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September 19, 2018

Chest Pain: Emergency Room Tips

Chest Pain: Emergency Room Tips

Pain in any region of the chest constitutes a chest pain. This kind of pain could be symptoms of severe disorders and generally considered a medical emergency which is treatable at FrontLine ER.

Chest pain is also widespread in children, and it is one of the reasons why children go to a cardiologist.  However, chest pain in children is rarely due to a heart condition, and the symptoms will eventually completely go away.

In both children and adults, a detailed history and physical examination are significant at FrontLine ER in understanding why a patient is experiencing chest pain and if the discomfort should be of great concern.

Chest pain can demonstrate itself as burning, stabbing, aching or pressure-like sensation in the chest. These associated symptoms vary due to a person’s age, sex, and any previous medical conditions.

Medical practitioners categorize chest pain into heart related and non-heart related.

Heart-Related (Cardiovascular) Chest Pains

  • Acute Coronary Syndrome (ACS) involves an array of conditions associated with a sudden drop in blood flow to the heart muscle. Inadequate blood flow causes the patient to feel pressure or tightness in the chest.
  • Angina Pectoris is a discomfort, often felt like a pressure or a squeezing sensation in the chest. The pain radiates or moves to the upper abdomen and back, neck, arms, and cervical spine.
  • Aortic dissection is a severe disorder in which there is a tear in the inner layer of the large blood vessel branching off the heart (aorta). Victims with this kind of illness usually present with acute pain which is sharp and may have tearing or ripping quality.
  • Pericarditis is a viral infection that causes the swelling of the pericardium, a thin membrane or sac surrounding the heart. A person may encounter a sudden, sharp and stabbing pain behind the sternum (breastbone) that worsens when lying down or breathing in.
  • Stress Cardiomyopathy (Takotsubo), also known as the broken heart syndrome had its first diagnosis in Japan in the year 1990. The disorder has symptoms that mimic those of an acute heart attack and is not caused by blocked coronary arteries. Patients experience sudden, intense chest pain occasioned by an emotionally stressful event like the breakup of a relationship, death of a loved one, devastating financial losses, or a natural disaster.

Lung Conditions Causing Chest Pain

  • Pulmonary embolism is an obstruction by blood clots in one or both of the pulmonary arteries within the lungs. Patients sometimes experience chest pains that worsen when breathing (pleuritic pain).
  • In addition to shortness of breath, victims with lung cancer often complain of chest pain usually located on the same side as the tumor. The pain gets worse with deep breathing, coughing, or laughing.

Gastrointestinal Causes – Digestive Disorders Causing Chest Pain

  • Gastroesophageal reflux disease (GERD) is a common cause of chest pain that occurs when stomach content or acid occasionally refluxes into the esophagus. The acid reflux irritates and may erode the lining of the esophagus causing the disease.
  • Esophagitis happens due to the swelling and inflammation of the esophagus. There are several forms of esophagitis, and they include infectious/candida esophagitis, reflux of esophagitis, pill esophagitis, and esophagitis caused by radiation therapy or chemotherapy for cancer. Patients with such conditions experience chest pain similar to angina pectoris; however, it is more persistent and usually lasts longer.

Musculoskeletal Causes of Chest Pain

Musculoskeletal chest pain can be made out as costosternal (Costochondritis) or lower rib pain syndromes. Having rheumatic conditions such as rheumatoid arthritis and fibromyalgia is more likely associated with the painful rib syndrome. It consists of pain in the upper abdomen or lower chest and a tender spot on the costal margin when pressed.

Psychiatric Chest Pain

Panic attacks are sudden and extreme episodes of fear or distress which can cause chest pain. Studies suggest that approximately one-quarter of patients who seek treatment at the ER for treatments of chest pain have panic disorder.

Diagnosis and Treatment of Chest Pains at FrontLine ER

Symptoms of chest pain syndrome can be quite vague and may also be confused with abdominal pain. No matter the cause, a victim in distress, wants to eliminate it quickly.

Home remedies are meant to treat occasional chest pain that the cause is known. It could be either due to digestive issues, such as gas, muscle strains, and anxiety.

The emergency physician at FrontLine ER will ask the appropriate questions of the patient to characterize the pain.

Critical patients should be evaluated to ensure that the Airway, Breathing, and Circulation (ABC) are intact. IV access, oxygen supplementation, and telemetry should be administered.

The doctor can order for electrocardiogram (ECG), chest X-rays, blood tests, and Computer tomography (CT scan) is to help make the correct cardiac diagnosis.

Treatment varies depending on the findings from the various tests carried out on what’s causing your chest pain. Common drugs that may be prescribed and administered to treat chest pain include:

  • Artery relaxers
  • Aspirin
  • Thrombolytic drugs
  • Blood Thinners
  • Acid-suppressing medications
  • Antidepressants

In most serious cases angioplasty and stent placement, Bypass surgery, dissection repair, and Lung reinflation can be carried out.

Emergency Care, Emergency Room