Dealing with chest pain
Tessa is a 22-year-old university student who says she walks from a nearby community to her classes every day. Recently, she has been experiencing chest pain which, sometimes, is very bad. It affects her when she moves in some positions and sometimes even when she breathes. She visited her campus doctor, who told her she had strained her chest and also that she might be a little anxious. Tessa asks Check Up, 'what about my heart?' The doctor requested an ECG heart test almost as an afterthought!
Well, chest pain is always alarming and we all tend to become concerned about our hearts which occupy centre stage in the chest area. Chest pain is one of the symptoms of heart disease, so the heart can never be ignored when chest pain occurs. But sometimes doctors' examination will lead to one of the other causes of chest discomfort which commonly occur. The majority of cases of chest pain will occur due to some cause outside of the heart. Indeed, chest pain is a fairly common symptom of panic disorder, and people experiencing a panic attack may very well feel they are experiencing a heart attack due to breathlessness and chest pain which can occur and even seem severe.
Cheat pain can be 'cardiac' or 'non-cardiac'. Cardiac (heart) pain occurs due to a lack of oxygen reaching the heart muscles because of a diminished blood supply to the area.
A non-cardiac cause of chest pain commonly experienced is the chest 'burn' of acid reflux, where the gastric acid from the stomach is either overproduced or flows backwards through a leaking stomach sphincter (valve). This also can also occur due to worry and stress and be contributed to by bad eating habits. Non-cardiac chest pain is commonly related to anxiety, resulting in a piercing or stabbing sensation to the chest wall. It is pretty common for people undergoing these symptoms to even visit the accidents and emergency department of hospitals in fear for their lives!
Anterior chest wall pain can also occur due to muscle inflammation of the anterior chest wall. This often occurs at the costo-chondral or costo-sternal junction, which is the area where the ribs attach to the sternum. The pain often stays to just one area, the left side of the chest, near the left border of the sternum, and sadly, near the heart, thus often causing confusion.
Costochondritis and chest wall muscle strain can become chronic if the causative agent is not removed. The chronic carrying of knapsacks over one shoulder, carrying around a too-heavy burden of books, lifting a too- heavy baby every day, or a sudden jerking movement of the chest wall while playing a sport, can all result in chest wall muscle strain, which will not heal until the hurtful stimulus is removed. Also, as the chest wall muscles are used to help with breathing, they can never truly rest and this can sometimes hinder a quick resolution of chest wall muscle strain. This chest pain worsens with exercise or activity. Sneezing, coughing or taking a deep breath can also exacerbate this pain. This condition is also occurs commonly in people with Fibromyalgia.
So Tessa, don't worry too much. Allow your doctor to complete his investigations in a timely manner. In the interim, muscle relaxants and anti-inflammatory drugs can be taken and heat applied to the painful region to help relax the injured muscles. If acid reflux is a component or stress, then taking antacids, H2 receptor antagonists and proton pump inhibitors (Dica, Maalox, Federgel Tums, Zantac, Nexium, Omeprazole, etc) and learning how to relax and de-stress, will result in a more rapid resolution of the chest symptoms.
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