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What are the common causes of chest pain

Author:Dr.Liu Haixia


1. Aortic dissection

Aortic dissection is a very dangerous condition. More than 80% of people with this condition have high blood pressure and often have poor blood pressure control. The chest pain caused by aortic dissection is severe, like a knife cutting, oftenaccompanied by profuse sweat. The rupture of the aortic dissection can quickly lead to shock and death.

2. Acute coronary syndrome

When the coronary artery spasm or infarctionhappens, it will cause acute myocardial ischemia or myocardial infarction. The chest pain manifested as post-sternal compression pain, often accompanied by chest tightness. The pain can be radiated to the left shoulder or arm, sometimes may be manifested as mandibular or abdominal pain. Chest pain usually lasts for a few minutes in angina attacks and can be relieved with rest or sublingual nitroglycerin. Chest pain is severein acute myocardial infarctionand may last for a long time, often accompanied by profuse sweat, chest tightness, and short of breath. These symptoms can not be effectively relieved with sublingual nitroglycerin. This kind of situation is very critical, patient should be admitted to hospital as soon as possible.

3. Pulmonary embolism

Pulmonary embolism is prone to the following conditions: venous thrombosis in lower limbs, long-term bed inactivity, post-operation, fracture, malignant tumors and oral contraceptives.Patients with pulmonary embolism have chest pain, chest tightness, suffocation, dry cough and other symptoms. Some patients may have hemoptysis, decreased blood pressure, breathing, increased heart beats. Some patients with less chest pain maybe easily missed the diagnosis.Embolism occurredin the main pulmonary artery is very dangerous which can lead to death.

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4. Spontaneous pneumothorax

Spontaneous pneumothorax is more common in thin and tall healthy young peopleand patients with chronic lung diseases, and often occurs in exertion, breath holding, strenuous activity or cough suddenly. The symptoms of spontaneous pneumothoraxare chest pain, chest tightness, suffocation. The chest pain is usually on one side. If the thin and tall young people suddenly appear the above situation, it is necessaryto see a doctor in time.

5. Lung cancer

patient with lung cancer can have chest pain, irritant dry cough, chest tightness, shortness of breath and even hemoptysis.

6. Pneumonia, Pleurisy

The patient with pneumonia or pleurisy usually has a recent history of upper respiratory tract infection. The chest pain would get obvious with cough or deep inhalation. Patient usually has fever, cough, expectoration, chest tightness, shortness of breath. Anti-infective drugs can alleviate the symptoms.

7. Acute pericarditis

The chest pain caused by acute pericarditis is usually accompanied by fever. The pain is located in the anterior heart area or after the sternum, which can be radiated to the neck, left shoulderand left arm. The degree of the pain varieswhile inhalation or cough. More pericardial exudate may result in dyspnea, while the chest pain may be relieved.

8. Reflux esophagitis

The chest pain caused by reflux esophagitis isa kind of burning pain behind the sternumand can be accompanied by acid reflux, heartburn, nausea. It happens more frequent in the supine position after full meal , bending or while sleeping.

9. Intercostal neuralgia

Intercostal neuralgia is a needle-like pain in the chest or back. It is recurrent and lasts for a few seconds or minutes. The pain can be relieved spontaneously.

10. Costal chondritis


The chest pain caused by costal chondritis is usually in the second to the fouth rib cartilages near the sternum , and most often occurredin the second rib cartilage unilaterally or bilaterally. The affected costal cartilage may be swelling locally,and the pain maybe dull or sharp. There is tendernessof the affected costal cartilage, and the skin may have redness changes. Sometimes there is pain in the back corresponding to the chest.

11. Herpes zoster (Shingles)

Herpes zoster can cause over sensitive or neuralgia of the chest or waist skin. The local skin has obvious tenderness. The pain is generally on one side of the body, and rarely cross the sternumor the spine, and usually be accompanied by a cluster of millet size red papule blister-like rashes.

12. Cardiac neurosis

The chest pain is often located in the apical area and the left breast area, tingling or dull, lasting for a few seconds or hours, and often accompanied by chest tightness, shortness of breath, palpitations, or insomnia. Chest pain isoften triggered by tensionor exciting, and has nothing to do with physical activity, but often occurred while resting. Activity or transfer of attention may reducethe pain.

13. Hysteria

Intense mood fluctuations may induce the shortness of breath, followed by severe chest pain, numbness of hands, convulsions. The chest pain can be significantly relieved after controlling the breathing rate and doing deep inhalation.

Patient with chest painshould be on close observation and be taken care of especially when the pain is severe and with no remission.For patients with chest pain, doctors will give detailed consultation, physical examination ,relevant testsand examinations in order to make clear the underlying causes of chest pain and correspondingly give appropriatetreatment for it.