Chest pain is an ambiguous symptom which occurs due to a wide range of causes. It can be a psychosomatic complaint or something sinister like a heart attack. 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 or sternum due to costochondritis (i.e. inflammation of this part). This sort of pain can be precipitated due to mental tension. Pain occurs even on touching the part. Fibromyalgia is a condition in which chest pain occurs due to mental stress and anxiety. In this condition along with chest pain, a person has associated symptoms of stress like disturbed sleep, palpitations, e.t.c. Similar to costochondritis, there is localized tenderness. Herpes zoster is a viral infection causing acute inflammation of the nerves resulting in severe agonizing pain of the part affected. In case of involvement of any nerve of chest, there will be severe pain on the affected part. Infections of the pleural surface (covering of lungs) or lungs like Tuberculosis or pneumonias will also produce pain on the affected part of chest. The pain will be augmented by breathing. There will be associated symptoms of cough, high fever and loss of appetite Many problems in the digestive system can also cause chest pain. Inflammation of the mucosa (Inner lining) of the esophagus or food pipe also causes pain which is perceived in the middle of the chest. It may be felt as heaviness in the chest or burning sensation. Gastritis 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 associated nausea or bilious vomiting. Flatulence or gaseous distension after meals produces bloating sensation in stomach and can also cause pain in chest. Chronic constipation if present also contributes to this problem. In elderly persons, sometimes cervical spondylosis can also compression of the anterior nerve roots producing chest pain. The most sinister cause of chest pain, a condition feared by all is ischemic heart disease. Diminished blood supply to the heart due to narrowing of coronary arteries or block in them leads to chest pain. Typically this pain occurs in left side of chest, arm, hands, fingers or jaws. Pain appears 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 and echocardiography 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. The author is a specialist in Internal Medicine E-mail – rachna212002@yahoo.co.uk
