Chest pain overview
|
Chest pain Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Chest pain overview On the Web |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Causes
There are many organ systems, that when affected, can lead to the symptoms of chest pain. The most common organs involved are the heart, lungs, and the digestive system. Psychiatric disorders, can also lead to the perception of chest pain. The most important facet of diagnosis is distinguishing the life-threatening causes of chest pain, to the more benign causes.
Differential Diagnosis
There are several life-threatening causes of chest pain which need to be evaluated for first, which include; myocardial infarction, aortic dissection, esophageal rupture, pulmonary embolism, and tension pneumothorax. The other possible causes of chest pain can be evaluated for by carefully assessing the nature of the pain, and obtaining a thorough patient history.
Diagnosis
History and Symptoms
The symptoms of chest pain can help to discern whether there is an underlying cause that may be dangerous. Symptoms that should cause alarm are; chest pain radiating to the back (aortic dissection), left arm or jaw pain, nausea, vomiting, lightheadedness, and anginal pain that is different from baseline (myocardial infarction). Pain that is reproduced with palpation, greatest in the abdominal region, radiating to lower extremities, brought on by inspiration, or brought on my movement or postural changes, is less characteristic of myocardial ischemia.
Physical Examination
Physical examination should focus on evaluating for the life-threatening causes of chest pain first. A complete physical exam should be done, which includes a thorough cardiac, lung, and abdominal exam.
Treatment
Medical Therapy
Surgery
Surgery may be indicated in the setting of an MI (angioplasty) or in an aortic dissection.