QUESTION-1: WHAT IS CHEST PAIN, CAN YOU DEFINE?
Answer:
Chest pain is one of the most common symptoms that patients complain about. The term “chest pain” is used by patients. It is used by clinicians to describe very unpleasant or uncomfortable conditions in the anterior chest that raise a cardiovascular concern. Although the term chest pain is used in clinical practice, patients often complain of pressure, squeezing, heaviness, burning, stinging, stabbing, or pain. They may also report a location other than the chest, including the shoulder, arm, neck, back, upper abdomen, or chin.
QUESTION 2: WHY IS CHEST PAIN IMPORTANT?
Answer:
The fact that it may be due to a life-threatening cause is an important symptom since positive results are obtained with emergency treatment in this case.
QUESTION 3: WHAT ARE LIFE THREATENING CONDITIONS THAT CAUSE CHEST PAIN?
Answer:
1-Acute coronary syndrome (heart attack): Chest pains that are central in the chest, compressive, gripping, pressure-burning or heaviness in the form of tension, left-sided effort-related, suggest this type of pain. Pain that lasts for a short time, changes with breathing or head-neck-arm movement, creates a punctuated, stabbing, tearing or stabbing sensation, removes coronary artery disease or heart attack. There may also be symptoms of shortness of breath, weakness, nausea and vomiting, palpitations, or fainting. The definitive diagnosis is made by coronary angiography.
2-Pulmonary Embolism: It is the sudden occlusion of the pulmonary artery. The most common symptoms include shortness of breath followed by chest pain with breathing, cough, bloody sputum, and deep vein thrombosis symptoms. Risk factors are malignancy (cancer), pregnancy, immobility, spinal fractures, orthopedic operations, nephrotic syndrome and hereditary coagulation disorder.
3-Aortic Dissection: Aortic dissection is the rupture of the inner surface of the aortic vessel. may progress and cause aortic perforation. It is rare but can be a surgical emergency. Pain is the most common pain in more than 90 percent of patients, occurring most commonly in the chest or back. is a common symptom. Patients with acute aortic dissection typically present with acute chest, abdominal, and back pain that is severe and sharp and may have a tearing or tearing quality
4-Tension Pneumothorax: Perforation of the inner lining of the lung or air filling of the outer membrane of the lung as a result of damage. Patients present with sudden onset of chest pain increasing with respiration and shortness of breath. There may be difficulty breathing or abdominal breathing. Hemodynamic deterioration (tachycardia, hypotension) is an adverse sign and indicates serious consequences, requiring rapid intervention.
5-Eesophagus perforation or rupture: Spontaneous perforation of the esophagus caused by straining or vomiting (Boerhaave syndrome) presents as unbearable chest pain. Although a history of severe retching and vomiting prior to the onset of pain is classic, 25-45% of patients do not have a history of vomiting. Sometimes unclear complaints can contribute to a delay in diagnosis and a poor outcome. Within hours, patients may develop pain with eating, shortness of breath and sepsis (systemic infection). Complaints begin suddenly and include chest pain, rapid and difficult breathing, and inability to lie flat. Tachycardia, hypotension develops, and becomes evident by increasing neck vascular pressure.
7-Sarcoidosis-related arrhythmias: Cardiac sarcoidosis can cause arrhythmias (including heart block and ventricular tachycardia) and chest pain, palpitations, fainting
QUESTION 4: WHAT CAN BE OTHER CAUSES OF CHEST PAIN?
Answer:
Heart-related causes:
-Stable myocardial ischemia: Due to coronary artery stenosis, increasing with effort, decreasing with rest or sublingual and generally in the form of pressure, burning, weight.
-Heart failure: It may be accompanied by shortness of breath, swelling of the feet, swelling of the abdomen, and inability to lie flat.
-Acute pericarditis: Inflammation of the pericardium. Key symptoms are sharp, aggravated chest pain radiating to the back and decreasing by leaning forward from a sitting position. includes the It is often associated with fever.
- Acute myocarditis: Inflammation of the heart muscle. Viral infection is common before.
-Stress cardiomyopathy: It develops after heavy stress (takotsubo). Symptoms, including chest pain, are similar to acute myocardial infarction
-Aortic or mitral valve stenosis
Lung related causes;
Pneumonia (Lung infection): There may be chest pain with frequent breathing.
Malignancy: Patients with lung cancer Patients may complain of chest pain, typically on the same side as the primary tumor. Other symptoms are cough, bloody sputum and shortness of breath.
Asthma and COPD: Associated with chest tightness with shortness of breath in exacerbations.
Pleuritis: Pleuritis is an inflammation of the pleura and causes chest pain with breathing. Causes include autoimmune diseases (lupus) and medications (procainamide, hydralazine, isoniazid).
Sarcoidosis: Common respiratory symptoms include cough, shortness of breath, and chest pain;
Pulmonary hypertension: It is pulmonary arterial hypertension. It is caused by increased right heart wall stress and myocardial (heart muscle) oxygen demand.
Causes related to the digestive system;
Gastroesophageal reflux disease (GERD): It is a common cause of non-cardiac chest pain. Chest pain due to GERD may mimic angina pectoris and may be defined as squeezing or burning that is located substernally and radiates to the back, neck, jaw, or arms. It can take minutes or hours and resolves on its own or with antacids. It may occur after meals, awaken patients from sleep, and be exacerbated by emotional stress.
Peptic ulcer disease: It usually presents with epigastric (stomach area) pain or food-induced epigastric discomfort and fullness, early satiety and nausea.
Esophagitis: Inflammation of the esophagus.
Other: Hiatus hernias (hernia in the diaphragm) reflux In addition to its symptoms, it can also cause chest pain. Inflammation of the gallbladder, pancreas and intestines may have chest pain.
Musculoskeletal Causes;
Isolated musculoskeletal chest pain syndrome: There is local or regional breast tenderness.
Rheumatic diseases patients usually have isolated chest wall has no pain and has other symptoms of rheumatic disease
Coastache: Rib fractures are associated with localized and tender chest pain, aggravated by breathing.
Trauma
Psychiatric reasons;
Panic attack/disorder: Panic attacks are typically characterized by spontaneous, discrete attacks of intense fear that begin suddenly and last from a few minutes to an hour. In fact, panic disorder has been considered as a risk factor for coronary artery disease in postmenopausal women.
Domestic violence: Patients exposed to domestic violence may complain of chest pain or associated psychiatric conditions (e.g. panic disorder). ) may experience chest pain in the environment
Foreign Substance Use; It is common in cocaine and methamphetamine and is related to spasm.
Referred pain: Inflammation of the gallbladder and pancreas can cause pain that radiates to the chest.
Herpes zoster (shingles): Especially In older adults, chest pain may be an initial symptom of shingles, usually two to three days before the typical rash.
Answer: This indicates a serious coronary artery disease. It should be evaluated with effort tests, scintigraphy or coronary angiography.
QUESTION 6: WHO SHOULD BE MORE AWARE OF BREAST PAIN
Answer: Those with a family history of heart attack or sudden death risk, diabetes mellitus, hypertension, heavy smoking Those who smoke, those with aortic vasodilation, orthopedic fracture and surgery history, and those who have undergone interventional procedures on the chest area should be more afraid of chest pain. MYSELF Z SHOULD WE USE ANY MEDICATION
Answer: It depends on the reason. For example, aspirin should be taken in case of heart attack, but not in case of aortic dissection or esophageal rupture. Sublingual nitrate can be taken, if the pain lasts longer than 15 minutes, the emergency should be consulted immediately.
QUESTION 8: WHICH COMPLAINTS OTHER THAN CHEST PAIN THINK A HEART ATTACK?
Answer: Shortness of breath at rest or with light exertion, shoulder, arm and jaw pain, nausea , vomiting, drowsiness, sweating, altered consciousness, fainting are other possible complaints.
QUESTION 9: DO YOU HAVE ANYTHING OTHER TO SAY ABOUT THIS?
Answer: Cardiovascular diseases are still the most common cause of death, and this rate has improved to approximately 50%. is based on. Chest pain is the most common symptom of cardiovascular diseases. It is often a precursor. When precautions are taken after this complaint, cardiovascular diseases that cause undesirable events are greatly reduced and prevented with appropriate examinations and treatments. For this reason, chest pain should not be neglected, cardiological controls should be performed.
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