Chest Pain

GENERAL DESCRIPTION 

Chest Pain is a pain often referred to the anterior portion or inside the Thoracic Cavity. It is a symptom of many disease conditions that are mostly serious. It is generally considered a medical emergency. It is mostly related to the Heart, Respiratory System or Gastrointestinal System.

DIAGNOSTIC APPROACH 

• First of all history is taken from the Patient. It helps in ruling out underlying serious illness. It also narrows down the associated diseases as we come to know different risk factors like smoking, diabetes etc.
• Physical Examination is the next step. After taking consent patient he is thoroughly examined. ECG of the patient is done at intervals to rule out serious Cardiac illness as it may be serious.
• After complete examination a number of laboratory test can be advised according to the findings. For e.g. If related to the Heart, test related Heart enzyme levels (CK-MB, troponin I etc.), Echocardiography, and if its related to Respiratory Tract, Laryngoscopy (examination of larynx) and Chest X-ray and sputum culturing can be done. If related to GIT, Endoscopy (internal examination by an endoscope), Ultrasound, CT scan can be done.

DIFFERENTIAL DIAGNOSIS 

Chest Pain can occur because of a number of reasons. They are given below separately according to the systems involved.

• Cardiovascular :

  • Acute Coronary Syndrome

  • Aortic Dissection

  • Pericarditis

  • Arrhythmia

  • Dysfunction of Valves

• Respiratory System :

  • Bronchitis

  • Pneumonia

  • Lung Cancer

  • Tuberculosis

• Gastrointestinal System :

  • Hiatus Hernia

  • Achalasia

  • Functional Dyspepsia

  • Gastroesophageal Reflux Disease (GERD)

• Others :

  • Panic Attack, Anxiety, Hypochondria etc.

  • Chest wall problems, Spinal Nerve problems, Breast abnormality, Osteoarthritis

  • Sarcoidosis, CO poisoning, Lead poisoning etc.