As I promised...

First I have to say sorry. Later, went 24 hours later. So as I promised, I’ll post something about chest pains. Well, recently a very good friend, with the same age of mine, asked me about chest pain. I was surprised because chest pains on our age is a little bit suspicious. Before I start differentiating we have to define some things such as:

Radiation – pain or tenderness moving from a location to another.

Aggravating factors – any factor that may increase or worsen the pain; also called precipitatingfactors

Angina - painful constriction or tightness somewhere in the body particularly

Angina pectoris which is chest pain due to lack of blood supply in the heart muscle.

Pleura – a membrane that surrounds the lungs

Pericardium - double-walled sac that contains, covers and protects the

heart


*pictures are taken from 20th U.S. edition of Gray's Anatomy

Reflex/ reflux – reversion of gastric substances especially gastric acid due to insufficiency of valves that separates esophagus to stomach

We now go to differentiating chest pains as to aggravating factors, quality, radiation severity and timing. Differentiating factors, quality and radiation may help you diagnose what type of chest pain

For Heart…
Angina Pectoris
Aggravating factors – physical exertion in cold, meals, emotional stress
Quality – pressing, squeezing, tight and heavy
Radiation – from sternum radiating to arms, shoulder, teeth and jaw
Severity – mild to moderate
Timing – 1-3 mins upto 10 mins

Myocardial Infarction (MI)
Aggravating Factors - -
Quality – same as angina
Radiation - same as angina
Severity – severe pain
Timing – 20 mins to several hours

Pericarditis
Aggravating Factors – breathing, changing position, coughing, lying down, swallowing
Quality – sharp and knife-like
Radiation - tip of the shoulder and neck
Severity – often severe
Timing - persistent

For Pulmonary (pleura, lungs, bronchioles, trachea)
Tracheobronchitis
Aggravating Factors – coughing
Quality - burning
Radiation - upper sternum or on its either sides
Severity – mild to moderate
Timing – variable

Pleural Pain
Aggravating Factors – breathing, coughing and trunk movements
Quality – sharp, knife-like
Radiation - confined to a single position usually at the bases of the lungs (lowest part of lungs)
Severity – often severe
Timing – persistent

For Gastrointestinal Tract (only involves esophagus)
Reflex Esophagitis
Aggravating Factors – hunger, stress or foods (spicy, sour, coffee and alcohol)
Quality – burning and squeezing
Radiation – may radiate at the back portion of the upper trunk
Severity – mild to severe
Timing – variable

Others
Anxiety
Aggravating Factors – unclear
Quality – stabbing, sticking, dull and aching
Radiation – to left breast or anterior chest
Severity – variable
Timing – hours to days

So, there you have it. These are the usual causes of chest pain but there maybe other more indications. Now if you’ve been experiencing one of this, I advise you to immediately visit a doctor especially a cardiologist. This is just a type written reviewer I made and just decided to share it. I’ve been experiencing reflex esophagitis since my Medical Technology internship days; I hope this is nothing but most books I read said this maybe a precancerous. So konting ingats lang tayo! And if you are feeling something unusual or atypical in you, not just a chest pain, see a doctor immediately, so you'll get the right medication and get proper care. Mahirap magkasakit!