Description

The major organs in the chest are the heart and the lungs, supported by the chest wall, sternum (breast bone), rib cage, and the spine. Any of these could be the source of your pain. However, not all chest pains are due to structures or organs in the chest. Other organs such as the gallbladder, stomach, or kidneys may be the source of your chest pains and are often termed "referred pain."

Therefore, it remains difficult to determine the cause of chest pain without an assessment by a physician or medical provider, and having appropriate testing performed. You will be better prepared to assist your physician in determining the source of the chest pain by carefully considering the answers to the following questions.

Classical verbalization of heart related chest pain include

• heaviness
• crushing
• tightness
• elephant sitting on my chest
• my bra is too tight
• pain going up into the neck or down the arm
• inability to breathe
• lightheadedness
• palpitations

As a caregiver, recognizing non-verbal signs of chest pain is important.

Classical non-verbal signs for heart related chest pain include

• fist clutched against the lower part of the breast bone
• difficulty breathing
• not being able to lie flat
• nausea
• sweating
• pale color
• confusion
• look of fear
• agitation and restlessness
• grimacing

• not taking in deep breaths
• holding still
• not wanting to be moved
• not eating

Questions

• How would you describe the chest pain?
• What activity was occurring when the pain started?
• Does the pain occur at rest?
• Does the pain worsen with deep breathing or coughing?
• When did the chest pain start?
• How often does the pain occur, and how long does it last?
• Does the pain stay at the same intensity, frequency and last the same amount of time?
• Are there any other symptoms occurring at the same time?
• Does the pain awaken you from sleep?

• Is the pain associated with eating? Does fatty or spicy food make the pain worse?
• What makes the pain better? What makes the pain worse?
• Is there any fever or cough?
• Does the chest pain prevent normal activity levels?
• Has there been any recent injuries/falls?
• Is there a history of back problems?
• Are there any rashes occurring on the back or chest?
• Is there a pattern of indigestion or heart burn?
• Are there any problems with urination? History of kidney stones?
• Is there a family history of aneurysms?

Important Points to Consider

• Chest pain due to heart related conditions can be life threatening, and require immediate medical attention. After having a heart attack, patients often recognize as an "after the fact" that they were experiencing warning symptoms.
• A heart attack causes irreversible damage to the part of the heart affected. The goal of treating coronary artery disease is to prevent actual injury to the heart muscle itself. Modern technological advances can result in better outcomes and quality of life if chest pain is appropriately recognized and diagnosed.
• Preventative care is the key to good health. Having routine health maintenance visits with a physician or medical provider is essential. Risk factors for heart disease includes: high blood pressure, poorly controlled diabetes, high cholesterol, obesity, lack of exercise, smoking and family history of heart disease. Life style choices are important to consider.
• Causes of chest pain not due to heart disease may also require an emergency visit. These conditions include thoracic aneurysms, pulmonary embolus, and trauma to the chest. Other causes of chest pain may not need immediate attention but should never be ignored.

Proper diagnosis and treatment of chest pain, regardless of the source, is the goal.

Related topics

Observing and Reporting Pain
Managing Pain
Managing Chest Pain