Chest pain, cause and treatment

Chest pain happens to everyone at some point. This can be temporary and caused by stress or tension. But in some cases there is more going on. For example, the cartilage, an intercostal muscle or the pericardium may be inflamed. There may also be angina or even a heart attack. The latter is often serious. More than 1/3rd of the population dies from heart disease. So chest pain is something we should take seriously.

What is chest pain?

With chest pain we feel pain in the center of the chest, on the left or on the right. A combination of these three can also be felt. The pain occurs in attacks or is continuously present. In most cases, chest pain is noticeable with exertion and is less with rest. In severe cases, the pain is also felt at rest. Chest pain should not be confused with sore breasts in women. Women who have chest pain sometimes feel the pain behind one or both breasts, but the breast and nipple themselves do not hurt.

Myocardial infarction or heart attack

When experiencing chest pain, many people fear a heart attack, also called a myocardial infarction. In many cases this fear is unfounded. However, chest pain can sometimes be a precursor to a heart attack or even mean a heart attack. A heart attack never just happens. There is a long process that precedes it, which people often don’t notice. Certain factors such as diet or smoking can cause blood vessels to clog. This is called arteriosclerosis and is often caused by high cholesterol, nicotine, glucose or high blood pressure. Due to inflammation of the vessel walls, plaque is formed on the vessel wall. Later, lime is deposited on this. Over the course of many years, more and more limescale deposits can occur. The artery becomes narrowed. Because the vessel wall has become stiff due to calcification, it can tear. Blood comes into contact with the plaque, resulting in a blood clot. These blood clots can break loose and travel to the coronary arteries. The heart no longer receives oxygen and will die. That’s a heart attack.
During a heart attack there is pain in the center of the chest. This pain can radiate to the shoulder and arm, usually on the left side. People have often had previous stomach complaints. During a heart attack, stomach pain or pain in the back or jaw may also occur. The pain lasts longer than 5 minutes and also occurs at rest. Sweating often occurs and the patient becomes nauseous or vomits. Breathing may be accelerated or there may be shortness of breath. There may be a feeling of heaviness in the chest, as if a band is tight around the chest. Women in particular have a period of extreme fatigue or a restless feeling beforehand. A heart attack is not always fatal when intervention is performed: in 1 in 3 cases it ends fatally. A patient having a heart attack needs to go to the hospital as soon as possible. There you can try to dissolve the blood clot with medication. Angioplasty or surgery are also used.

Angina pectoris

Angina pectoris is not the same as a heart attack. although the symptoms are the same. Here too, chest pain occurs, often in the center and sometimes slightly to the left. There is a tight feeling in the chest and shortness of breath and shortness of breath may occur. The pain disappears when the body no longer needs extra oxygen. The cause is a narrowing of the coronary arteries, which means that the heart muscle receives less oxygen. Angina pectoris often occurs during exertion or stress. Treatment consists of reducing exertion and stress, lowering blood pressure or dilating the vessels.

Tietze syndrome

With this disease there is chest pain that can be precisely identified. This is in contrast to a heart attack, where the pain cannot be precisely localized. The pain mainly occurs during actions such as laughing, sneezing, coughing, lifting or bending. When resting, the pain is absent or much less. Sometimes the pain also occurs in a certain lying or sitting position, when the chest is somewhat collapsed or compressed. Sometimes a red and warm swelling can be seen on the chest itself. The cartilage of the chest is inflamed. Treatment is often difficult. The inflammation can occur in phases with symptom-free periods. Sometimes the complaints disappear again, sometimes they remain present for a lifetime.

Inflamed intercostal muscle

Something that often occurs and sometimes takes a long time to fully recover: an inflamed intercostal muscle. There are muscles between the ribs that connect the ribs together and provide mobility. Sometimes an intercostal muscle can become inflamed due to prolonged irritation. Pain is palpable in the chest, often clearly visible. When multiple intercostal muscles are inflamed, the location is often more difficult to pinpoint. The pain worsens with exertion or a certain position. Treatment consists of rest and sometimes painkillers. The inflammation will disappear on its own, but can sometimes take months to years.

Other causes of chest pain

Chest pain can have a variety of causes. A number of them have already been mentioned above. Other causes may include:

  • Stress and panic causes a tight feeling, shortness of breath and chest pain.
  • Chronic bronchitis: pain in the lungs that is felt just behind the breastbone.
  • Coughing a lot, causing the sternum to become overloaded and irritated.
  • An inflammation in the heart such as an inflamed pericardium, the heart valve or the inner wall of the atria and chambers.
  • Hyperventilation, which causes too deep breathing and often causes panic.
  • Damage to the large arteries, especially the coronary artery.
  • Pectus or chicken breast, or other abnormality or deformity of the chest.
  • Stomach complaints causing pain to travel towards the sternum.
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