What is chest pain?

Chest pain, to be cataloged as such, must be located in the anterior part of the trunk of the human body. Precisely, you should feel in some area between the neck and the abdomen. Some describe it as pain, others as discomfort. It can also be interpreted as a tightness in the chest.

This chest pain can come from any structure found in the chest. It can be a pain originating in an organ, such as the esophagus, or in the chest wall, from the muscles, ribs or nerves. And it may radiate, extending pain to the neck, upper limbs or even to the face.

On certain occasions, chest pain begins as a backache and feels first in the back. That will depend on the specific origin of the pathology that generates pain. In any case, to be considered as a thorax, it must manifest in the front.

It is a pain that people fear very much. Unconsciously, is always associated with a cardiac problem; hence the fear. Approximately 5% of consultations in the emergency services are attributed to chest pain. In pediatrics it is less frequent, constituting less than 1% of emergency consultations at that age.

Organic causes of chest pain

Chest pain It is usually divided into two large groups: that of cardiac origin and that of non-cardiac origin. This allows doctors to quickly differentiate between pain that requires urgent attention, and that which can be managed less quickly.

Let's first list the causes of cardiac chest pain and then some groups of structures that can cause non-cardiac chest pain.

Cardiovascular origin

• Ischemic disease: Chest pain is the fundamental sign of angina pectoris and myocardial infarction. It is a very intense pain, disabling, with a feeling of oppression. It is located in the heart area and radiates to the upper limbs and to the neck. It represents an absolute urgency.
• Aortic rupture: Although the aortic artery has a thick wall that supports high pressures, it can break. It is an uncommon clinical situation called aortic dissection and causes severe pain. It also requires urgent attention.
• Pericarditis: The membrane that covers the heart is called pericardium. Due to various circumstances, it can accumulate fluid and become inflamed, causing pericarditis. Pericarditis is expressed with chest pain that can be intermittent and usually changes depending on the position.

Chest pain

• Pneumonia: Infection of the lungs with microbial agents causes chest pain. The pain can be continuous and intensify with cough or respiratory movement. In general, it is a pain in the side, coinciding with the infected area.
• Pulmonary embolism: The arteries and veins of the respiratory system can be covered with clots in a box called pulmonary embolism. These clots can be formed in the same lung or come, through the circulation, from other parts of the body. It is a very urgent situation too.
• Pneumothorax: Just as the heart is surrounded by the pericardium, the lungs are surrounded by the pleura. If the virtual space that forms the pleura is filled with air, it is called pneumothorax. It is very painful, in addition to being accompanied by symptoms such as dyspnea.
• Pleuritis: The pleura is plausible of inflammation. This is pleurisy or pleurisy. As with pericarditis, the pain is intermittent and may vary with changes in posture.

Read on: Pneumonia or pneumonia

Pain originating in the digestive system

• Esophageal spasm: The esophagus runs through the center of the chest to communicate the mouth with the stomach. As it is a hollow organ whose wall is muscular, it can suffer spasms. In spasm, the esophagus closes on itself producing chest pain and preventing the passage of food.
• Gastritis: Although the stomach is located lower, sometimes gastritis and dyspepsia manifest the pain upward in the thorax. Gastritis does not only present pain, but is usually accompanied by digestive signs, such as belching, reflux and nausea. Chest pain from gastroesophageal reflux feels like a painful tie in the center of the chest.
• Biliary lithiasis: If the gallbladder has stones, although the usual pain is abdominal, it can affect the chest. According to the anatomical position of the gallbladder and the position of the biliary stones, some patients perceive colic pain in the right pulmonary region and even in the right shoulder.

Keep discovering: 7 steps to interpret an electrocardiogram

Other causes of chest pain

As we said, in addition to the organs of the chest and abdomen, other structures and other situations can generate chest pain. It will always be necessary to rule out the most serious sources of pain, before going on to diagnose the other causes that can be treated with less urgency.

Among these causes we have:

• Causes of psychogenic origin: the panic attack, for example, in which the pain comes from psychology and not from anatomy. There is a feeling of oppression and discomfort in the chest that does not respond to an organ or its malfunction.
• Costochondritis: It is the inflammation of the cartilage that joins the ribs to the sternum. It can come from an effort or trauma, although not always. Its treatment is very easy with anti-inflammatory and local cold.
• Myalgia: The intercostal muscles that make up the chest wall can hurt, either from strains, tears, bruises from trauma or inflammation. In general, also the treatment is carried out basically with anti-inflammatory drugs.
• Neuritis: The nerves that pass between the ribs can become inflamed and cause chest pain. A classic example is shingles, in which the viral infection manifests itself as an intense and burning pain that runs along the path of the affected nerve.