the neck, throat, lower jaw, teeth (feeling like a toothache), or the shoulders and arms. Sometimes, pain is felt in the wrists, fingers, or back (between the shoulder blades). It is often unrelated to exertion. Noncardiac pain may last only a few seconds or may persist for hours. Pain may improve with nitroglycerin or may persist and be severe. Pain that has been unchanged in severity and constant over days or weeks is not likely to be angina or a heart attack. For example, if the pain begins during an activity that increases physical exertion, such as walking up stairs, sexual intercourse, or raking leaves, and the pain is relieved within minutes of resting, it could be angina. The reason for this is that exercise increases the heart's need for oxygen- rich blood, and the need decreases as the person rests. Other things that can increase oxygen demand in the heart include emotional stress, exposure to cold, and physical effort shortly after a meal. Body Detox And Colon Cleanse How to Lose Weight Fast Cholesterol Hdl 78 Weight Loss Clinics In Brooklyn Ny Weight Loss Aids Celebrities Use Weight Loss Program Called Tops Quick Weight Loss Center Blue Cross The point. Detox Tea For Weight Loss At Cvs How Many Calories To Lose One Pound Per Week Detox Tea For Weight Loss At Cvs How Many Steps Each Day To Lose Weight detox cleanse. If the pain is relieved with nitroglycerin, a medicine used to treat angina, it suggests (but does not prove) that ischemia is the cause. Other conditions, especially muscular spasms or esophageal spasm, may also improve with nitroglycerin. If eating a meal or taking antacids always relieves the pain, it could be caused by a problem with the esophagus or stomach. Finally, the pain of ischemia is not usually affected by taking a deep breath or by pressing on the area of discomfort. Ischemic pain tends to be the same regardless of body position, although some patients with ischemia feel relief when sitting up, especially if they lean forward. These can include. For example, an elderly person with multiple risk factors, including a prior MI, peripheral vascular disease (claudication), stroke, heavy smoking, high blood pressure, diabetes, high cholesterol, and a family history of heart disease would be treated as a person with a high risk of coronary disease despite having symptoms that are not typical for angina. On the other hand, if a person in a very low risk category reports chest pain, the remote possibility of coronary disease is not ignored, although other possible causes are also investigated. Other cardiovascular problems — Some heart- related problems that are not related to blood flow in the coronary arteries can cause pain in the chest. This is called variant angina, which may be caused by a temporary spasm of the coronary arteries. The arteries are usually normal and have no cholesterol- related narrowing or obstruction, although there may be partial blockage occasionally due to spasm in one segment.(See . Pain may be relieved when sitting forward. The person may have abnormal heart sounds and characteristic changes in the electrocardiogram (ECG). Myocarditis is often caused by a viral infection. People with this condition have no known cause of their chest pain. People with a diagnosis of mitral valve prolapse or aortic stenosis, for example, may complain of pain in the chest. The aorta is the main artery in the body. It is composed of layers of muscle cells, much like the layers of an onion. Rarely, the layers can separate and rupture, causing the blood to flow into areas of the body outside of the circulatory system. This is a very serious condition that can be corrected with vascular surgery. The pain of aortic dissection is usually severe, comes on very suddenly, is felt in the back or between the shoulder blades, and is often described as a ripping or tearing sensation. Chest wall pain — A number of conditions can cause the skin, muscles, bones, tendons, soft tissue, and cartilage of the chest to become painful.
The pain is longer- lasting than most episodes of ischemic pain and is often made better or worse by a particular position. Taking a deep breath may make the pain worse, and it may only affect a specific, localized area of the chest. Pressing on this area of the chest usually causes the pain to become worse. This is known as costochondritis. Shingles (herpes zoster) affects the nerves of the chest wall and can be quite uncomfortable. Shingles also causes a painful skin rash. Because the esophagus and the heart are served by some of the same nerves, some cases of esophageal pain can be confused with cardiac ischemia. In some patients, esophageal pain is caused by spasm and may be relieved by nitroglycerin. A number of conditions can cause pain in the esophagus, including. This can be uncomfortable or painful. Many will cause pain that gets worse with breathing. This almost always occurs in someone who is at high risk for the disorder due to recent surgery, bed rest, pregnancy or recent pelvic surgery, or a long airplane flight. The pain occurs suddenly, is accompanied by shortness of breath, and may be worsened with deep breaths. Hyperventilation, which is associated with panic attacks, can cause chest pain, sometimes with changes in the ECG. Referred pain — Referred pain can occur when the same nerves supplying areas of the chest wall also supply the tissues around the lungs, the diaphragm or the lining of the abdomen. A herniated disc or arthritis in the neck can cause . Some signal a serious condition, such as a heart attack, while others require evaluation but are not life- threatening. Most people think that a heart attack is sudden, intense, and dramatic, but this is not always true. Many heart attacks start slowly as mild pain or discomfort, which builds in intensity with time. It is common for a patient with a heart attack to have other symptoms, such as discomfort in one or both arms, back, neck, jaw, or stomach, shortness of breath, breaking out in a cold sweat, nausea, or light- headedness. However, some heart attacks occur without these symptoms. Studies have shown that people often delay seeking help for a heart attack because they thought the symptoms were not serious or would go away. The best advice for anyone with chest pain is to seek help immediately since every minute between the start of the attack and treatment means increased loss of heart muscle. Testing. Electrocardiogram — An electrocardiogram, or ECG, depicts the progress of the electrical wave through various parts of the heart muscle. In people with ischemic chest pain, there are often changes in the ECG. A normal ECG means that a heart attack is less likely, but it does not mean that a person does not have angina or a heart attack. Blood tests — Blood tests can be used to measure certain enzymes normally found in the heart muscle. During a heart attack, these enzymes leak out of the heart into the blood.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. Archives
November 2017
Categories |