Sunday, April 1, 2012

Chest pain


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Infections

Mild chest pain is often associated with respiratory infections. Coughing may cause muscle cramps and sometimes even broken ribs in the chest.

If there is prolonged chest pain connected to infections, it is advisable to have a examination in order to eliminate the possibility of pneumonia, infection of the pleura and other illnesses requiring treatment. A pulmonary x-ray usually gives all the necessary information.

Self-treatment follows traditional treatment for a flu—drinking plenty of liquids and getting enough rest. Over-the-counter (OTC) inflammation pain medication or medications targeted for alleviating flu symptoms may also be used.



Coronary Artery Disease

Heart-related problems are a significant reason for chest pains. The most common heart ailment, that causes pain, is coronary artery disease (CAD). With this disease, the arteries in the heart cannot deliver enough blood to the heart muscle, and the resulting lack of oxygen causes pain.

This type of pain is most commonly felt behind the sternum or in the chest. It may radiate to the left shoulder or arm, to the back, upper stomach or throat. The pain can be mild or strong. Sometimes coronary artery disease shows no symptoms. Upper abdomen problems are sometimes hard to distinguish from heart-related problems.

The pain typically appears in connection with exertion and lasts only for a short time after exertion. Pain lasting for more than 15-20 minutes may be a sign of myocardial infarction.

Myocardial infarction-type pain requires a doctor’s inspection and suspicions of myocardial infarction require a trip to the emergency room. In cases of coronary artery disease, the EKG shows changes compatible with reduced blood circulation in the heart. During a heart attack, a higher level of specific proteins releases in the bloodstream. This can be measured to assist in diagnostics of a hearth attack.

To make the accurate conclusion it may be required to perform an exercise stress test, during which the EKG is monitored, while the patient keeps moving and the strain level is gradually increased. If the diagnosis is not complete, it can be confirmed with coronary angiography, a special contrast medium x-ray examination of the heart and blood vessels.

Medication usually includes medicines that improve efficiency of circulation in the heart via different mechanisms and reduce the risk of myocardial infarction. In most cases, current medications reduce the symptoms. If medication does not help to achieve adequate functioning, a balloon angioplasty or a bypass surgery may be considered.

Self-treatment includes attaining normal weight. Reviewing your diet and making necessary changes is useful. Avoid fats, especially saturated fats, eat more vegetables and fruits and reduce the amount of salt in your diet. When a person eats fewer calories than he, or she uses, weight loss is inevitable.

If an exercise stress test has been performed, ask the doctor who performed it, for information on what your pulse level during exercise should be. Learn to measure your pulse or use a pulse meter and exercise regularly at this appropriate level.

It makes sense stop smoking and drinking coffee as well as other caffeinated substances such as soft drinks, tea, and diet pills.



Pericarditis

A sudden inflammation of the pericardium, or pericarditis, may cause pain that resembles myocardial infarction pain. The difference is that pericarditis pain is often reduced when leaning forward. Breathing phase and the person’s posture may have effect on the pain level. Pericarditis may be preceded by a respiratory infection.

During the inflammation, fluid collects in the pericardium. This may increase even fast and lead to the prevention of filling of the heart and consequently to death, if treatment is not started quickly.

The examining doctor may hear a friction sound or weakening of heart sound through a stethoscope. Laboratory tests show an increased number of leukocytes and an increased sedimentation rate. EKG shows changes consistent with this condition, and the heart may enlarge in x-rays. Echocardiography or ultrasound may also be used in diagnostics along with laboratory tests.

The patient should go to the emergency room, because treatment will take place in the hospital. Treatment first focuses on reducing pain and finding the cause of the problem. Causes for this inflammation may be tuberculosis, rheumatism, myocardial infarction or a suppurative infection. Naturally the underlying disease has to be treated.

Pulmonary Embolus

An embolus usually travels to the lungs from a leg or a venous thrombosis in the pelvis. Symptoms typically include shortness of breath, irritation cough, and chest pain.

At its worst, this condition can quickly lead to death. At its mildest, a small embolus is virtually asymptomatic and may cause only temporary shortness of breath.

Pulmonary embolus or suspicions thereof always require a visit to a hospital emergency room.



Neurocirculatory Conditions

Sometimes during chest pain evaluation, coronary artery disease or other illness that would explain the symptoms are not found, even though the pain may be remarkably strong. This may be a case of neurocirculatory heart disease.

Pains of this category are often short duration ones that repeat, and have a stabbing or grabbing feel. They often arrive at night after a tough day and may prevent the person from sleeping.

Nervousness, fatigue, and miscellaneous digestive tract symptoms may accompany the symptoms. Persons experiencing these symptoms often tolerate sauna baths, alcohol, coffee, and tobacco poorly.

These symptoms require a careful examination. After an consideration there is no need to fear a life-threatening illness.

Treatment includes various medications depending on symptoms. It is often useful to cut out coffee, tobacco, caffeinated soft drinks, and tea as well as excessive alcohol. It is also helpful to achieve normal weight.

Neurocirculatory heart conditions do not present an obstacle to even high-level exertion if that level is reached gradually. Symptoms of a neurocirculatory heart condition often ease as the physical condition improves.



Breast Tumors

Temporary pains caused by hormonal fluctuations may be experienced in the breasts. It is necessary for every woman to learn to self-examine her breasts and make it regularly whether there are symptoms or not. Taking advantage of group breast mammographies is worth the effort. Regular mammographies are recommended for women over 40 even if no symptoms are present.

An examination is warranted if there are lumps, continuous pain, changes in the skin, withdrawal of the nipple or if bloody fluid leaks from the nipples. Mammography is an easy way to assess the status of the breast tissues.

Breast cancer is the most common cancer in women. The faster it is detected and treated, the better the treatment outcome. Majority of the tumors is found through self-examination.

Breast Infections

Breast infections are commonly associated with breast-feeding. A painful area is usually noticed in the breast during breast-feeding, and it may be accompanied by a low temperature and possibly swollen lymph nodes.

The cause of the infection is often external—the skin, nursing staff or the child’s mouth. The infection spreads via mammary gland ducts. Milk is an ideal base for bacteria to grow in.

Treatment consists of antibiotics. Breast-feeding can be continued with the healthy breast, and the infected breast can be emptied with a pump. If the nipples are cracked, they can be treated with antibacterial ointment.



Tietze’s Syndrome

Sometimes pain can be felt in the chest, in the area joining a rib and its costal cartilage. The cause for this phenomenon, Tietze’s syndrome, is not known.

Diagnosis is based on identifying the painful areas via palpation. An x-ray usually shows nothing out of the ordinary, MRI may be more useful.

Treatment includes pain medication. Physical therapy or cortisone shots usually do not help significantly. The symptoms will fade with time even though it may take a while.

Self-treatment can include OTC anti-inflammatory medicine and gels. Cold compresses may be useful. If they feel irritating, try a hot water bottle, or a heating pad. Avoid movements straining the chest area.

Emergencies

Prolonged chest pain.
Sudden chest pain and shortness of breath.
Respiratory infection accompanied with chest pain.
Chest pain and fever.

See a Doctor

Repeated chest pain during exercise.
Chest pain that does not diminish with self-treatment.
Painful breasts and changes felt in palpation of the mammary glands.

Chest pain, more information:

Medscape.com about upper respiratory infections.
Wrongdiagnosis.com about respiratory infections.
National Heart, Lung, and Blood Institute pages about coronary artery disease.
Mayoclinic.com pages about coronary artery disease.
Medicinenet.com about pericarditis.
MDGuidelines pages about neurocirculatory asthenia.
Webmd.com pages about benign breast lumps.
Mayoclinic.com pages about breast cancer.
Cancer.org about breast cancer.
Webmd.com pages on breast infections.
NHS Choices about Tietze's syndrome.

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