How to stop chest pain
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Summary
6 papers analyzed
These studies suggest that cognitive-behavioral therapy, proton pump inhibitors, antidepressants, antireflux therapy, lifestyle modifications, and shared decision-making are effective strategies for managing different types of chest pain.
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Effective Strategies to Stop Chest Pain
Chest pain can be a distressing symptom, often leading individuals to seek immediate medical attention. While cardiac causes are a primary concern, non-cardiac chest pain (NCCP) is also prevalent and requires different management strategies. This article synthesizes research findings on various approaches to alleviate chest pain, focusing on non-cardiac origins.
Cognitive-Behavioral Therapy for Non-Cardiac Chest Pain
Cognitive-behavioral therapy (CBT) has shown significant promise in treating atypical non-cardiac chest pain. A controlled trial demonstrated that CBT, which involves teaching patients to anticipate and control symptoms and modifying inappropriate health beliefs, led to substantial reductions in chest pain, distress, and psychological morbidity. These improvements were maintained at follow-up, highlighting the long-term benefits of CBT for chest pain management.
Coping Strategies and Lifestyle Modifications
Coping strategies play a crucial role in managing unexplained chest pain (UCP). Research indicates that emotive coping, which involves expressing emotions, is linked to higher chest pain intensity. Physical activity, on the other hand, can reduce reliance on emotive coping. Additionally, addressing factors such as sleep problems, stress, and negative life events can help mitigate chest pain. Encouraging patients to verbalize their emotions and recognize the impact of these factors on their pain experience is beneficial.
Pharmacological Interventions
Pharmacological treatments are essential for managing esophageal-related chest pain. Proton pump inhibitors (PPIs) like omeprazole are effective for gastroesophageal reflux disease (GERD)-related chest pain. Antidepressants, such as sertraline and trazodone, have also shown efficacy in treating esophageal hypersensitivity and anxiety disorders associated with chest pain. However, the evidence for other treatments like nifedipine, diltiazem, and biofeedback therapy is less robust.
Lifestyle and Dietary Adjustments
For patients with GERD-related chest pain, lifestyle modifications are crucial. Recommendations include elevating the head of the bed, reducing fat intake, quitting smoking, and avoiding foods that exacerbate reflux. These changes, combined with PPI therapy, can significantly reduce symptoms. In some cases, laparoscopic fundoplication may be considered, although its effectiveness for chest pain specifically is less clear.
Pre-Hospital Management of Acute Chest Pain
In the pre-hospital setting, managing chest pain often involves a combination of narcotic analgesics, nitrates, beta-blockers, and benzodiazepines. Morphine is commonly used but can have side effects. Alfentanil offers rapid pain relief, while nitrates are effective with fewer side effects. Beta-blockers can enhance pain relief when combined with morphine, though this combination may increase side effects. The optimal combination of these drugs remains unclear, and further research is needed to establish best practices.
Conclusion
Managing chest pain, particularly of non-cardiac origin, requires a multifaceted approach. Cognitive-behavioral therapy, effective coping strategies, pharmacological treatments, and lifestyle modifications all play vital roles. While significant progress has been made, ongoing research is essential to refine these strategies and improve patient outcomes.
Sources and full results
Most relevant research papers on this topic
7
Relaxation: a nursing therapy to help relieve cardiac chest pain.
7
4 Citations
2000