Chest pain, to be classified as such, must be located in the anterior area of the trunk of the human body. Precisely, it should be felt 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 in the chest. It can be pain originating in an organ, such as the esophagus, or in the chest wall, from the muscles, ribs or nerves. And it is possible that it radiates, spreading the pain to the neck, upper limbs or even to the face.
At times, chest pain begins as a pain in the back and is felt first in the back. This will depend on the specific origin of the pathology that generates pain. In any case, to be considered from the thorax, it must manifest itself in the front.
It is a pain that people fear very much. Unconsciously , it is always associated with a heart problem; hence the fear. Approximately 5% of emergency department visits 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 is usually divided into two large groups: that of cardiac origin and that of non-cardiac origin. This allows clinicians to quickly differentiate between pain that requires urgent attention and pain that can be managed less quickly.
We are going to list the causes of cardiac chest pain first and then some groups of structures that can cause non-cardiac chest pain.
- Ischemic disease: chest pain is the fundamental sign of angina pectoris and myocardial infarction. It is a very intense, disabling pain, with a feeling of tightness. It is located in the heart area and radiates to the upper limbs and up to the neck. It represents an absolute urgency.
- Aortic rupture: Although the aorta artery has a thick wall that supports high pressure, it can rupture. It is a rare clinical situation called aortic dissection and causes severe pain. It also requires urgent care.
- Pericarditis: The lining of the heart is called the pericardium. Due to various circumstances, it can accumulate fluid and become inflamed, producing pericarditis. Pericarditis is expressed as chest pain that can be intermittent and usually changes according to position.
Lung chest pain
- Pneumonia: infection of the lungs with microbial agents causes chest pain. The pain may be continuous and intensify with coughing or respiratory movement. In general, it is a pain in one side, coinciding with the infected area.
- Pulmonary embolism: The arteries and veins of the respiratory system can become clogged with clots in a condition called pulmonary embolism. These clots can be formed in the lung itself or come, through the circulation, from other parts of the body. It is a situation of extreme urgency as well.
- 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 fills with air, it is called a pneumothorax. It is very painful, in addition to being accompanied by symptoms such as dyspnea.
- Pleurisy: the pleura is plausible with inflammation. This is pleurisy or pleurisy. As with pericarditis, the pain is intermittent and can vary with changes in posture.