Chest pain causes
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Overview of Chest Pain Causes
Chest pain is a frequent reason for medical visits and can be caused by a wide range of conditions, from benign to life-threatening. It is important to quickly and accurately determine the underlying cause to ensure proper treatment and avoid missing serious conditions 14568.
Cardiac Causes of Chest Pain
Ischemic Cardiac Pain (Angina and Myocardial Infarction)
Cardiac causes are a major concern, especially those related to reduced blood flow to the heart, such as angina pectoris and acute coronary syndromes. Stable angina is often a warning sign of underlying heart disease, while unstable angina and myocardial infarction are medical emergencies that require urgent attention 14568. Women may underestimate their risk of heart disease, so special attention is needed in their assessment .
Non-Ischemic Cardiac Pain
Other heart-related causes include conditions not directly related to reduced blood flow, such as pericarditis or heart failure. However, heart failure is less likely if there is no shortness of breath 45.
Non-Cardiac Causes of Chest Pain
Gastrointestinal Causes
Non-cardiac chest pain is very common, with gastroesophageal reflux disease (GERD) being the most frequent cause. Other gastrointestinal issues include esophageal motility disorders, esophageal inflammation, ulcers, and even perforation of the esophagus or stomach 469.
Musculoskeletal Causes
Pain from the chest wall, muscles, or bones is also a frequent cause. This type of pain is often reproducible by pressing on the chest and is less likely to be related to the heart 358. Musculoskeletal pain is especially common in children and adolescents .
Pulmonary Causes
Lung-related conditions such as pneumonia, pulmonary embolism, and spontaneous pneumothorax can also cause chest pain. These conditions are important to identify quickly because they can be life-threatening 568.
Neurological Causes
Some neurological conditions, including migraine, epilepsy, and multiple sclerosis, can present with chest pain. These causes are often overlooked and may go undiagnosed for long periods .
Psychiatric and Psychological Causes
Psychological factors, such as panic disorder, anxiety, and depression, can either cause chest pain or make it feel worse, regardless of the underlying physical cause. Screening for these conditions is important, especially when no clear physical cause is found 45810.
Special Considerations in Children
In children, chest pain is rarely due to heart disease. Most cases are idiopathic (unknown cause), musculoskeletal, pulmonary, psychiatric, or gastrointestinal in origin. Life-threatening causes are uncommon, but prompt evaluation is still necessary to rule them out .
Diagnostic Approach
A careful history and physical examination are essential. Additional tests, such as electrocardiograms, chest X-rays, blood tests, and sometimes advanced imaging, help identify the cause. The approach should be systematic to avoid missing serious conditions while also addressing common benign causes 158.
Conclusion
Chest pain has many possible causes, including cardiac, gastrointestinal, musculoskeletal, pulmonary, neurological, and psychological origins. Accurate diagnosis is crucial to ensure appropriate treatment and to avoid missing life-threatening conditions. A multidisciplinary approach and careful evaluation are key to managing patients with chest pain effectively 14568910.
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