Pain in the chest

If you get chest pain it can have many different causes. One of the most common is that the muscles in the chest hurt because you strained them more than usual. Mental stress can also create a feeling of pain or discomfort in the chest. Occasionally, chest pain may be due to diseases of the heart, stomach or muscles. A strong, pressing pain in the chest can be symptoms of angina or heart attack and then it is important to seek care.

If you are not sure what causes the chest pain, it is best to have a doctor do an examination. Then you can describe your symptoms, your life situation and if you have had any illnesses before. The doctor then does a body examination and listens to the heart.

symptoms

Chest pain can be felt in different ways depending on the cause of your pain. Read more about various causes of chest pain in the chapter “Why Do I Have Chest Pain?”.

When should I seek care?

  • You have a strong, pressing or spasmodic pain in the chest that does not disappear within a quarter
  • you have a diffuse but unpleasant feeling in the chest that lasts for more than a quarter and does not have a natural, harmless explanation
  • you have chest pains and at the same time feel short of breath, nausea, cold sweat or have irregular heartbeats.

If you do not need to seek urgent help, but still feel chest pains that do not have a natural explanation, contact a health care center.

You can  seek care  at any healthcare center you want throughout the country. You also have the opportunity to have a regular doctor’s contact at the health center. 

You have the right to understand

In order for you to be able to participate in your care and make decisions, it is important that you understand the  information you receive  from the healthcare staff. Ask questions if you don’t understand. You can also ask for information printed so that you can read it peacefully. 

Investigations and investigations

Since chest pain can have so many different causes, you must first describe your life situation, your past illnesses and your symptoms. The doctor does a body examination and listens to the heart.

An ECG can provide answers

To see how the heart works, a resting ECG and a working test are often taken when the ECG is recorded during exertion. Among other things, an ECG can show if the heart muscle is suffering from oxygen deficiency, which is a clear sign of angina.

Chest X-ray

If your doctor suspects a pneumonia or you have air in your lungs due to a pulmonary burst, you may undergo an X-ray examination of the lungs.

Ultrasonography

An ultrasound examination of the heart , echocardiography, may reveal, among other things, whether there is an increase in the amount of fluid in the heart sac. This may indicate a myocardial infarction. The study can also show if there is a defect in any heart valve or heart muscle.

blood tests

Cells in the heart muscle damaged or killed by oxygen deficiency release various proteins that do not leak from healthy cells. The proteins can be measured by different blood samples.

coronary angiography

Through a coronary x-ray , the doctor will see if you have any constrictions in the vessels that can cause angina.

A thin plastic tube, a so-called catheter, is passed through a blood vessel in the groin or arm, up to the coronary artery. When a contrast agent is injected, the constrictions that may be present in the vessels are visible.

Investigations of the lungs

If there is a suspicion of a plug in the lung, so-called pulmonary embolism, you may undergo one of the following examinations:

  • Chest X-ray
  • Computer tomography
  • Ultrasonography
  • isotope survey
  • Contrast X-ray.

Different types of X-ray cameras are used in the studies. Often, the image needs to be more detailed, and then contrast agents are used which are usually not transparent on the X-ray. Sometimes, ultrasound examination of the heart can also be used if the doctor suspects a large blood clot.

Gastroscopy

If you have abdominal pain or other signs that may indicate stomach upset or ulcer, you may undergo a gastroscopy .

Gastroscopy means that you first get a local anesthetic in the throat and a relaxing drug. Then a tube is passed through the mouth and throat into the stomach. Through the hose, both photographs and different types of tissue samples can be taken.

Examination of the biliary tract

Gallstones , especially if they get stuck in the bile ducts, can affect the liver. Therefore, blood samples are taken that show how the liver works.

To further investigate whether gallstones are present in the gallbladder or bile duct, an ultrasound examination or a contrast x-ray may be needed.

Treatment

Primarily, heart problems are treated with drugs that reduce the stress on the heart and increase blood flow in the coronary vessels. They also relieve pain, shortness of breath and fatigue. 

If you have angina, it may be necessary to widen the coronary arteries so that the heart gets better blood supply. The procedure is called balloon enlargement after the small balloon used when the constriction expands. The procedure often shortens PCI.

You may also have a coronary artery bypass operation. Then the blood is passed past the constriction in the coronary vessels of the heart through blood vessels which are moved from other parts of the body and sewn to the coronary vessels.

If you have a heart valve that causes a narrowing or leak in the opening between the left atrium and ventricle, it may be necessary to replace the valve during surgery. This also applies if you have a narrowing or a leak in the opening between the heart chamber and the body’s artery, aorta.

It is also possible to replace a narrow valve with puncture of blood vessels, called catheter technology. The procedure can then be done without open heart surgery. It is called TAVI and is often used in elderly and frail patients.

Treatment of lung diseases

Certain blood clots in the lungs should be treated with a clot-dissolving drug. This applies especially to large blood clots or those that are located in particularly sensitive blood vessels. First, drugs are given in drip form, and then you switch to drugs in tablet form.

A lung bladder that has ruptured often heals itself. In more severe cases, the air in the lung sac is sucked out through a tube via the chest. In some cases, surgery is also required.

Pneumonia usually heals on its own and you are given painkillers for the pain. Sometimes you also get antibiotics.

Treatment of gastric disorders 

The inconvenience of a hernia in the middle can be treated with drugs that suppress the production of acid in the stomach. You also get advice on what to avoid eating and drinking. If the treatment does not help, and if the problems are very severe, you may undergo an operation that restores the function of the upper abdomen.

During gastric ulcer , you receive medicines to reduce acid production in the stomach. Nowadays antibiotics are also usually given against the bacterium helicobacter pylori. It is rare that surgery for peptic ulcer needs to be done.

Against gallstones, treatment for the stones is often not needed. If the gallstones cause cramp pain, you will be given medication for the pain. If the gallbladder is affected by inflammation, and often simultaneously with infection, the disease must be treated with medication or with surgery. During operation of the gallbladder, the entire bladder is removed. Gallstones that get stuck in the bile duct usually have to be removed, and surgery is usually necessary.

Treatment of muscular diseases

Temporary muscle inflammation often does not need treatment. If the pain is severe or lasts longer, painkillers or anti-inflammatory drugs may be beneficial.

If prolonged muscle pain is due to mental tension, anxiety or depression, it is important to try to influence the very cause of the mental disorders. At a health care center, you can get advice on where to go. Prolonged muscle pain associated with stressful or unilateral work may require changes in the workplace. Occupational health care then plays a major role.

Sometimes muscle pain can be so severe that it may be necessary to rest from work and maybe get help from a physiotherapist.

Treatment of shingles

The infection heals by itself, but you may need painkillers for the pain.

Treatment of panic anxiety

Panic anxiety has psychological causes that can sometimes go far back in time and are triggered by one or more events. Because anxiety is more difficult to live with than many bodily illnesses, it can be important to get help quickly with treatment. If you are aware of your anxiety and want help, you can contact a psychologist, curator or psychiatric doctor. If you come to a doctor at a health center or hospital, you will often receive a referral to one of these occupational groups. The treatment usually consists of a combination of supportive conversations, some form of psychotherapy and medication.

Why do I have chest pain?

Here are the most common causes of chest pain:

angina

The reason why it hurts in the chest during angina pectoris is usually that one or more of the coronary arteries of the heart have been affected by atherosclerosis, also called atherosclerosis. The coronary arteries then become narrower and pass through less blood to a part of the heart muscle.

Myocardial infarction

In a myocardial infarction , the constriction in the blood vessels has led to a complete halt to the blood flow in one of the coronary arteries.

Myocardial infarction and myocardial infarction

A pericarditis may result from a viral infection. At the same time as the inflammation, you may also have myocarditis . The viral infection usually means that you have symptoms of flu or sore throat at the same time, but sometimes you may have only inflammation of the heartbeat or heart muscle.

Heart muscle disease or enlargement of the heart muscle

The disease is because the heart muscle grows abnormally. A common cause is high blood pressure.

Rupture of the vessel wall in the large body pulmonary artery

Large coronary artery, aortic, vessel wall may burst. One reason for this to happen is atherosclerosis, but it can also be due to a congenital weakness in the vessel wall itself.

Blood clot in the lung, pulmonary embolism

Blood clots can form in the veins, the blood vessels that bring the blood back to the heart from the various parts of the body. The risk of getting blood clots in the legs is greater than usual during and after surgery and in connection with certain other diseases, such as tumor diseases. If you sit still for a long time, for example during a long flight, the risk also increases.

Blood clots are often formed in the legs but can also occur in other parts of the body. Part of a blood clot or the whole blood clot may be released and passed through the blood vessels to the blood vessels of the lungs. The blood clots in the lungs that then occur are called pulmonary embolism.

Rupture of pulmonary vesicles

The small pulmonary vesicles may burst even in a healthy person, but ruptures are much more common in elderly people with a lung disease where the pulmonary vesicles are enlarged. It can occur even in younger people, but often in people who exercise.

PLEURISY

Oftentimes, pleurisy of a virus infection, but sometimes it can be caused by pneumonia, or of certain allergic diseases.

Mid-ventricular hernia or esophageal catheter

A hernia can cause the upper stomach mouth not to close completely, and then acidic stomach contents from the stomach leaks up into the esophagus. The mucous membrane of the esophagus does not withstand the acid and reacts with inflammation and cramp. You may also suffer from ulcers in the esophagus.

Gastric ulcer

A wound can occur in the lining of the stomach or the duodenum. Gastric ulcer is caused by, among other things, a bacterium, Helicobacter pylori.

Gallstones and gallbladder inflammation

In the gallbladder bile is formed, which affects the digestion. The bile goes from the gallbladder, out through a narrow aisle, and empties into the duodenum. Hard stones, gallstones , can be formed in the gallbladder. Gallstones can pass through the bile duct, but can also get stuck there.

Gallstones can also lead to inflammation of the gallbladder and sometimes to acute inflammation of the pancreas.

Muscle pain and muscle inflammation

There are many different causes of muscle pain. Several different types of stress conditions in the chest muscles can also cause chest pain. Muscle tension, often long lasting, is common in connection with mental tension, anxiety and depression. Prolonged mental tension can lead to prolonged muscular inflammation in the chest and other muscles.

Tietze’s disease

Tietze’s disease is an inflammation of the chest muscles and the sternum of the sternum.

Symptoms can often be triggered when you press the sternum

Disk hernia in the spine

The spine consists of the top seven vertebrae in the spine, which are particularly movable for easy turning of the head. Those who work for long periods of time in unsuitable postures can experience changes in the joints between the cervical vertebrae and in the softer discs, so-called disks, that exist between each vertebra. Almost all people are affected by similar changes with increasing age.

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