Exploring the Complexity of Chest Pain: Beyond Cardiac Causes

Chest pain is one type f pain that a lot of people feel on a regular, and it has become a thing that once a person presents with chest pain, the first thing we consider is a cardiac arrest. It is always important to look at the worse case scenario but then, chest pain can also be as a result of non cardiac issues. In this post, I will be discussing chest pain in detail but first what is the chest and how does its pain differ from one another?

When we mention chest pain, it is a broad term for pains that can occur in different region of the thoracic region. Someone who just stressed their Pectoralis major muscle would claim they have chest pain whereas they do not have chest pain. Since it is very difficult to make precise, people have termed any pain that occurs after the neck but before a abdomen chest pain.

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Chest pain can mean a lot of thing since the chest is made up of numerous things. When we are talking about the chest, are we talking about the chest wall, the structures around the chest cavity, and the internal organ (such as the lungs and the heart). The outside of the chest cavity which is the chest wall is made up of the rib cage which is made up of the rib which attaches posteriorly to the bones of the vertebral column, while it attaches interiorly to the sternum, and superiorly to the manubrium and anteriorly to the xiphoid process. Where the first 7 ribs are regarded as true rib and rib 8 to 12 is known as false ribs with 11 and 12 being float ribs.

Since pain isn't too local when it comes to the body, there can be so many part of the thorax that can lead to pain. For instance, there crushing substernal pain which goes to the shoulder, and this can be as a result of coronary artery diseases, such as atherosclerotic cardiac coronary artery disease, myocardial infarction,

Another type of chest pain can be a sharp, stabbing, and burning pain that gets worse when inhaling, laughing, or coughing. When people present with such pain, the lungs are being affected. People suffering from Pleuritis, can have irritated pleura and this leads to pleuritic chest pain. Also, trauma to be pleura can lead to this pain and people with pneumothorax can suffer this type of pain.

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If a person suffers a burning substernal pain and difficulty swallowing, then there is a possibility that it affects the digestive system, and since the esophagus is in the thoracic region, then it is possible that it can be caused by acid reflux (GERD) as a result lower esophageal sphincter not closing properly.

Another chest pain can also present as a parasternal pain with tenderness to palpation, and this can be as a result of costochondritis where the costochondral joint is inflamed. This is the less severe of them, and can be treated quickly compared to he once mentioned above.

Understanding chest pain goes beyond immediately associating it with cardiac concerns. The thoracic region's intricate anatomy and the diverse sources of discomfort highlight the need for a comprehensive approach to evaluating and addressing chest pain. By recognizing the various types and potential causes of chest pain, healthcare professionals can provide more accurate diagnoses and targeted treatments, ultimately ensuring better patient outcomes.

Reference

https://archivesphysiotherapy.biomedcentral.com/articles/10.1186/s40945-021-00099-x
https://www.ncbi.nlm.nih.gov/books/NBK416/
https://www.mayoclinic.org/diseases-conditions/coronary-artery-disease/symptoms-causes/syc-20350613
https://www.ncbi.nlm.nih.gov/books/NBK470557/
https://www.aafp.org/pubs/afp/issues/2017/0901/p306.html
https://www.ncbi.nlm.nih.gov/books/NBK558958/
https://www.nhs.uk/conditions/costochondritis/
https://www.nhsinform.scot/illnesses-and-conditions/muscle-bone-and-joints/conditions/costochondritis/