in this article:
Acid reflux is not popularly called ‘heartburn’ for nothing: although the original regurgitation of acid from the stomach has nothing to do with the heart, in a limited number of cases the symptoms of increased gastric acidity and heart pain overlap, creating dangerous ambiguities. The present piece deals with differentiation of acidity and cardiac symptoms to show you how to tell the two conditions apart and act accordingly in each situation.
Heartburn or heart attach?
It is not always easy to distinguish a strong heartburn from a heart attack. Various gastrointestinal disorders (such as gastroesophageal reflux, ulcers, esophagus muscle spasms, pancreatitis) may cause chest pain and other symptoms similar to those related to heart attack or anxiety. Heartburns, moreover, is one of the symptoms with which a heart attack may occur. The ambiguity of the symptoms is due to the lack of clarity of the signal on the origin of the pain that the nerves of the heart and stomach enter into the brain.
What are the symptoms of heartburn?
Heartburns is a feeling of discomfort or pain that from the upper part of the abdomen ascends to the chest and often manifests itself after eating or after lying down or bent. It can accompany a bitter taste in the mouth – due to gastric acid dating back to the esophagus – and to regurgitation phenomena. Heartburns may also occur at night with sleep disturbances and awakenings, especially if no more than two hours have elapsed between the end of the meal and sleep.
What are the symptoms of heart attack?
Heart attack, in most cases, occurs with sudden chest pain and difficulty breathing. Symptoms may, however, vary from person to person, and even heartburn can be counted among the signs of a heart attack.
The characteristic symptoms are:
- Feeling of pain, pressure or crush on the chest or arms, which can extend to the neck, jaw and back.
- Nausea, indigestion, abdominal pain and stomach burns.
- Shortness of breath
- Sudden drowsiness
What to do if you feel chest pain?
It is good to go to first aid if you feel a sudden and overwhelming chest pain, increased sweating, pallor and weakness. Just look at your doctor before a chest discomfort that tends to improve or disappear while at rest. However, further examinations may be required to identify any heart problems.
Other possible causes of chest pain
Sometimes, however, the discomfort associated with a burning sensation in the chest is caused by something totally different than the two conditions we talked about in the previous paragraphs. Read on to learn about them.
Anxiety is a very common condition in people with periods of severe stress. In these cases, the subject, in a state of particular tension, contracts the muscles continually, and this leads to an annoying feeling of tension, pain and burning in the chest. These symptoms, in turn, in an anxious subject, are very easy to feed the fear of being a heart problem, further creating stress and boosting muscle contraction.
These episodes affect the chest musculoskeletal structures and the patient-related sensation is somatic pain, so well-located at one point. The burning sensation can easily join the sensation of intercostal pain on a coast fracture, muscular stretching or even cost-scarring, i.e. a cartilage-related inflammation that connects the ribs to the sternum.
Growth of the uterus in the abdominal area exerts pressure on the stomach. This condition favors the passage of the gastric juices to the esophagus, thus creating an esophagitis, condition that typically manifests giving heartburn to the chest in the central area.
In this set there are a multitude of disorders and pathologies that constitute one of the major causes of heartburn and chest pain. Stomach acidity: a condition also known as pyrosis, is very common and does not have to be particularly anxious if it occurs sporadically. In any case, it is always good to talk to your GP.
In this pathology, there is an increase in the production of gastric acid following an abundant meal or after ingestion of particular foods such as tomato, chocolate, tea, coffee, citrus, fatty and fried foods. This increase in acidic substances produced affects the esophagus leading to a state of inflammation (esophagitis) which manifests itself as a strong sense of burning and constraining the chest;
Gastroesophageal reflux disease, or GERD: this is a chronic form of the previous disorder. In this case, because of a hernia or a hyperproduction of gastric acid, there is a continuous state of inflammation of the esophagus. This is a pathology that needs targeted treatments because there is a real risk that with time it can degenerate into cancerous squamous caries of the esophagus and stomach;
Gastric ulcers that can also be caused by bacteria such as Helicobacter;
Abdominal swelling caused by gas accumulation.
Respiratory tract infections
Failure to treat respiratory system easily causes heartburn to the chest. The main cause of the disorder is to bring back to the bronchitis, it is a purely infectious nature of the disease (viruses that are associated with an over-bacterial infection), but in many cases the triggering factors are smoking or environmental pollution.
In both cases, the cataract is formed in the airways that will be ejected through the cough mechanism, which causes a repeated contraction of the chest musculature and the forced air emission through the high airways, causing a feeling of burning and pain. Other causes of burning in the chest may, however, be of a more serious nature, as in the case of pulmonary embolism.
Herpes zoster infection
This is the pathogen that causes the varicella, the disease most people contract during childhood. Once the varicella has been resolved, the Herpes zoster virus remains in the latent stage and goes to the level of the nerve ganglia, and when the subject is in a state of low immune defenses, the virus is reactivated and may give rise to a manifestation such as erysipelas. This condition is characterized by the presence of red spots on the skin, often located on the chest or back, which cause a strong sensation of burning, pain and itching.
Of course it is the event that gives rise to greater fears. As mentioned earlier, these are episodes that occur at a much lower rate than other causes. Heart conditions and blood vessels that cause burning on the chest include angina pectoris (temporary decrease in blood flow to the heart), myocardial infarction, pericarditis (pericardial inflammation, the membrane that covers the heart and the aortic aneurysm of the aorta if they manifest themselves in the left part of the chest. Chest pain is a clinical manifestation common to many morbid conditions, some of which are also very serious.
Let’s dwell on the diseases referred to above in more detail in the paragraphs that follow.
Based on triggering causes, chest pain may be: acute, dull, burning, pinching or pressing.
Among the conditions that may cause chest pain include heart disease, lung disease, gastroesophageal problems, pancreatitis, gall bladder problems, coastal fractures, costcondition, Tietze’s syndrome, pectoral muscle injuries, intercostal muscle injuries, and Herpes Zoster infections. Therapy varies depending on triggering factors.
Chest pain, or chest pain, is a characteristic symptom of many morbid conditions, some of which are more serious than others. The possible area of interest is very wide: it includes, in fact, the entire anatomical area that goes from the base of the neck to the front of the human body to the upper abdomen.
Depending on the triggering cause, chest pain may be:
- Pressing (or crushing), in the sense that the patient has the impression that something weighs on the chest.
Inside the chest there are several organs and anatomical structures. In addition to the known heart and lungs, in fact, the breast includes: the esophagus, the first aortic section, pulmonary arteries, vein veins, gall bladder, part of the stomach, pancreas, most ribs, sternum, clavicles, chest muscles, intercostal muscles, diaphragm and a wide nerve network (e.g.: intercostal nerves, etc.). Readers should not forget the outer anatomical aspect of the chest, which includes the breasts and, of course, a layer of skin.
Hence, the causes of chest pain are numerous. Some of them has been looked at above in the introductory passages, others will be presented below. We will briefly describe all of them.
Among the most common and common triggers are:
- Heart disease;
- Lung diseases;
- Problems with gastroesophageal site, i.e. stomach and / or esophagus;
- Pancreatitis episodes;
- Problems with gallbladder and biliary tract;
- Coastal fractures, i.e. rib fractures;
- Accidents of chest and / or intercostal muscles;
- Costcondrite and Tietze syndrome;
- Herpes zoster infections (or Fire of Sant’Antonio);
- Mastitis episodes.
Particular causes of chest pain are panic attacks and anxiety. These conditions do not reflect a malfunction or alteration of anatomical organs or structures located in the chest, but are the result of psycho-emotional problems which, for unknown reasons, result in a painful sensation at the chest level.
Heart diseases that cause chest pain
When doctors talk about heart disease, they refer to a wide variety of conditions, including:
Coronary heart disease, which is coronary artery disease. Coronary arteries (or more simply coronary) are the blood vessels that supply oxygen and nourish the heart. In the presence of coronary artery disease, coronary arteries present a more or less severe shrinkage, which prevents the blood from flowing adequately. The impairment of blood flow within the coronary arteries involves a reduced supply of oxygen and nutrients to cardiac tissues, which are affected in terms of function and, in the worst cases, they also need to meet necrosis. Those suffering from a coronary heart disease are a subject of high risk of heart attack or myocardial ischaemia.
In medicine, chest pain from a coronary artery takes the specific name of angina pectoris. In addition to the chest, angina pectoris may also affect the arms (typically the left), the shoulders (usually the left) and / or the jaw. It can make its appearance or worsen in intensity during physical activity or during stressful circumstances. Other symptoms are: profuse sweating, nausea, dyspnoea, weakness, etc.
Myocarditis is myocardial inflammation. Myocardial is the muscle of the heart, especially because it has the extraordinary ability to self-confront. Probable causes of myocarditis may be: viral or bacterial infections, some autoimmune diseases, heavy metal exposure, alcohol abuse, some allergic reactions, and so on. Other symptoms of myocardial inflammation include: fever, fatigue, heartbeat acceleration, respiratory problems, etc.
Pericarditis. Pericarditis is the pericardial inflammation. The pericardium is the membrane that envelops, sustains and protects the heart. Pericardial episodes may occur due to viral, bacterial or parasitic infections, endocarditis, pneumonia, thoracic trauma, autoimmune diseases, and so on. Generally, the chest pain that characterizes pericarditis is an acute and constant feeling that in some patients tends to spread to the upper part of the neck and shoulder muscles. It is rare (but possible) that the painful sensation becomes more intense, in the case of deep breathing, while swallowing the food and in a relaxed position on the back. Other symptoms of pericarditis include: dyspnoea, dysphagia, fever, cough, hiccups, etc.
Cardiomyopathies. Cardiomyopathies are diseases that are characterized by anatomical alteration of the myocardium and consequent failure of the heart. There are various cardiomyopathies; the most common are: dilated cardiomyopathy, hypertrophic cardiomyopathy and restrictive cardiomyopathy. Cardiomyopathies may be hereditary or acquired type pathologies. Their other symptoms are: persistent tiredness, dyspnoea, syncope, lower limb edema, irregular heartbeat, etc.
Valvulopathy. Valvulopathy is cardiac valve disease. The heart valves are all 4 and they have the task of fine tuning blood through the heart. Those who suffer from a generic valvulopathy have a certain heart valve that is altered or functioning in an inadequate way. Valvulopathy may have a congenital nature or appear in the course of life as a result of certain triggering factors. Among the most widespread valvulopathies, the mitral valve prolapse and aortic stenosis are worth mentioning. Other symptoms are: palpitations, dizziness, dyspnoea, lower limb edema, and so on.
Lung diseases that cause chest pain
Among the pulmonary diseases that cause chest pain are:
Pleuritis (Pleurisy). Pleurisy is inflammation of the pleura. The pleura is the thin membrane with protective function that wraps the lungs and is located in the cavities where the latter are housed. As a rule, pleurisy-induced chest pain is acute and tend to worsen during deep breathing and coughing or sneezing. Pleurisy can be caused by certain viral or bacterial infections, pulmonary embolism or pneumothorax episodes. Other symptoms of pleurisy are: dyspnoea, fever, cough, and so on.
Pneumonia. Pneumonia is inflammation of the lungs. Pneumonia may occur as a result of: certain bacterial or viral infections, mechanical damage to the lungs, or inhalation of toxic substances or simple objects. Generally, chest pain caused by a generic pneumonia is a dull and deep feeling. Other symptoms include fever, chills, coughs, dyspnoea, respiratory distress, and so on.
Pulmonary embolism. Pulmonary embolism is a pathological condition characterized by the obstruction of one of the two pulmonary arteries or one of the ramifications of the latter. The pulmonary arteries and their associated ramifications are blood vessels that carry the oxygen poor blood from the heart to the lungs. The element that hampers blood flow – the so-called embolism – can be a blood clot, an air bubble, a fat lump, a cholesterol crystal, a lump of amniotic fluid, and so on. Other symptoms of the disease include: respiratory problems, acceleration of heartbeat, dyspnoea, cyanosis, coughing, etc.
Pneumothorax. Pneumothorax is an abnormal infiltration of air inside the pleural cavities, resulting in collapse of one of the two lungs. Generally, pneumothorax is the result of chest trauma. The resulting pain tends to get worse during deep breathing. Other symptoms of pneumothorax: hypotension, dyspnoea, cyanosis, etc.
Pulmonary hypertension. Pulmonary hypertension is a serious morbid condition characterized by persistent elevation of blood pressure within the pulmonary arteries and within the right heart cavities (right atrium and ventricle). Generally, pulmonary hypertension is caused by an alteration that affects the walls of the pulmonary arteries and causes narrowing of the inner lumen of these pulmonary arteries. Other symptoms are: dyspnoea, syncope, tachycardia, etc.
Asthma. Asthma is a chronic inflammatory condition affecting the bronchial tree (bronchitis and bronchitis). Other symptoms include dyspnoea, cough, choking, respiratory noises, etc.
Gastroesophageal diseases that cause chest pain
The main gastroesophageal problems that cause chest pain are:
Gastroesophageal reflux disease (GERD): Gastroesophageal reflux disease is the chronic and excessive ascension to the esophagus of the stomach acid content. The rise of the stomach acid content to the esophagus causes inflammation of the mucous membrane wall. In more severe cases, gastroesophageal reflux disease may also affect the larynx and alter the proper functioning of the vocal cords present in this anatomical structure. The chest pain in this case is a painful burning sensation. The main risk factors of gastroesophageal reflux disease are: cigarette smoking, obesity and the tendency to eat spiced foods or fat. Other GERD symptoms are: dysphagia, pharyngitis, laryngitis, laryngospasm, irritation and burning behind the shoulder blades, etc.
Peptic ulcer. Peptic ulcer is a small, deep-located lesion that affects the digestive mucosa exposed to the action of gastric juices. Peptic ulcers may have various sites: stomach (gastric ulcer), duodenum (duodenal ulcer) and lower esophagus (esophageal ulcer). The most common causes of peptic ulcer are bacterial infections by Helicobacter pylori and prolonged intake of certain drugs, including NSAIDs and cortisone. Other peptic ulcer symptoms are: dysphagia, nausea, vomiting, bad digestion, etc.
Hiatal hernia. Hiatal hernia is the protrusion of the stomach through the so-called diaphragmatic esophageal diaphragm, that is, the diaphragm hole in which the esophagus is normally inserted. Doctors have not yet identified the exacting cause, but have noted that the most vulnerable are: those who have had a severe abdominal trauma, those who have an abnormality of oesophageal obesity, obese or overweight people, and Individuals with chronic cough. Generally, chest pain induced by hiatal hernia is a burning sensation. Other symptoms are: aerophagia, anorexia, bitter mouth, nausea, eruptions, etc.
Pancreas diseases that cause chest pain
In medicine, the term pancreatitis indicates a generic inflammation of the pancreas. Among the causes of pancreatitis include: infections, pancreatic cancer, gall bladder calculations, cigarette smoking, alcoholism, hypercalcemia, and so forth. Generally, chest pain that characterizes pancreatitis episodes appears suddenly and violently and has a tendency to radiate towards the back. In addition to chest pain, other typical symptoms of pancreatitis are nausea, vomiting, fever, agitation, shock, lack of appetite, and so on.
Gallbladder and bile ducts problems causing chest pain
The most common problem with gallbladder and gall bladder is the condition known as gallstones (or gall bladder calculations). Gallstones are small solid aggregates, consisting of cholesterol and calcium salts, which can obstruct the bile duct and cause a strong painful chest sensation. The presence of biliary calculus is often associated with: abscesses, inflammation of the gallbladder, chronic gall bladder diseases, gall bladder polyps, gall bladder cancer or gallbladder cancer. The resulting pain can be deaf and persistent or acute and waves; Also, sometimes, it can spread to the back. A notable complication of biliary calculus is the so-called acute cholecystitis. In addition to chest pain, typical symptoms of biliary calculus are: nausea, vomiting, profuse sweating, jaundice, facial conditions, etc.
Rib fractures and chest pain
Coastal fractures, or fractures to the ribs, are quite common injuries, which consist of the more or less severe breaks of the chest strain. In most cases, they are the result of strong chest strokes, resulting, for example, in automobile accidents, game collisions during contact sports, and so on. More rarely, they can occur as a result of severe coughing and as a result of repetitive movements that stress a particular region of the chest cage (of which the ribs are part). Chest pain caused by coastal fractures tends to get worse during deep breaths. In addition to chest pain, other characteristic symptoms of coastal fractures include: swelling and presence of a hematoma at the level of the fractured ribs or ribs.
Muscular injuries and chest pain
Muscle injuries consist of contractures, stretching or tearing and may affect the pectoral muscles or the intercostal muscles. In general, chest muscle injuries are due to severe chest trauma or abrupt abdominal movements. The resulting chest pain varies according to the magnitude of the accident (a tear is more severe than a contracture) and can be acute or deaf, intermittent or continuous.
Costochondritis and Tietze syndrome
Costochondritis and Tietze syndrome are the two most known inflammatory diseases of the cartilage, the cartilage of the ribs of the rib cage. Both cause chest pain, but while costochondritis causes a painful sensation, Tietze’s syndrome is responsible for a feeling of pain. It is a typical infection of adult people, which causes typical pruriginal red spots on the trunk and chest. These red spots are often very painful and are the cause of chest pain. Other common symptoms of Tietze syndrome: chills, fever, stomach ache, headache, and so on.
In medicine, the term mastitis indicates the generally infectious inflammation of the breast tissue. Mastitis episodes are typical of women and usually occur during lactation (although it is also excluded that they may also take place in other phases of life). In addition to chest pain, another typical symptom of mastitis is the presence of inflammation in the inflamed or inflame
It is important to see doctor
Generally, the diagnostic iteration leading to the diagnosis of chest pains begins with an accurate examination and a careful medical history. Then, depending on the circumstances, it can proceed with: an electrocardiogram (ECG), an echocardiogram (ECC), a myocardial scintigraphy, a coronary artery, a chest x-ray (RX-chest), a nuclear magnetic resonance or a chest TAC, An endoscopy and / or blood tests. Recognition of the condition at the origin of painful sensation is crucial for therapeutic purposes: only by knowing the triggering factors, the treating physician may prescribe the most appropriate therapy.
Treatment of chest pain depends on triggering causes. For example, in the presence of non-bacterial pericarditis, non-bacterial myocardium, non-bacterial pleurisy, early heart disease, gastroesophageal reflux disease, early pulmonary embolism, early pulmonary hypertension, pancreatitis, non-severe hysterectomy, costcondrite and Tietze’s syndrome doctors prescribe specific pharmacological treatments and, in many cases, a drastic change in lifestyle (which in people with the aforementioned pathologies tends to be inadequate). In the presence of severe gallstones, severe heart disease, pulmonary hypertension at an advanced stage, severe pulmonary embolism and severe hysterectomy, the intended therapy is of a surgical type. In the presence of conditions of bacterial origin (such as bacterial pneumonia, bacterial pericarditis, etc.), treatment consists of the administration of antibiotic drugs. In the presence of rib fractures or injury to chest or intercostal muscles, chest pain treatments are mainly based on resting and taking painkillers.