Definition: Pain or discomfort in the chest, caused by cardiac or non-cardiac conditions.
Types: Cardiac (Heart-related) & Non-Cardiac (Lungs, Muscles, Stomach, Anxiety).
CAUSES OF CHEST
PAIN
1. CARDIAC CHEST
PAIN (DANGEROUS)
• Angina Pectoris → Pain due to reduced blood
supply to the heart (ischemia).
• Myocardial Infarction (Heart Attack) → Severe,
crushing pain due to blocked arteries.
• Pericarditis → Sharp pain, worse with deep
breathing & lying down.
• Aortic Dissection → Sudden, tearing pain
radiating to back.
Mnemonic:
"HAPI" (Cardiac Causes)
- Heart Attack
(MI)
- Angina
- Pericarditis
- Internal
Tear (Aortic Dissection)
2. NON-CARDIAC
CHEST PAIN (Common & Less Dangerous)
• Respiratory (Lung-related)
- Pulmonary Embolism (PE)
→ Sudden chest pain, breathlessness.
- Pneumothorax
→ Sharp pain + sudden lung collapse.
- Pneumonia & Pleurisy
→ Pain on breathing, fever, cough.
• Gastrointestinal (Stomach-related)
- GERD (Acid Reflux)
→ Burning pain, worse after food & lying down.
- Esophageal Spasm
→ Feels like heart pain, but relieved by drinking
water.
- Peptic Ulcer
→ Pain after eating, relieved by antacids.
• Musculoskeletal (Rib & Muscle Pain)
- Costochondritis
→ Pain at rib-sternum junction, tender on
pressure.
- Muscle strain
→ Pain on movement, relieved by rest.
• Psychological
- Anxiety & Panic Attack
→ Fast heartbeat, breathlessness, fear of dying.
Mnemonic:
"R-G-M-P" (Non-Cardiac Causes)
- Respiratory
(Lungs)
- Gastrointestinal
(Stomach)
- Musculoskeletal
(Ribs & Muscles)
- Psychological
(Anxiety, Panic)
HOW TO DIFFERENTIATE CARDIAC vs. NON-CARDIAC PAIN
|
Feature |
Cardiac Pain |
Non-Cardiac Pain |
|
Type of Pain |
Heavy, Squeezing,
Crushing |
Sharp, Burning,
Stabbing |
|
Radiation |
Left arm, Jaw,
Neck, Back |
Localized, Rib
area, Stomach |
|
Trigger |
Exertion, Stress |
Breathing, Posture,
Food |
|
Relief |
Rest, Nitroglycerin |
Change in position,
Antacids |
DIAGNOSIS OF
CHEST PAIN
History & Examination → Most important!
ECG (Electrocardiogram) → Checks heart rhythm &
ischemia.
Cardiac Markers (Troponin, CK-MB) → Detects heart
attack.
Chest X-ray → Checks lungs & ribs.
Endoscopy → If GERD or ulcer is suspected.
Mnemonic:
"HEART" (Tests for Chest Pain)
- History
& Symptoms
- ECG
- Angiography
(For blockages)
- Radiology
(X-ray, CT Scan)
- Troponin
Test (For Heart Attack)
TREATMENT OF
CHEST PAIN
1. Cardiac Pain
Treatment
Angina → Nitroglycerin (GTN), Beta-Blockers
Heart Attack (MI) → Aspirin, Blood Thinners,
Angioplasty
Pericarditis → Painkillers (NSAIDs), Treat
Infection
Aortic Dissection → Emergency Surgery!
2. Non-Cardiac
Pain Treatment
Lungs (Pneumonia, PE) → Antibiotics, Blood
Thinners
GERD, Ulcer → Antacids, PPI (Omeprazole)
Muscle & Rib Pain → Painkillers, Rest, Heat
Therapy
Anxiety & Panic → Reassurance, Breathing
Exercises
Mnemonic: "R-E-L-I-E-F"
(Treatment of Chest Pain)
- Rest &
Reassurance
- ECG
Monitoring
- Lifestyle
Changes (Avoid Smoking, Fatty Foods)
- Investigations
(ECG, X-ray, Blood Tests)
- Emergency
Care (For Heart Attack, PE, Aortic Dissection)
- Food
Modifications (For GERD, Ulcer)
FINAL REVISION WITH MNEMONICS
- Cardiac Causes = "HAPI" (Heart Attack, Angina, Pericarditis, Internal Tear)
- Non-Cardiac Causes = "R-G-M-P" (Respiratory, Gastro, Muscle, Psychological)
- Tests = "HEART" (History, ECG, Angiography, Radiology, Troponin)
- Treatment = "R-E-L-I-E-F" (Rest, ECG, Lifestyle, Investigations, Emergency, Food Changes)
