Chest Pain: Find Out The Cause Article and Video By Dr. Willie T. Ong (Internist and Cardiologist) To help diagnose the possible cause, here is a guide using the mnemonic PQRST: P -- Provokes. If the pain occurs with deep breathing, then the problem could be in the lungs. If the pain occurs with movement of the chest, then it could just be a minor chest wall pain. However if the pain occurs with exertion, such as after climbing a flight of stairs, then it could be coming from the heart. Q - Quality. Is the quality of the chest pain pricking in character? If so, then its probably harmless. If its a burning acidic sensation, then it could be hyperacidity. But if its a heaviness, like someone placed a heavy bag on your chest, then this could be heart pain (called angina). R - Region. Where is the pain located? If its in the right side of the chest, it is usually harmless. If its in the left or far left area, then its also probably benign. But if its in the center or slightly below the rib cage, then it could be from the heart. Another tip is to ask the person to use one finger to point exactly where the pain is located. If the person can point to a specific area, then this pain is NOT coming from the heart. Heart pain is deeper, more generalized and cannot be located at one point. S -- Severity. How bad is the pain? Usually, the more severe the pain, the more serious it is. T- Timing. The usual duration of pain coming from the heart is between 5 to 15 minutes. Check For Risk Factors: If the patient is young (below 25), looks healthy and can go about his or her daily activities, then the chest pain is probably benign. However, if the patient is an older man (especially 50s and above), a smoker, and has medical conditions (like high blood pressure, high cholesterol or diabetes), then we should carefully investigate for heart disease. Non-heart Causes of Chest Pain: 1. Harmless chest wall pain -- The cause is unclear but may be due to anxiety and stress. No treatment is necessary, just reassurance to the patient. 2. Minor chest injury -- Some people have a minor injury (like a strain) on the rib cage. This can be due to exercise, unusual sleeping position or frequent coughing. Again, no treatment is necessary. 3. Lung causes such as pneumonia and asthma -- Treatment is towards curing the primary lung problem. 4. Gastritis and peptic ulcer -- Too much acid from the stomach can occasionally regurgitate upwards towards the esophagus. This typically causes a burning pain at the middle to lower chest area. More Serious Causes: 1. Coronary heart disease --Angina is the term used to describe chest pain arising from the heart. Angina occurs when the heart muscle lacks oxygen because of clogged arteries. If left untreated, this can lead to a heart attack. Initial tests to rule out coronary heart disease include a (1) ECG, (2) 2D-Echocardiogram, and (3) Treadmill Exercise Test for selected patients. See your doctor. 2. Aortic dissection -- The chest pain is typically described as severe, tearing and can be felt penetrating to the back area. Aortic dissection is a medical emergency. When To See A Doctor: Based on our description above, you should be more concerned about chest pain if (1) the symptoms are suggestive of coronary heart disease and (2) if you have some of the risk factors for heart disease (older age, smoker, overweight, etc.). Good luck. ~ myxpress-online.net
Posted on: Wed, 20 Aug 2014 04:52:42 +0000
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