CHESTPAIN

The smooth working of the human body is governed by a wonderfully co-ordinated functioning of the various organ systems like the digestive system, circulatory system etc. Nervous system is one such system comprising of the brain, the spinal chord and the nerves. The nerves act as pathways to carry sensation to the brain and spinal chord convey the commands from them. The nervous system thus comprises of the sensory and the motor parts. All the order from the brain are transmitted to the muscles by the motor nerves. As a result the muscles execute the command and the movements take place.

The sensory nervous system has a wide spread distribution all over the body. The nervous branch and re-branch to reach all the areas of the human body. The sensation of pain is picked up at one end by these nerves. This is then delayed to the spinal chord from where it eventually goes to the brain. Any injury to any part of the body or inflammation leads to stretching of these nerve endings of the sensory nerves. This information gets analyzed immediately in the brain which makes us feel the pain.

Have you ever wondered why the heart pain is mostly felt on the left chest wall and may a times radiated to the left arm?

These are an innumerable number of nerves present on the heart muscles. Like the other nerves they  also takes signals and pass it on to the brain via the spinal chord. Whenever shortage of oxygen occurs in the heart due to the blockages in the coronary arteries, the sensory nerve endings present in the wall of the heart relay this information to the brain via the spinal chord. These substations in the spinal chord also receive sensory nerves from the nearby areas of the heart, especially the left chest and the left arm. All these information are relayed to the brain. This is the reason why the heart pain is felt in these areas. Heart pain is known as “angina”.

Frequent heart pain can also be felt elsewhere like right shoulder, back of the chest, jaws or the neck. This happens is those in whom the spinal chord sub stations get nerves from these areas and the heart. Since the chest wall also contains other organs like the lungs and the skin itself, pain in the chest can also originate from them. It thus becomes important to differentiate them from the heart pain.

CHEST PAIN – IS IT JUST INDIGESTION OR A HEART ATTACK?

Sumit was on his way home after lunch with friends when he felt a pain in the middle of his chest. At first he thought it was just indigestion, but by the time he arrived home the pain had spread to both his arms and he was perspiring and feeling faint.

“ My wife took one look at me and wanted to call an ambulance. I told her not to bother that I’d be okay after a rest,” he said. “But she insisted on getting an ambulance and 20 minutes later I was in hospital”

His wife’s fast action saved 45-year-old Sumit’s life. The pain was the symptom of a heart attack caused when a clot formed in one of his arteries. This clot blocked the artery, cutting off the blood supply to his heart. But by getting to hospital promptly meant doctors could use a special drug to dissolve the clot, allowing blood to flow back to his heart again. This prevented serious damage to Sumit’s heart and gave him a good chance of recovering.

How can you tell the difference between heart attack symptoms and simple indigestion? Like a heart attack, indigestion can create a burning pain, but it’s unlikely to spread to other parts of the body. But if you’re in any doubt, don’t hesitate to call an ambulance and say you’re having chest pains, especially if you don’t normally suffer indigestion. If it turns out to be a false alarm and you’re not having a heart attack, don’t worry – the hospital staff won’t mind. But besides knowing the symptoms of heart attack, it’s also important to know how to prevent one. Not smoking, getting regular exercise, eating plenty of cereals, grains, vegetables, fruits and avoiding fatty foods, reducing stress and keeping blood pressure healthy can all help reduce the risk of heart disease.

CHEST PAIN IS IT ALWAYS THE HEART?

Chest pain refers to pressure, squeezing or general discomfort in the chest area, which includes the heart, breast and neck areas. Any pressure or pain in the chest area is collectively referred to as chest pain. Chest pain varies in location, duration, frequency and strength, depending largely on its cause. The pain may be temporary or prolonged. It may occur sporadically, frequently, only during certain times (e.g., during exercise or only once.

The chest is the area where the heart and lungs are located. These organs are protected by the rib cage and breastbone. Many different conditions can cause pain in the chest. Some causes of chest pain require prompt medical attention, such as angina, heart attack, or tearing of the aorta. Other causes of chest pain can be evaluated electively, such as spasm of the esophagus, gallbladder attack, or inflammation of the chest wall. Therefore, an accurate diagnosis is important in providing proper treatment to the patients with chest pain. In adults, it is often a cause for concern because it can signal a heart attack. However, many conditions ranging from a pulled muscle to pneumonia can also cause chest pain.

                                                                                  

WHAT ARE THE SIGNS AND SYMPTOMS OF THE CONDITION?        

Chest pain symptoms are related to the underlying cause of the pain. The person’s description of the pain can be helpful to the healthcare provider in determining its source. Questions the provider may ask include: F What is the exact location of the pain? F What is the quality of the pain: dull, sharp, pressure-like, stabbing, or throbbing? F How severe is the pain on a scale of 1 to 10? F When did the pain start? F What was the person doing when the pain started? F How long has the pain lasted? If the pain has stopped, when did it stop or how often has the person experienced this pain? F Does the pain travel outside the chest or through to the back? F Do other symptoms occur with the pain such as nausea, sweating, or shortness of breath?

What are the causes and risks of the condition?

      There are many different causes for chest pain. These include:

1.       Heart Pain

2.       Muscle strain in the chest

3.       Injury to the chest

4.       Damage, irritation o inflammation of the lungs

5.       Blood vessel-related pain

6.       Gastrointestinal pain

7.       Irritation of other organs in the abdomen

8.       Herpes zoster

9.       Emotional or psychological conditions

What can be done to prevent the condition?

Prevention depends on the underlying cause of the chest pain. For example , avoiding overexertion can prevent muscle strain.

How is the condition diagnosed?

Individuals can determine for themselves that they have chest pain. It is the healthcare provider’s job to find the cause of the pain. The provider will perform a physical examination and take a medical history. Sometimes the cause of the chest pain can be uncovered from this alone. Further testing may be ordered based on the history and physical. This may include chest  x-rays, blood and urine tests, and heart tracing called an electrocardiogram (ECG).

What are the long term effects of the condition?

The long-term effects are related to the underlying cause of the chest pain. For example , a heart attack may result in heart failure or death. The pain itself may cause discomfort severe enough to prevent sleeping and other activities.

What are the risks to others?

Chest pain itself poses no risks to other. However, a person’s chest pain may be due to a contagious infection such as pneumonia.

What are the treatments for the condition?

Treatment is directed at the underlying cause of the chest pain. For example, a person with an infection such as pneumonia is treated with antibiotics. A person with aortic dissection may need surgery. Pain medications can be given to control pain. In some cases this is the only option since the surgery. Pain medications can be given to control pain. In some cases this is the only option since the underlying cause cannot be treated. An example of this situation would be a person with chest pain due to lung cancer. Pain medications such as no steroidal anti-inflammatory drugs and narcotics may be ordered.  

Hope you liked this article!

This article is written by Dr. Bimal Chajjer (Delhi’s best doctor for heart)