Chest pain

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[UPDATED MAY 2022]

This symptom always needs to be taken seriously and any sufferer should be seen and assessed by a doctor.

  • Angina - pain which is a symptom of heart disease. Angina is classically felt in the middle of the chest, behind the breast bone and is variously described as crushing, squeezing, tightening or "pressure, like a weight". It may also go across the chest, typically into the left arm, but can be felt in the shoulder, neck and sometimes lower jaw. It is typically brought on by exercise, emotion and cold weather. It is relieved by rest. Angina may be caused by poor blood supply (see Arteriosclerosis - what causes it and how to prevent it), mitochondrial failure (see CFS - The Central Cause: Mitochondrial Failure), heart dysrhythmia, valve problems, anaemia.
  • Pericarditis - this is uncommon. Usually a burning pain, sometimes occurring with each beat of the pulse, sometimes relieved by leaning forwards, worsened by swallowing.
  • Viral infection - 'flu like illness often cause myalgia (muscle pain). There are muscles between the ribs which can be affected to cause chest pain. A particularly severe variant is called Tietze's syndrome.
  • Lung disease - classically one gets pleuritic pain - the pain is felt every time one takes a deep breath, and is sharp, "like a knife". However any infection of the lung can cause chest pain or discomfort.
  • Bronchitis - causes a "raw" sensation behind the breastbone worse with breathing and coughing.
  • Inflammation of the oesophagus - oesophagitis. This is felt as a burning type pain behind the breastbone. Often worsened by hot or spicey foods, relieved by milk or antacids, worse lying down.
  • Gastritis - inflammation of the stomach. Again this can be felt as a burning type pain behind the breastbone. Often worsened by hot or spicey foods, relieved by milk or antacids. *
  • Pesticide poisoning - many of my patients complain of chest pain, not due to angina. I do not know why they get chest pain.
  • Hyperventilation can certainly cause chest pain. During a panic attack sufferers often hyperventilate and experience chest pain. See Hyperventilation - makes you feel as if you can't get your breath
  • Trauma - this is usually obvious - bruised or broken ribs, muscle stain etc..
  • Shingles - this viral infection of a nerve root can cause chest pain before the rash appears if one of the nerves to the chest wall is affected.
  • A "stitch" - thought to be due to cramp of the diaphragm. Usually caused by exercise. Can usually be relieved by standing bent over for a minute or two. Sometimes bought on by hyperventilation.
  • Allergies - can certainly cause chest pain

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