St. Luke's Hospital
Main Number: 314-434-1500 Emergency Dept: 314-205-6990 Patient Billing: 888-924-9200
Find a Physician Payment Options Locations & Directions
Follow us on: facebook twitter Mobile Email Page Email Page Print Page Print Page Increase Font Size Decrease Font Size Font Size
America's 50 Best Hospitals
Meet the Doctor
Spirit of Women
Community Health Needs Assessment
Home > Health Information

Multimedia Encyclopedia

    Print-Friendly
    Bookmarks

    Chest pain

    Chest tightness; Chest pressure; Chest discomfort

    Chest pain is discomfort or pain that you feel anywhere along the front of your body between your neck and upper abdomen.

    Considerations

    Many people with chest pain fear a heart attack. However, there are many possible causes of chest pain. Some causes are not dangerous to your health, while other causes are serious and even life-threatening.

    Any organ or tissue in your chest can be the source of pain, including your heart, lungs, esophagus, muscles, ribs, tendons, or nerves. Pain may also spread to the chest from the neck, abdomen, and back.

    Causes

    Heart or blood vessel problems that can cause chest pain:

    • Angina or a heart attack. The most common symptom is chest pain that may feel like tightness, heavy pressure, squeezing, or crushing pain. The pain may spread to the arm, shoulder, jaw, or back.
    • A tear in the wall of the aorta, the large blood vessel that takes blood from the heart to the rest of the body (aortic dissection) causes sudden, severe pain in the chest and upper back.
    • Swelling (inflammation) in the sac that surrounds the heart (pericarditis)causes pain in the center part of the chest.

    Lung problems that can cause chest pain:

    • A blood clot in the lung (pulmonary embolism)
    • Collapse of the lung (pneumothorax)
    • Pneumonia causes a sharp chest pain that often gets worse when you take a deep breath or cough.
    • Swellingof the lining around the lung (pleurisy) can cause chest pain that usually feels sharp, and often gets worse when you take a deep breath or cough.

    Other causes of chest pain:

    • Panic attack, which often occurs with fast breathing
    • Inflammation where the ribs join the breast bone or sternum (costochondritis)
    • Shingles, which causes sharp, tingling pain on one side that stretches from the chest to the back, and may cause a rash
    • Strainof the muscles and tendons between the ribs

    Chest pain can also be due to the following digestive system problems:

    • Spasms or narrowing of the esophagus (the tube that carries food from the mouth to the stomach)
    • Gallstones cause pain that gets worse after a meal (most often a fatty meal)
    • Heartburn or gastroesophageal reflux (GERD)
    • Stomach ulcer or gastritis (burning pain occurs if your stomach is empty and feels better when you eat food)

    In children, most chest pain is not caused by the heart.

    Home Care

    Formost causes of chest pain, it is best to check with your doctor or nurse before treating yourself at home.

    When to Contact a Medical Professional

    Call 911 if:

    • You have sudden crushing, squeezing, tightening, or pressure in your chest.
    • Pain spreads (radiates) to your jaw, left arm, or between your shoulder blades.
    • You have nausea, dizziness, sweating, a racing heart, or shortness of breath.
    • You know you have angina and your chest discomfort is suddenly more intense, brought on by lighter activity, or lasts longer than usual.
    • Your angina symptoms occur while you are at rest.
    • You have sudden, sharp chest pain with shortness of breath, especially after a long trip, a stretch of bedrest (for example, following an operation), or other lack of movement, especially if one leg is swollen or more swollen than the other (this could be a blood clot, part of which has moved to the lungs).

    Your risk of having a heart attack is greater if:

    • You have a family history of heart disease
    • You smoke, use cocaine, or are overweight
    • You have high cholesterol, high blood pressure, or diabetes

    Call your doctor if:

    • You have a fever or a cough that produces yellow-green phlegm
    • You have chest pain that is severe and does not go away
    • You are having problems swallowing
    • Chest pain lasts longer than 3 to 5 days

    What to Expect at Your Office Visit

    Your doctor may ask questions such as:

    • Is the pain between the shoulder blades? Under the breast bone? Does the pain change location? Is it on one side only?
    • How would you describe the pain? (Severe, tearing or ripping, sharp, stabbing, burning, squeezing, tight, pressure-like, crushing, aching, dull, heavy)
    • Does it come on suddenly? Does the pain occur at the same time each day?
    • Does the pain get better or worse when you move?
    • Can you make the pain happen by pressing on a part of your chest?
    • Is the pain getting worse? How long does the pain last?
    • Does the pain go from your chest into your shoulder, arm, neck, jaw, or back?
    • Is the pain worse when you are breathing deeply, coughing, eating, or bending?
    • Is the pain worse when you are exercising? Is it better after you rest? Does it go away completely, or is there just less pain?
    • Is the pain better after you take nitroglycerin medicine? After you eat or take antacids? After you belch?
    • What other symptoms do you have?

    The types of tests that are done depend on the cause of the pain and what other medical problems or risk factors you have.

    References

    Anderson JL, Adams CD, Antman EM, et al. ACC/AHA Guidelines for the Management of Patients With Unstable Angina and Non-ST-Segment Elevation Myocardial Infarction: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on the Management of Patients with Unstable Angina). Circulation. 2007;116:803-877.

    Goldman L. Approach to the patient with possible cardiovascular disease. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 50.

    Sabatine MS, Cannon CP. Approach to the patient with chest pain. In: Bonow RO, Mann DL, Zipes DP, Libby P, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 53.

    Wright RS, Anderson JL, Adams CD, et al. 2011 ACCF/AHA Focused Update of the Guidelines for the Management of Patients with Unstable Angina/Non-ST-Elevation Myocardial Infarction (Updating the 2007 Guideline). J Am Coll Cardiol. 2011;57:1920-1959.

    BACK TO TOP

    • Chest pain

      Animation

    • Heart attack symptoms

      illustration

    • Chest pain

      Animation

    • Heart attack symptoms

      illustration

    A Closer Look

      Talking to your MD

        Self Care

        Tests for Chest pain

        Review Date: 6/22/2012

        Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and Michael A. Chen, MD, PhD, Assistant Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.

        The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
        adam.com

        A.D.A.M. content is best viewed in IE9 or above, Fire Fox and chrome browser.


        Back  |  Top
        About Us
        Contact Us
        History
        Mission
        Locations & Directions
        Quality Reports
        Annual Reports
        Honors & Awards
        Community Health Needs
        Assessment

        Newsroom
        Services
        Brain & Spine
        Cancer
        Heart
        Maternity
        Orthopedics
        Pulmonary
        Sleep Medicine
        Urgent Care
        Women's Services
        All Services
        Patients & Visitors
        Locations & Directions
        Find a Physician
        Tour St. Luke's
        Patient & Visitor Information
        Contact Us
        Payment Options
        Financial Assistance
        Send a Card
        Mammogram Appointments
        Health Tools
        My Personal Health
        mystlukes
        Spirit of Women
        Health Information & Tools
        Clinical Trials
        Health Risk Assessments
        Employer Programs -
        Passport to Wellness

        Classes & Events
        Classes & Events
        Spirit of Women
        Donate & Volunteer
        Giving Opportunities
        Volunteer
        Physicians & Employees
        For Physicians
        Remote Access
        Medical Residency Information
        Pharmacy Residency Information
        Physician CPOE Training
        Careers
        Careers
        St. Luke's Hospital - 232 South Woods Mill Road - Chesterfield, MO 63017 Main Number: 314-434-1500 Emergency Dept: 314-205-6990 Patient Billing: 888-924-9200
        Copyright © St. Luke's Hospital Website Terms and Conditions  |  Privacy Policy  |  Patient Notice of Privacy Policies PDF Sitemap St. Luke's Mobile