High Altitude Pulmonary Hypertension: Effects of Altitude, Effects of Altitude on Pulmonary Pressures, Adaptation and ...
What's Causing My Chest Pain?
Chest pain is not something to ignore. But you should know that it has many possible causes. In many cases, it's related to the heart. But problems in your lungs, esophagus, muscles, ribs, or nerves may also cause chest pain. Some of these conditions are serious and life-threatening; others are not. If you have unexplained chest pain, the only way to confirm its cause is to have a doctor check you.
Problems with your heart aren't the only possible cause of chest pain. (Photo credit: PhotoAlto Agency RF Collections/Getty Images)
You may feel chest pain anywhere from your neck to your upper abdomen. It can also spread to other areas of your upper body, like your jaw, back, or down your arm. The pain can persist for a few minutes to hours, and sometimes even for months or more. It might get worse when you're doing something active but ease up when you're taking it easy. Or it could hit you even when you're just relaxing. The pain might feel like it's in one spot or spread out more.
This condition might be unilateral, affecting only one side of your chest, or be bilateral, affecting both sides or in the middle. Depending on its cause, chest pain may be:
Here are some of the more common causes of chest pain.
These heart problems are common causes:
Coronary artery disease (CAD). This blockage in the heart's blood vessels lowers blood flow and oxygen to the heart muscle. It can cause pain, known as angina. It's a symptom of heart disease but typically does not cause permanent damage to the heart. It is, though, a sign that you are at risk for a heart attack in the future. The chest pain may spread to your arm, shoulder, jaw, or back. It may feel like a pressure or squeezing sensation. Exercise, excitement, or emotional distress can trigger angina, and rest makes it better.
Myocardial infarction (heart attack). This lowered blood flow through heart blood vessels causes the death of heart muscle cells. Though similar to angina chest pain, a heart attack is usually a more serious and crushing pain, usually in the center or left side of the chest, and rest doesn't make it better. Sweating, nausea, shortness of breath, or severe weakness may happen with the pain.
Myocarditis. Along with chest pain, this heart muscle inflammation may cause fever, fatigue, fast heartbeat, and trouble breathing. Although you don't have a blockage, myocarditis symptoms can feel like those of a heart attack.
Pericarditis. This is an inflammation or infection of the sac around the heart. It can cause pain similar to that caused by angina, but it often causes a sharp, steady pain along the upper neck and shoulder muscles. Sometimes, it gets worse when you breathe, swallow food, or lie on your back.
Hypertrophic cardiomyopathy. This genetic disease causes the heart muscle to grow abnormally thick. Sometimes, this leads to problems with blood flow out of the heart. Chest pain and shortness of breath often happen with exercise. Over time, you may have heart failure when your heart muscle becomes very thickened. This makes the heart work harder to pump blood. Along with chest pain, this type of cardiomyopathy may cause dizziness, lightheadedness, fainting, and other symptoms.
Mitral valve prolapse . It happens when a valve in the heart fails to close properly. A variety of symptoms have been associated with mitral valve prolapse, including chest pain, palpitations, and dizziness, but it can also have no symptoms, especially if the prolapse is mild.
Coronary artery dissection. Many things can cause this rare but deadly condition, which results when a tear develops in the coronary artery. It may cause a sudden, severe pain with a tearing or ripping sensation that goes up into the neck, back, or abdomen.
Aortic dissection. It happens when there's a tear in the inner layer of a weak spot in your aorta, the big artery carrying blood from your heart to the rest of your body. You may suddenly feel a sharp pain in your chest or back, like tearing or ripping. Other symptoms include shortness of breath, fainting, and dizziness.
Aortic aneurysm. Aortic aneurysms are like bulging balloons that form in the aorta. Normally, the aorta has strong walls that can handle the pressure of blood flow. But health issues, genetics, or injury sometimes damage or weaken these walls. When blood presses against these weakened areas, an aneurysm can form.
Aortic stenosis. Your aortic valve is like a gatekeeper, allowing blood to move from the heart's left lower chamber (left ventricle) into the aorta, carrying blood throughout your body. Aortic stenosis happens when this valve becomes narrow, disrupting the normal flow of blood.
Heart rhythm problems. Also known as heart rhythm disorders, this can happen to anyone, even if you don't have any other heart diseases. But people with other heart problems are more vulnerable. Heart rhythm problems are divided into three categories:
These are common causes of chest pain:
Pleuritis. Also known as pleurisy, this is an inflammation or irritation of the lungs and chest lining. You likely feel a sharp pain when you breathe, cough, or sneeze. The most common causes of pleuritic chest pain are bacterial or viral infections, pulmonary embolism, and pneumothorax. Other less common causes include rheumatoid arthritis, lupus, and cancer.
Pneumonia or lung abscess. These lung infections can cause pleuritic and other types of chest pain, such as a deep chest ache. Pneumonia often comes on suddenly, causing fever, chills, cough, and pus from the respiratory tract.
Pulmonary embolism. When a blood clot travels through the bloodstream and lodges in the lungs, it can cause acute pleuritis, trouble breathing, and a rapid heartbeat. It may also cause fever and shock. Pulmonary embolism is more likely following deep vein thrombosis, after being immobile for several days following surgery, or as a complication of cancer.
Pneumothorax. Often caused by a chest injury, pneumothorax happens when a part of the lung collapses, releasing air into the chest cavity. This can also cause pain that gets worse when you breathe and other symptoms, such as low blood pressure.
Pulmonary hypertension. With chest pain resembling that of angina, this abnormally high blood pressure in the lung arteries makes the right side of the heart work too hard.
Asthma. An inflammatory disorder of the airways, asthma causes shortness of breath, wheezing, coughing, and sometimes chest pain.
Chronic obstructive pulmonary disease (COPD). This includes one or more of three diseases — emphysema, chronic bronchitis, and chronic obstructive asthma. The disease blocks airflow by shrinking and damaging both the airways that bring gases and air to and from your lungs and the tiny air sacs (alveoli) that transfer oxygen to your bloodstream and remove carbon dioxide. Smoking is the most common cause.
Lung cancer. You get lung cancer when unusual cells grow out of control in your lungs. It's a major health problem and can be fatal. The symptoms include a cough that doesn't go away, chest pain, and trouble breathing.
Tuberculosis (TB). It is a contagious illness caused by bacteria that usually affects the lungs. TB spreads through the air when infected individuals cough, sneeze, or spit.
Viral infection. Respiratory viruses such as SARS-CoV-2 (which causes COVID-19) and influenza can cause myocarditis, a rare condition often triggered by an infection reaching the heart. The heart muscle becomes thick, swollen, and weak. One symptom is chest pain similar to a heart attack.
Gastrointestinal problems can also cause chest pain and include:
Gastroesophageal reflux disease (GERD). Also known as acid reflux, GERD happens when stomach contents return to the throat. This may cause a sour taste in the mouth and a burning sensation in the chest or throat, known as heartburn. Things that may trigger acid reflux include obesity, smoking, pregnancy, and spicy or fatty foods. Heart pain and heartburn from acid reflux feel similar partly because the heart and esophagus are close to each other and share a nerve network.
Esophageal contraction disorders. Uncoordinated muscle contractions (spasms) and high-pressure contractions (nutcracker esophagus) are problems in the esophagus that can cause chest pain.
Esophageal hypersensitivity. This occurs when the esophagus becomes very painful at the smallest change in pressure or exposure to acid. The cause of this sensitivity is unknown.
Esophageal rupture or perforation. A sudden, severe chest pain following vomiting or a procedure involving the esophagus may be a sign of a rupture in the esophagus.
Peptic ulcers. These painful sores in the lining of the stomach or the first part of the small intestine may result in vague, repeated discomfort. They're more common in people who smoke, drink a lot of alcohol, or take painkillers such as aspirin or NSAIDs. The pain often gets better when you eat or take antacids.
Hiatal hernia. This common problem occurs when the top of the stomach pushes into the lower chest after eating. This often causes reflux symptoms, including heartburn or chest pain. The pain tends to get worse when you lie down.
Pancreatitis. You may have pancreatitis if you have pain in the lower chest that is often worse when you lie flat and better when you lean forward.
Gallbladder problems. After eating a fatty meal, do you feel full or have pain in your right lower chest area or the right upper side of your abdomen? If so, your chest pain may be due to a gallbladder problem.
Esophagitis. This happens when your esophagus, the tube that carries food from your mouth to your stomach, becomes inflamed. Symptoms include painful swallowing and chest pain.
Sometimes, chest pain may result from overuse or an injury to the chest area from a fall or accident. Viruses can also cause pain in the chest area. Other causes of chest pain include:
Rib problems. Pain from a broken rib may worsen with deep breathing or coughing. It is often confined to one area and may feel sore when you press on it. The area where the ribs join the breastbone may also become inflamed.
Muscle strain. Sometimes, even hard coughing can injure or inflame the muscles and tendons between the ribs and cause chest pain. The pain tends to persist, and it worsens with activity.
Shingles. Caused by the varicella-zoster virus, shingles may prompt a sharp, band-like pain before a telltale rash appears several days later.
Costochondritis. Also called chest wall pain syndrome or costosternal chondrodynia, this is an inflammation of the cartilage connecting a rib to the breastbone. Pain from the condition can be similar to that of a heart attack or other heart issues.
Another potential cause of chest pain is anxiety and panic attacks. As everyone experiences anxiety at some point, it's hard to pinpoint when it becomes an anxiety disorder. However, if your worries start affecting your daily life for an extended period, it's wise to seek advice from a mental health expert. Anxiety disorders and stress come in various forms, but they typically share these common symptoms:
If you notice these signs in a friend or family member, it's essential to talk to them about seeking help from a mental health professional. Some associated symptoms can include dizziness, sensation of shortness of breath, palpitations, tingling sensations, and trembling.
When in doubt, call your doctor about any chest pain you have, especially if it comes on suddenly or is not relieved by anti-inflammatory medications or other self-care steps, such as changing your diet.
Call 911 if you have any of these symptoms along with chest pain:
Call your doctor if you have any of these symptoms:
Chest pain can signal various issues, from heart problems such as aortic dissection to lung conditions such as pneumonia. Gastrointestinal troubles (such as GERD) or bone and muscle issues (such as costochondritis) can also cause discomfort. Anxiety and panic attacks are also potential causes of the condition. Also, note that the pain can be short or long, depending on the cause. You should get medical help if you have symptoms such as trouble breathing or pain spreading to the jaw or arm.
How do you know if chest pain is serious?
The best way to know how serious your chest pain is is to visit your doctor or call 911 or the local emergency number for medical help.
What can cause chest pain in women?
One of the most common causes is angina, but there are others including reflux, esophageal spasms, lung issues such as asthma or COPD, musculoskeletal pain, and stress.
Thrombosis Vs. Embolism
Thrombosis and embolism are both blood clots that reduce or block blood flow inside your blood vessels. They're two different yet serious conditions. Here's a look at the differences and similarities.
Thrombosis occurs when a blood clot (thrombus) forms locally in a blood vessel and slows or blocks the flow of blood. There are two types of thrombosis:
Venous thrombosis is when the blood clot blocks a vein. Veins carry blood from the body back into your heart. Deep vein thrombosis (DVT) is the most common type. It usually forms in the deep veins of your lower leg. But it can also form in the veins of your thigh, pelvis, or arm.
Arterial thrombosis is when the blood clot blocks an artery. The arteries carry oxygen-rich blood from the heart to the rest of your body.
Arterial thrombosis occur when deposits of fat and calcium (plaque) build up on the walls of the arteries that supply blood to the heart. When this buildup makes the artery walls thick, it's called arteriosclerosis. This thickening slows or blocks the flow of blood and causes blood pressure to build. If a plaque deposit bursts, a blood clot can form and cause a heart attack. If it blocks the arteries that carry blood to your brain, it can cause a stroke.
An embolus is any foreign substance that moves in your bloodstream until it blocks a blood vessel. An embolism is often caused when a thrombus or a piece of thrombus breaks off from where it formed and travels to another area of your body.
An embolism is a life-threatening condition and can cause serious complications such as stroke (clot in the brain) and pulmonary embolism (clot or blockage in the lung).
There are many types of thrombosis and embolism. Venous thromboembolism (VTE) is an umbrella term that doctors use to refer to blood clots that start in the veins, such as DVT. The most serious complication of these clots is a pulmonary embolism (PE). This is when the clot travels through the bloodstream to the lung, where it can cause permanent damage.
A DVT can occur in anybody at any age. But they are usually preventable and treatable if found early. This can also prevent a PE from forming.
Blood clot conditions like DVT and PE affect as many as 900,000 people per year in the U.S.
Risk factors for thrombosis and embolism include:
Signs and symptoms vary for each person and depend on where the clot is located and how big it is. And it's possible that you might not have symptoms. In fact, it happens in about half the cases.
Common DVT symptoms include:
If you notice this, tell your doctor right away.
Arterial thrombosis symptoms may include:
If you have any of these signs, call 911 and get immediate medical help.
If you have a PE, your symptoms may include:
PE is life-threatening. If you notice these symptoms, get medical help right away.
If your doctor suspects a thrombosis, they'll first do a detailed physical exam and history. Your doctor will also run imaging tests to help locate the clot, such as:
Your doctor may also use blood tests:
These tests can help your doctor pinpoint where the clot is located and what might have caused it. This will help come up with an appropriate treatment plan.
A pulmonary embolism is hard to diagnose, especially if you have heart or lung disease. Diagnostic tests are similar to thrombosis tests. Additional tests may include:
Many different things will affect your treatment plan. Your doctor will look at:
Treatment options for thrombosis and embolism may include:
If your embolism is caused by an air bubble, your doctor might recommend a hyperbaric chamber. It's a clear case long enough for you to lie down. The air pressure inside the chamber is higher than the normal air pressure outside. This helps to reduce the air bubble inside your body.
Complications may include:
If you have a thrombosis like DVT, the outlook is good. The symptoms usually go away in time with proper treatments like medication and lifestyle changes. It may take anywhere from 3-6 months for your clot to dissolve.
As for embolisms like PE, how well you recover depends on a few things such as:
About 33% of those with a DVT or PE have another blood clot within 10 years. Untreated or serious DVT or PE kills up to 100,000 people per year in the U.S. And about 25% of those with PE die suddenly with no symptoms.
It's hard to detect a blood clot in your body before it forms. But they are preventable. The key to preventing a clot from becoming a deadly embolism is lifestyle changes.
You should:
If you have a DVT, it's important to follow your treatment plan closely to stop it from progressing to PE. If you notice signs and symptoms of an embolism, call 911 immediately or head to the nearest hospital for medical help.
Researchers Link Urban Green And Blue Spaces To Less Coronary Artery Calcification
Being near and having more exposure to urban green space and blue (water) space is linked to lower odds of having coronary artery calcification in middle age, which is an early marker of cardiovascular disease.
The associations were more pronounced among Black individuals and those living in neighborhoods with lower socioeconomic status, with the strongest effects observed in Black individuals in economically deprived neighborhoods.
Specifically, Black participants with the highest accessibility to a river had 32% lower odds of coronary artery calcification compared to those with the lowest accessibility. Black participants with greater access to green spaces had up to 35% lower odds of calcification. For each 10%-point increase in green space, the odds of having coronary artery calcification decreased by 15% on average.
The study was published today June 27 Circulation.
Coronary artery calcification (CAC) is when calcium builds up in the plaque found in the walls of the coronary arteries. It can be a sign of early coronary artery disease, which can cause a heart attack.
"The protective effect of having access to urban blue and green spaces with coronary artery calcification highlighted in our study underscore the potential benefits of such infrastructure, particularly for underserved populations at higher risk for cardiovascular disease," said corresponding author Dr. Lifang Hou, a professor of preventive medicine at Northwestern University Feinberg School of Medicine.
"Our findings provide quantitative evidence supporting environmental policies to enhance the accessibility and quality of residential blue and green spaces, which can promote public health benefit and address racial and neighborhood-related health disparities."
Why do green and blue spaces improve health?"Having more green and blue spaces may provide increased opportunities for physical activities, social interactions, stress relief and restoration, all of which have been linked to improved metabolic and cardiovascular health," Hou said.
"Additionally, exposure to green and blue spaces has been shown to boost people's immune system, reduce chronic inflammation and slow down the biological aging process, all of which are biologically important in people's overall health and cardiovascular health. More studies are needed to fully understand the role of urban natural environments in pathways related to human health."
Conversely, the study also showed shorter distances to parks were associated with higher odds of CAC in these neighborhoods, with individuals having the highest park accessibility showing 29% higher odds of CAC compared to those with the lowest accessibility.
"The poor condition of parks and/or safety concerns in underserved urban neighborhoods might deter park use and prevent residents from fully benefiting from these spaces," said study first author Kyeezu Kim, adjunct assistant professor of preventive medicine at Feinberg and assistant professor at Sungkyunkwan University School of Medicine in South Korea.
"From a public health perspective, the results suggest the need for quality control and management of the surrounding environment in neighborhoods with disadvantaged social determinants of health. More data is warranted to fully explain this observation."
How the study was conductedThe study included 2,960 Black and white men and women (average age of 50 years) from Birmingham, Ala., Chicago, Ill., Minneapolis, Minn., and Oakland, Calif., who were followed for 25 years (from 1985–1986 to 2010–2011). While proximity to urban blue and green spaces has been linked to better cardiovascular health, few studies have examined the role of social determinants of health, such as race and neighborhoods with lower socioeconomic status in these associations, particularly with long-term observational data.
Data for this study were drawn from the Coronary Artery Risk Development in Young Adults (CARDIA) study, a multi-center prospective cohort study across four urban cities in the U.S. The CARDIA study began in 1985–1986 with 5,115 self-reported Black and white individuals in early adulthood (mean age 24.8).
For blue and green spaces, researchers included percent blue space cover, distance to the nearest river, percent green space cover and distance to the nearest major park within 5 km of the participants' residential addresses. The presence of CAC was measured using a CT (computed tomography) scan when participants were about 50 years old. Researchers examined the associations between each blue and green space and CAC by race and neighborhood socioeconomic status.
More information: Kyeezu Kim et al, Associations of Urban Blue and Green Spaces With Coronary Artery Calcification in Black Individuals and Disadvantaged Neighborhoods, Circulation (2024). DOI: 10.1161/CIRCULATIONAHA.123.067992
Citation: Researchers link urban green and blue spaces to less coronary artery calcification (2024, June 27) retrieved 29 June 2024 from https://medicalxpress.Com/news/2024-06-link-urban-green-blue-spaces.Html
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