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Heart Disease (Expert Forum)
Re: Chest Pains
This forum is for questions and support regarding heart issues such as: Angina, Angioplasty, Arrhythmia, Bypass Surgery, Cardiomyopathy, Coronary Artery Disease, Defibrillator, Heart Attack, Heart Disease, High Blood Pressure, Mitral Valve Prolapse, Pacemaker, PAD, Stenosis, Stress Tests.
Re: Chest Pains
by Cleveland Clinic, MD, Jan 01, 1995 12:00AM
, Jan 01, 1995 12:00AM
Posted By CCF CARDIO MD - CRC on October 09, 1998 at 14:40:18:
In Reply to: Chest Pains posted by Kristine on October 09, 1998 at 11:14:07:
Ok, I am a 26 year old mother of two children. I have
experienced chest pains off and on for the last 4 years.
They are sometimes just a real sharp pain that does not
radiate down my arm, but is just in my chest, and I usually only
have one of those at a time. Every once
in awhile I have pains that last off and on throughout the day.
When these happen they are not real sharp pains, but just
a noticable pain in the chest area. I notice that my pains
usually happen when I am in the sitting position, but not
always. When I take walks (and especially when I am
walking up a hill) I make it a point to pay attention to
whether or not I have a pain and I never have had
any of the pains during exertion, so I was just wondering
what in the world this could be!? I have had a history of
anxiety attacks so you can imagine when I have these
pains, they send me into a frenzy thinking I am going to die!
I am currently taking 10 mg of Paxil daily.
Any advice you can give would be greatly appreciated. Thank
you ......Kristine
_____
Dear Kristine,
There are many causes of chest pain. The one that doctors worry about the most is cardiac because it has the potential to be life-threatening. Once this is ruled out the work-up can proceed at a more leisurely pace.
Amongst the cardiac causes of chest pain are: ischemia (due to blockages - including both stable and unstable angina and acute heart attack), pericarditis (inflammation of the sack around the heart), myocarditis (inflammation of the heart), cardiomyopathy (heart failure) and rarer causes such as coronary artery dissection, acute rupture of the heart and valves and infections of the pericardium.
Gastrointestinal causes of chest pain include reflux (acid from the stomach washing back into the esophagus), gallstones, esophageal spasm, esophageal rupture, varicose veins of the esophagus, strictures of the esophagus, tumors of the esophagus and other less common GI problems.
Pulmonary (lung) causes include pneumonia, pulmonary embolus, pneumothorax, pleuritis and bleb rupture.
Other potential causes are aortic dissection, back and spine problems and musculoskeletal (muscle strain, rib fracture, etc.).
Psychological causes of chest pain are common and include panic attacks, anxiety, stress and mental duress.
As you can see the list of potential causes in long and may take a little bit of time to determine the precise cause. A good Internal Medicine doctor should be able to work through the potential causes of your symptoms. You can be encouraged from the fact that the risk of heart disease in a young woman is very low.
I hope you find this information useful. Information provided in the heart forum is for general purposes only. Only your physician can provide specific diagnoses and therapies. Please feel free to write back with additional questions.
If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire online by using the Heart Center website at www.ccf.org/heartcenter. The Heart Center website contains a directory of the cardiology staff that can be used to select the physician best suited to address your cardiac problem.
In Reply to: Chest Pains posted by Kristine on October 09, 1998 at 11:14:07:
Ok, I am a 26 year old mother of two children. I have
experienced chest pains off and on for the last 4 years.
They are sometimes just a real sharp pain that does not
radiate down my arm, but is just in my chest, and I usually only
have one of those at a time. Every once
in awhile I have pains that last off and on throughout the day.
When these happen they are not real sharp pains, but just
a noticable pain in the chest area. I notice that my pains
usually happen when I am in the sitting position, but not
always. When I take walks (and especially when I am
walking up a hill) I make it a point to pay attention to
whether or not I have a pain and I never have had
any of the pains during exertion, so I was just wondering
what in the world this could be!? I have had a history of
anxiety attacks so you can imagine when I have these
pains, they send me into a frenzy thinking I am going to die!
I am currently taking 10 mg of Paxil daily.
Any advice you can give would be greatly appreciated. Thank
you ......Kristine
_____
Dear Kristine,
There are many causes of chest pain. The one that doctors worry about the most is cardiac because it has the potential to be life-threatening. Once this is ruled out the work-up can proceed at a more leisurely pace.
Amongst the cardiac causes of chest pain are: ischemia (due to blockages - including both stable and unstable angina and acute heart attack), pericarditis (inflammation of the sack around the heart), myocarditis (inflammation of the heart), cardiomyopathy (heart failure) and rarer causes such as coronary artery dissection, acute rupture of the heart and valves and infections of the pericardium.
Gastrointestinal causes of chest pain include reflux (acid from the stomach washing back into the esophagus), gallstones, esophageal spasm, esophageal rupture, varicose veins of the esophagus, strictures of the esophagus, tumors of the esophagus and other less common GI problems.
Pulmonary (lung) causes include pneumonia, pulmonary embolus, pneumothorax, pleuritis and bleb rupture.
Other potential causes are aortic dissection, back and spine problems and musculoskeletal (muscle strain, rib fracture, etc.).
Psychological causes of chest pain are common and include panic attacks, anxiety, stress and mental duress.
As you can see the list of potential causes in long and may take a little bit of time to determine the precise cause. A good Internal Medicine doctor should be able to work through the potential causes of your symptoms. You can be encouraged from the fact that the risk of heart disease in a young woman is very low.
I hope you find this information useful. Information provided in the heart forum is for general purposes only. Only your physician can provide specific diagnoses and therapies. Please feel free to write back with additional questions.
If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire online by using the Heart Center website at www.ccf.org/heartcenter. The Heart Center website contains a directory of the cardiology staff that can be used to select the physician best suited to address your cardiac problem.
