Chest pain is a reason adults seek medical care. Because the chest contains the heart, lungs, esophagus, ribs, and numerous muscles, discomfort in this area may originate from many sources. Some causes are minor, but others involve the heart and call for prompt evaluation. Learning about treatment approaches can help you make informed decisions about your care.
What Causes Chest Pain?
Chest pain generally falls into two categories: causes unrelated to the heart and causes linked to cardiac function. Non-cardiac sources are common, and they can include muscle strain from heavy lifting or strenuous exercise. Acid reflux is a digestive condition in which stomach acid flows back into the esophagus. This may produce a burning sensation behind the breastbone known as heartburn.
Emotional factors can also contribute. High stress may lead to chest tightness, and an anxiety attack is able to cause pain that feels intense. Because these sensations resemble heart-related symptoms, a medical evaluation can help clarify the source.
Chest pain that originates in the heart is called angina. Angina is a symptom rather than a disease, and it suggests the heart muscle is not receiving enough oxygen-rich blood. People often describe it as a squeezing or heavy pressure, which may spread to the arms, shoulders, neck, jaw, or back. Heart disease is a leading cause of angina. Fatty deposits can build up inside the coronary arteries over time, narrowing them and limiting blood flow. Cardiac chest pain may occur with other symptoms, including:
- Dizziness or lightheadedness
- Shortness of breath
- Cold sweats
- Nausea
Angina can also stem from coronary microvascular disease (MVD); this affects the smallest blood vessels of the heart.
How Is It Diagnosed?
Diagnosis usually begins with a discussion of your symptoms and health history, followed by a physical exam. An electrocardiogram (EKG) can be one of the first tests performed. This painless procedure uses small electrodes on the skin to record the heart’s electrical signals. An EKG reveals irregular rhythms, and it may help detect a heart attack or other urgent problems.
An echocardiogram can also be recommended. This ultrasound test uses sound waves to create moving images of the heart, and it allows the care team to assess its structure, valves, and pumping strength. If initial results do not explain the symptoms, additional testing may follow. Holter monitoring involves wearing a portable device that records heart activity during daily routines. Stress testing examines how the heart responds to exertion, typically on a treadmill, or to medication that mimics the effects of exercise.
How Is It Treated?
Treatment depends on the underlying cause. Pain from muscle strain or acid reflux is managed differently than pain related to the heart, so an accurate diagnosis shapes the care plan. For cardiac chest pain, lifestyle adjustments are often part of the approach. A cardiologist may recommend exercising regularly and eating a balanced diet. Medications can also be prescribed to help manage symptoms and related conditions. Depending on individual needs, options may include:
- Aspirin
- Beta blockers
- ACE inhibitors
- Angiotensin II receptor blockers
- Calcium channel blockers
- Vasodilators
- Diuretics
When coronary artery disease is advanced, a minimally invasive procedure may be appropriate. Balloon angioplasty uses a small inflatable balloon to widen a narrowed artery, and atherectomy removes plaque from the artery wall. Both techniques aim to improve blood flow to the heart.
Meet With a Cardiologist
A cardiologist is able to evaluate your situation, and they can develop a treatment plan suited to your needs. Sudden or severe chest pain warrants immediate emergency care. For recurring or unexplained discomfort, schedule an appointment with a cardiologist to learn more about the cause and your options.
