Description

Chest pain has many causes. You will need to see your medical provider to determine the cause (diagnosis) of your chest pain. Some causes of chest pain carry the potential for sudden death or rapid decompensation such as angina (coronary artery disease), heart attack (myocardial infarction), thoracic aneurysms, blood clot to the lung (pulmonary embolism) or any recent prior traumas (car accident or falls with the potential of puncturing the lung).

There are many other causes of chest pain which require constant monitoring or reevaluation by your medical provider. Until a diagnosis with an effective treatment plan is developed, do not ignore your pain or assume that medical follow up is no longer necessary. Additionally, there are other causes of chest pain which are due to chronic conditions which may cause distress, but can be effectively managed with medication and routine follow-up visits; such an example would be arthritis.

Once the cause of your pain has been determined, discuss with your medical provider how to use any medications ordered correctively and effectively. You will need a clear understanding of what activities cause or intensify your pain, and what is/are the best way/ways to prevent or relieve your pain.

Helpful tips

Chest Pain Due to Heart Disease (Coronary Artery Disease or Myocardial Infarction)

• Each person experiences heart related pain differently, for example women tend to describe their angina as epigastric pain (pain in the pit of their stomach along with nausea). Just because you do not experience pain in the same way as someone else does not mean that you do not have angina. Establish the correlation that your particular symptom (or group of symptoms) is how you monitor your chest pain.
• Understanding the pattern and progression of your chest pain allows you to intervene appropriately as directed by your medical providers treatment plan (ie: rest, take medications, calm down emotionally or utilize oxygen.)
• Activities or stressors (such as emotional upset) that routinely bring on chest pain may require medication prior to the activity-discuss this with your medical provider.
• Medications commonly prescribed for angina (chest pain) may lower your blood pressure resulting in lightheadedness and possibility of falling when standing. Change position from lying or sitting to standing, slowly.
• If your pattern of chest pain is occurring more frequently, does not respond to the interventions as before, intensifies, or awakens you from a sound sleep, you must seek medical attention immediately. (It may be appropriate to call an emergency number such as 911.)
• Risk factors which impact Coronary Heart Disease include: high blood pressure, Diabetes, smoking tobacco, high cholesterol and high triglycerides, along with family history. Controlling your blood pressure, blood sugar, cholesterol and triglyceride levels as well as smoking cessation, will be helpful. Develop and follow a treatment plan with your medical provider.
• The heart is also a muscle. Exercise and staying fit will benefit the heart muscle just as any other muscle of the body. Activity tolerance needs to be discussed with your medical provider. If the prescribed activity level causes new or worsening chest pain, stop those activities and follow up with your medical provider.

Chest Pain Due to Thoracic Aneurysm

• If you have a known thoracic aneurysm, it is extremely important to adhere to the medical treatment plan which is designed to maintain a lower blood pressure and minimize the risk of rupture. Medications should be taken as prescribed and doses should not be missed.
• Sudden severe chest pain in people who have a diagnosis of thoracic aneurysm may constitute a medical emergency-preplan with your medical provider the steps to be taken if this should occur.

Chest Pain Due to Pulmonary Embolism (Blood Clot to Lung)

• The most likely causes of Pulmonary Embolisms include: known Deep Venous Thrombosis (blood clots in the extremities), underlying Cancers (known and undiagnosed) or Blood Disorders (that increase the tendency of blood to clot.)
• Sudden severe chest pain associated with severe respiratory distress in people who have the above pre-disposing illnesses which can cause pulmonary embolism, constitutes a medical emergency. Seek emergency help immediately (call 911 if available in your area.)
• Medications prescribed for the Treatment of Pulmonary Embolism are blood thinners. It is essential that you fully understand and take the medications as prescribed along with lab work as ordered by your medical provider. If your blood is not thin enough, recurrent blood clots are likely to occur. If your blood is too thin, may result in catastrophic problems such as bleeding in the brain or gastrointestinal bleeding.

Chest Pain Due to Traumatic Injury

• Any trauma requires a medical evaluation for the extent and severity of injuries. Remember that any fractures, including those of the chest wall, may not be visible immediately on x-rays. If a fracture of the rib is present, it may result in puncture of the lung, causing an air leak which is considered an emergency situation; seek appropriate emergency help (call 911 if available in your area.) Continued or worsening chest pain especially if associated with shortness of breath, will require medical re-evaluation.
• Trauma can also result in soft tissue injury and pain. Seek medical care and follow the prescribed treatment plan.
• In people who have had trauma to the chest without displaced factures, holding a pillow to the chest wall when taking a deep breath or with coughing may be helpful in managing pain. Consider taking pain medication prior to any activity that causes or increases pain.

Chest Pain Due to Chronic Conditions (Arthiritis)

• Chronic Arthritic conditions, while not life threatening, cause pain which may be much harder to deal with. Living with chronic chest pain is a very real challenge and will require long term symptom management and episodic modification of the plan of care by your medical provider. There is no cure. Treatment is designed to manage symptoms.
• Other modalities of treatment include: application of heat, topical arthritic preparations, massage, and acupuncture.
• Lifestyle modifications may be necessary (i.e.: relocation to warmer climate, job modification)

Discussion

If you are a caregiver for a person who is unable to verbally report their symptoms of chest pain, you will need to observe them for nonverbal signs of pain or distress. Pay close attention to any pattern or progression of pain as described above. You will also need to understand the plan of care and when to seek additional medical help. Please discuss with your medical provider when/if you will need to seek emergency help.

Just because you have been diagnosed with one cause of chest pain, does not mean that another cause of chest pain can not develop. You should not ignore what your body is telling you. It is always better to seek timely medical attention.

Related topics

Discussing Chest Pain
Observing and Reporting Pain
Managing Pain