chest pain

Chest pain can be from a number of causes (both dangerous and other) but it is important that we rule out things that are dangerous.  For instance, you can use what the symptoms of a heart attack are to see if you may be suffering from one.  However, always seek professional help if you are concerned as dangerous causes of chest pain can often present atypically (and some patients, especially women, may have almost no symptoms).

Dangerous causes of chest pains include:

  • Heart attacks (or Myocardial infarction, abbreviated as “MI”):  A problem where a blood vessel supplying the heart gets blocked resulting in damage to the heart muscle.
  • Pulmonary embolism:  a clot in an artery going to the lungs.  Results in symptoms like shortness of breath, fast heart rate, passing out (syncope).
  • Esophageal rupture:  a perforation of the esophagus (the tube that takes food from mouth to the stomach).   This can happen with severe vomiting and with certain patients that have liver problems.
  • Aortic Dissection:  a perforation of the main artery that comes out of the heart to supply the rest of the body.  This is a fatal condition that often requires immediate surgery (type A dissections).
  • Coronary Dissection:  a perforation of a blood vessel supplying the heart muscle.
  • Lung collapse:  a part of the lung collapses (like a balloon that pops).  This impairs oxygenation of blood.
  • In-stent thrombosis:  a previously deployed stent gets blocked (can happen if patient is not compliant with their medications or dual anti-platelet therapy such as with aspirin and plavix).

Other causes include:

  • Pneumonia
  • Gastroesophageal reflux disease or GERD:  gastric (stomach) acid contents regurgitate up the esophagus to cause symptoms of chest pain that are very similar to a heart attack.
  • Esophageal Vasospams
  • Musculoskeletal

GERD

 

Chest pain symptoms from a heart attack can be very similar to something benign like GERD.  Both can present as intermittent pain that comes and goes.  With both GERD and Cardiac related pain, you can have chest pressure sensation after eating.  After you eat, there is more blood flowing to the gut and less to heart muscle.  This leads to cardiac angina.  Similarly, with GERD, you have discomfort from food contents regurgitating up through a relaxed lower esophageal sphincter.  This leads to the GERD-related pain.  With cardiac related pain, the pain may be worse with exertion (again less supply than is needed for the heart muscle when exercising).

 

 

Certain tests (like a stress test) can be done to determine etiology of the chest pain.  Sometimes, your doctor may do a trial of a PPI (a proton pump inhibitor) to treat the gastric acid related pain.  If your symptoms resolve, then most like the pain was from GERD.

Dr. Saifullah Nasir is experienced in treating and managing all of the above conditions and can assist you in avoiding needless procedures.  We have offices in Chicago and suburbs.