Chest pain is mostly linked to heart problems and is frightening to the individual, whenever it occurs. It can be due to multiple causes, harmless in most cases. Muscular pains can occur in the chest due to excess work, trauma or exposure to cold weather. Young adults particularly men can develop pain at the junction of the rib with the chest bone due to costochondritis. This pain is presumed to be precipitated due to mental tension and anxiety. Pain occurs even on touching the part. Fibromyalgia is also a condition in which chest pain occurs due to mental stress and anxiety. In this condition, a person has associated symptoms of stress like disturbed sleep, palpitations, e.t.c. along with chest pain. Here also, even a touch is painful. Herpes zoster is a viral infection of the nerves. If any nerve of chest is affected, it causes acute inflammation resulting in severe agonizing pain over the part affected. Infections of the pleural surface (covering of lungs) or lungs like Tuberculosis, pneumonia will also produce pain on the affected part of chest. The pain will be augmented by breathing. There will be associated symptoms of cough, low grade fever and loss of appetite with weight loss. Problems in the digestive system can also cause chest pain. Inflammation of the inner lining of the esophagus or food pipe causes pain which is perceived in the middle of the chest. It may be felt as heaviness in the chest or burning sensation. Inflammation of the stomach can cause burning pain in abdomen and also in the chest. The pain in this situation occurs typically in the middle of the chest and is burning in nature. It augments after food. There may be or not be associated nausea or bilious vomiting. Flatulence or gaseous distension after meals produces bloating sensation in stomach and pain in chest. Chronic constipation if present also contributes to this problem and can aggravate the pain. In elderly persons, sometimes cervical spondylosis can cause compression of the anterior nerve roots producing chest pain, which may mimic pain of heart problem.. The most sinister cause of chest pain is ischemic heart disease. Diminished blood supply to the heart due to narrowing of coronary arteries leads to chest pain. Typically this pain occurs in left side of chest, arm, hands, fingers or jaws. It can be felt in left side of back, below left shoulder. Pain occurs after any exertion. The pain which occurs due to ischemia is pressure like and one experiences a sense of suffocation. Diagnosis of the cause of chest pain can be decided easily by determining the site, nature and other characteristics of the pain and associated features like fever, nausea; e.t.c. X-ray chest, electrocardiogram echocardiography, endoscopy, e.t.c. also help in the diagnosis. When diagnosed and treated timely chest pain is definitely cured whatever the cause. But some precautions are necessary to prevent relapse. Prevention of exposure to cold weather by wearing warm clothes keeps away myalgias or muscular pains. Regular meals, abstinence from alcohol, excess tea or coffee, intake of fresh fruits and green vegetables ensures the digestion to be good and prevents related problem of abdominal symptoms and chest pain. Good control of hypertension and diabetes minimizes the risk for angina or myocardial infarction. A healthy life style which includes proper diet and physical exercise keeps one healthy and also prevents pain in the chest of any kind. Therefore one should not worry on suffering from chest pain, but should not hesitate to seek medical advice either. Dr Rachna Pande, Specialist, internal medicine rachna212002@yahoo.co.uk
