When we hear the word chest pain, we all get scared, right? The first thing that comes to mind is, "Is this a heart attack?" It's a reasonable fear. But did you know that not all chest pain is caused by a heart problem? Today we're going to talk about these strange, unusual chest pains that sometimes occur. We call these 'Atypical Chest Pain'.
What is atypical chest pain?
Simply put, this is pain that does not exhibit all the classic chest pain symptoms that we typically associate with heart disease.
Now you may be wondering, what is "typical" chest pain ? Doctors usually suspect heart disease if you have all three of these symptoms:
1. A pain in the middle of the chest, under the breastbone, that feels like a weight is being placed on it .
2. This pain increases when you do strenuous work (e.g., climbing stairs) .
3. This pain lasts for at least two minutes and subsides when you rest or take a medicine like nitroglycerin prescribed by a doctor.
However, atypical chest pain is different. It may have only one or two of the above symptoms, or it may have completely different symptoms. For example:
- Coming for a few seconds and then disappearing quickly.
- The pain increases when you change your position (e.g., when you tilt, bend).
- Feeling a sharp pain, like being stabbed by a knife.
Imagine, you are just sitting and suddenly you feel a stabbing pain in your chest... It goes away in a few seconds. Now you are scared, right? Is this a heart attack? That is what we call abnormal chest pain. Surprisingly, many people who come to the Emergency Department (ETU) come with this kind of chest pain. But 66% of them are not due to a heart problem.
Let's know exactly the difference between normal and abnormal chest pain.
It is very important to understand this difference. You can get a clear idea about this from the table below.
| Characteristic | "Typical" chest pain | "Atypical" chest pain |
|---|---|---|
| Nature of pain | It feels like it's being squeezed, pressed, crushed, and weighed down. | A sharp pain, like a knife. |
| Relationship with exercise | It increases when the body is tired, and decreases when it rests. | It may be unrelated to exercise. It will not be reduced by rest. |
| Other features | It can come with things like sweating, nausea, and difficulty breathing. | It may increase when changing position. |
| Spreading pain | The pain may spread to the arms, neck, or jaw. | Usually in the same place. |
| Duration of pain | It usually lasts at least two minutes. | It comes in a few seconds and disappears just as quickly. |
What are the risk factors for this type of unusual chest pain?
Some people are more likely to experience these types of pain. If you have any of the following, you may be at a slightly higher risk:
- You being a woman .
- Having high blood pressure .
- Having kidney disease .
- Having diabetes .
- Having had a previous heart attack .
What are the main causes of this kind of chest pain?
Here's the important part. Unusual chest pain can have a wide range of causes. It can range from the heart, lungs, digestive tract, bones, and even your mental health.
Cardiac Causes
- Acute Coronary Syndrome - An obstruction of blood flow to the heart.
- Pericarditis - Inflammation of the membrane surrounding the heart.
- Myocarditis - Inflammation of the heart muscle.
- Broken Heart Syndrome - An effect on the heart caused by severe stress.
- Aortic Dissection - Tearing of the main blood vessel leading from the heart.
- Aortic aneurysm - A bulge in the main blood vessel.
Lung-related Causes
- Pulmonary Embolism (PE) - A blood clot in the lungs.
- Lung Cancer
- Pneumonia
- Pneumothorax - A collapsed lung.
Digestive System Causes
- Gastritis or Acid Reflux (Chronic Acid Reflux) - We say 'gas', which means stomach acid coming up into the throat.
- Esophageal Spasm
- Esophageal Rupture
Other Causes
- Stress and Anxiety - This is a very common cause.
- Costochondritis - Inflammation of the cartilage that connects the ribs in the chest.
- Broken Rib .
Don't ignore any chest pain. It's up to your doctor, not you, to decide whether it's normal or abnormal.
How is this treated? What tests are done?
Treatment depends entirely on the cause of your pain. So, the first thing to do is to find out exactly what the cause is . Your doctor may do some tests for this.
- Electrocardiogram (EKG) - A test that measures the electrical activity of the heart.
- Echocardiogram (Echocardiogram - Echo) - A scan of the heart.
- Chest X-ray
- CT scan (Computed Tomography - CT scan)
- Heart MRI scan
- Stress Test - Testing the heart while exercising.
- Cardiac Catheterization
After these tests, treatment methods, ranging from medications, various procedures, or surgery, are determined based on the cause.
Can we prevent this situation?
Although we cannot control some of the causes of unusual chest pain, we can greatly reduce the risk by adopting a healthy lifestyle.
- Avoid using tobacco products. This is very important.
- Eat heart-healthy foods. Eat a diet rich in vegetables, fruits, and low in fat.
- Exercise regularly.
- Get the vaccinations recommended by your doctor.
- Get proper treatment for any diseases you already have, such as high blood pressure and diabetes.
Take-Home Message
- Although not all chest pain is a heart attack, it is essential to have any chest pain checked by a doctor.
- Atypical pain is usually sharp, short-lived, and may increase with changes in position.
- The cause could be anything from the heart, lungs, digestive tract, to stress. Therefore, it is important to know the exact cause.
- Never try to treat chest pain at home on your own. It can be dangerous.
- If the pain is severe and accompanied by difficulty breathing, go to the nearest hospital's Emergency Department (ETU) immediately.
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