Chest Problems
Topic OverviewChest pain and heart attackChest discomfort or pain
may be a key warning symptom of a
heart attack. Heart attack symptoms may include: - Chest pain or pressure, or a strange feeling in the chest.
- Sweating.
- Shortness of
breath.
- Nausea or vomiting.
- Pain, pressure, or a
strange feeling in the back, neck, jaw, or upper belly, or in one or both
shoulders or arms.
- Lightheadedness or sudden
weakness.
- A fast or irregular heartbeat.
Chest discomfort or pain that comes on or gets worse with
exercise, stress, or eating a large meal and goes away with rest may also be a
symptom of heart disease called angina. If you have any of these symptoms of a heart attack,
call 911 or other emergency services immediately. After you call 911, the operator may tell you to chew 1 adult-strength or 2 to 4 low-dose aspirin. Wait for an ambulance. Do not try to drive yourself. Since most of the damage to the
heart muscle during a heart attack occurs in the first 6 hours, emergency
treatment may prevent damage to the heart muscle and death. For men and women, the most common symptom is chest pain or pressure. Women are somewhat more likely than men to have other symptoms like shortness of breath, nausea, and back or jaw pain. Other causes of chest discomfort or painMost people
fear that chest pain always means that something is wrong with the heart. This is
not the case. Chest discomfort or pain, especially in people who are younger
than age 40, can have many causes. - Angina (say "ANN-juh-nuh" or "ann-JY-nuh") is a type of chest pain or discomfort that happens when there is not enough blood flow to the heart muscle. Angina is a symptom of coronary artery disease, also called heart disease. Angina is called stable angina when you can usually predict when your symptoms will happen. You probably know what things cause your angina. A sudden and unexpected change in your usual pattern of angina means that the blood flow has become more impaired and you could be having a heart attack. This is called unstable angina.
- Pain in the muscles or bones of the chest often
occurs when you increase your activities or add exercise to your schedule. This
is sometimes called
chest wall pain.
- Costochondritis is an inflammation of the joints formed by the
cartilage connecting the ribs to the breastbone (sternum). The inflammation could
be caused by an injury to the chest, but often the reason for the inflammation
is not known.
- Burning chest pain that
occurs when you cough may be caused by an upper respiratory infection caused by
a virus.
- Burning chest or rib pain, especially just before a rash
appears, may be caused by
shingles.
- An injury such as a
broken rib or bruised lung can be quite painful, especially when you
cough or try to take a deep breath.
- Swelling (inflammation) of the thin layers of tissue (pleura) covering the lungs and the chest wall may occur.
This is called pleurisy.
- Gastroesophageal reflux disease
(GERD) can cause pain just below the breastbone. Many
people will say they have "heartburn." This pain is usually
relieved by taking an antacid or eating.
Other, more serious problems that can cause chest pain
include: - An infection, such as pneumonia.
- A collapsed lung (pneumothorax),
which usually causes a sharp, stabbing chest pain and occurs with shortness of
breath.
- A blood clot in the lung (pulmonary embolism), which usually causes deep chest pain with the rapid
development of extreme shortness of breath.
- Lung cancer,
which may cause chest pain, especially if the cancer cells spread to involve
the ribs.
- Diseases of the spine, which can cause chest pain if the
nerves in the spine are "pinched."
Check your symptoms to decide if and when
you should see a doctor. Check Your SymptomsDo you have a problem in the chest area, such as pain or an injury? Review health risks that may make any symptom more serious. Yes Symptoms in chest area How old are you? Less than 12 years Less than 12 years 12 years or older 12 years or older Do you have only breathing problems with no other symptoms? Do you have moderate or severe belly pain? This is not the cramping type of pain you have with diarrhea. Is your main symptom a cough? Do you have symptoms of shock? Do you have any shortness of breath that is not caused by pain? Pain may make it hurt to breathe, but this is not the same as being short of breath. Would you describe your shortness of breath as severe, moderate, or mild? Severe Severe shortness of breath Moderate Moderate shortness of breath Mild Mild shortness of breath Have you been diagnosed with angina? Has there been a change in your angina over the past week? Yes Change in angina in the past week No Change in angina in the past week Is your treatment plan controlling the angina? If the plan is working, it should either make the symptoms go away or get them back to the level they were at before the angina got worse. Yes Treatment plan is controlling symptoms No Treatment plan is controlling symptoms Over the last few months, have you been getting angina more often or has it been worse than usual? Yes Angina occurring more often or getting worse No Angina occurring more often or getting worse Have you had any symptoms that you think may have been caused by your heart? These could include pain, pressure, or a strange feeling in the chest or a nearby area, like your neck or shoulder. Other symptoms can include shortness of breath, nausea or vomiting, or lightheadedness. Yes Possible heart symptoms No Possible heart symptoms How recently did you have these symptoms? Within the past week Heart-related symptoms within the past week More than a week ago Heart-related symptoms more than a week ago Have you had an injury to your chest in the past 2 weeks? Yes Chest injury within past 2 weeks No Chest injury within past 2 weeks Is there any blood in your urine? This can happen if you get hit in the ribs or side and damage the kidneys. Are you coughing up blood? This means blood that is coming up from your chest or throat. Blood that is draining down from your nose into your throat (because of a nosebleed, for example) is not the same thing. How much blood is there? A lot of bright red blood [2 tsp (10 mL) or more] Large amount [2 tsp (10 mL)] of bright red blood in sputum Streaks of bright red blood Streaks of bright red blood in sputum Specks or spots of blood Specks or spots of blood in sputum Has this been going on for more than 2 days? Yes Specks or spots of blood in sputum for more than 2 days No Specks or spots of blood in sputum for more than 2 days Do you take a medicine that affects the blood's ability to clot, such as aspirin, warfarin (such as Coumadin), enoxaparin (Lovenox), or clopidogrel (Plavix)? These medicines can cause bleeding and can make it harder to control bleeding. Yes Takes medicine that affects blood's ability to clot No Takes medicine that affects blood's ability to clot Do you have pain in your ribs or the muscles of your chest? This type of pain may feel worse when you press on or move the area or when you take a deep breath. How bad is the pain on a scale of 0 to 10, if 0 is no pain and 10 is the worst pain you can imagine? 8 to 10: Severe pain Severe pain 5 to 7: Moderate pain Moderate pain 1 to 4: Mild pain Mild pain Has the pain: Gotten worse? Pain is getting worse Stayed about the same (not better or worse)? Pain is unchanged Gotten better? Pain is getting better Do you know what caused the pain, such as severe sneezing or coughing? Yes Pain is from sneezing, coughing, or other known cause No Pain is from sneezing, coughing, or other known cause Has the pain lasted for more than 2 days? Yes Pain for more than 2 days No Pain for more than 2 days Do you have pain deep in one leg? Sudden chest pain that occurs with deep pain or swelling in one leg can be a symptom of a blood clot that has moved from the leg to the lung. Do you think the chest problem may be causing a fever? Do you have a new rash on only one side of your chest? The rash may be in a strip or band. Yes New rash on only one side No New rash on only one side Have you had symptoms for more than a week? Yes Chest symptoms for more than a week No Chest symptoms for more than a week Many things can affect how your body responds to a symptom and what kind
of care you may need. These include: - Your age. Babies and older
adults tend to get sicker quicker.
- Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart
disease, you may need to pay closer attention to certain symptoms and seek care
sooner.
- Medicines you take. Certain
medicines, herbal remedies, and supplements can cause symptoms or make them
worse.
- Recent health events, such as surgery
or injury. These kinds of events can cause symptoms afterwards or make them
more serious.
- Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug
use, sexual history, and travel.
Try Home TreatmentYou have answered all the questions. Based on your answers, you may be
able to take care of this problem at home. - Try home treatment to relieve the
symptoms.
- Call your doctor if symptoms get worse or you have any
concerns (for example, if symptoms are not getting better as you would expect).
You may need care sooner.
Pain in adults and older children - Severe pain (8 to 10): The pain
is so bad that you can't stand it for more than a few hours, can't sleep, and
can't do anything else except focus on the pain.
- Moderate pain (5 to 7): The pain is bad enough to disrupt your
normal activities and your sleep, but you can tolerate it for hours or days.
Moderate can also mean pain that comes and goes even if it's severe when it's
there.
- Mild pain (1 to 4): You notice the pain,
but it is not bad enough to disrupt your sleep or activities.
Severe trouble breathing means:
- You cannot talk at all.
- You have to
work very hard to breathe.
- You feel like you can't get enough
air.
- You do not feel alert or cannot think clearly.
Moderate trouble breathing means: - It's hard to talk in full
sentences.
- It's hard to breathe with activity.
Mild trouble breathing means: - You feel a little out of breath but can still talk.
- It's becoming hard to breathe with activity.
Shock is a life-threatening condition that may quickly occur
after a sudden illness or injury. Symptoms of shock (most of which will be present) include: - Passing out (losing consciousness).
- Feeling very dizzy or
lightheaded, like you may pass out.
- Feeling very weak or having
trouble standing.
- Not feeling alert or able to think clearly. You
may be confused, restless, fearful, or unable to respond to questions.
Shock is a life-threatening condition that may occur quickly
after a sudden illness or injury. Symptoms of shock in a child may include: - Passing out (losing consciousness).
- Being very sleepy or hard
to wake up.
- Not responding when being touched or talked to.
- Breathing much faster than usual.
- Acting confused.
The child may not know where he or she is.
Symptoms of a heart attack may
include: - Chest pain or pressure, or a strange feeling in the chest.
- Sweating.
- Shortness of
breath.
- Nausea or vomiting.
- Pain, pressure, or a
strange feeling in the back, neck, jaw, or upper belly, or in one or both
shoulders or arms.
- Lightheadedness or sudden
weakness.
- A fast or irregular heartbeat.
The more of these symptoms you have, the more likely it is that
you're having a heart attack. Chest pain or pressure is the most common
symptom, but some people, especially women, may not notice it as much as other
symptoms. You may not have chest pain at all but instead have shortness of breath, nausea, or a strange feeling in your chest or other areas. Seek Care TodayBased on your answers, you may need care soon. The
problem probably will not get better without medical care. - Call your doctor today to discuss the symptoms
and arrange for care.
- If you cannot reach your doctor or you don't
have one, seek care today.
- If it is evening, watch the symptoms and
seek care in the morning.
- If the symptoms get worse, seek care
sooner.
Make an Appointment Based on your answers, the problem may not improve without medical
care. - Make an appointment to see your doctor in the
next 1 to 2 weeks.
- If appropriate, try home treatment while you
are waiting for the appointment.
- If symptoms get worse or you have
any concerns, call your doctor. You may need care sooner.
Seek Care NowBased on your answers, you may need care right away. The problem is likely to get worse without medical care. - Call your doctor now to discuss the symptoms and
arrange for care.
- If you cannot reach your doctor or you don't have
one, seek care in the next hour.
- You do not need to call an
ambulance unless:
- You cannot travel safely either by driving
yourself or by having someone else drive you.
- You are in an area
where heavy traffic or other problems may slow you down.
Call 911 NowBased on your answers, you need
emergency care. Call911or other emergency services now. Call 911 NowBased on your answers, you need
emergency care. Call911or other emergency services now. After you call
911 , the operator may tell you to chew 1 adult-strength (325 mg) or 2
to 4 low-dose (81 mg) aspirin. Wait for an ambulance. Do not try to drive yourself. Abdominal Pain, Age 11 and Younger Respiratory Problems, Age 11 and Younger Coughs, Age 12 and Older Abdominal Pain, Age 12 and Older Respiratory Problems, Age 12 and Older Coughs, Age 11 and Younger « Back C 2.1.0.0
R 11.4.0.0 Start Over Home TreatmentHome treatment is not appropriate
for chest pain if the pain occurs with
symptoms of a heart attack. If you think a heart
attack might be the cause of your symptoms, call 911 or other emergency services immediately. After you call 911, the operator may tell you to chew 1 adult-strength or 2 to 4 low-dose aspirin. Wait for an ambulance. Do not try to drive yourself. Home treatment for people who have been diagnosed with chest pain (angina)If you have stable angina, you can probably predict when your symptoms will happen. You probably know what things cause your angina. If you and your doctor
have made a
home treatment plan, follow that plan. If you are having angina symptoms more often than usual or if they are different or worse than usual, call your doctor right away. If you have angina symptoms that do not go away with rest or are not getting better within 5 minutes after you take a dose of nitroglycerin, call 911 or other emergency services immediately. You may be able to
control how much your angina bothers you by making changes in your lifestyle.
You may find it helpful to: - Avoid strenuous activities that bring on
angina.
- Eat balanced, nutritious meals. Try to limit the amount of
fats and fatty foods you eat.
- Maintain a healthy
weight.
- Limit the amount of alcohol you drink. Don't drink more than 2 alcoholic drinks a day if you are a man, or 1 alcoholic drink a day if you are a woman.
- Do not smoke or use other tobacco products. For more information, see the topic
Quitting Smoking.
- Reduce stress. For more
information, see the topic
Stress Management.
- Control your blood
pressure with diet and medicine. For more information, see the topic
High Blood Pressure.
- Avoid
extremely cold or hot environments.
- Take all medicines, such as nitroglycerin, as
instructed by your doctor.
- Follow the exercise or activity program
you and your doctor developed.
If you do not need 911
emergency medical treatment for your chest pain or angina,
take your pulse before reporting your symptoms to your
doctor. Your heart rate and rhythm at the time of your chest pain may help your
doctor evaluate your symptoms. Home treatment for minor pain in the chestHome
treatment for minor chest pain depends on the cause of the pain. Minor chest
pain often improves with home treatment. A visit to your doctor
may not be needed. Chest wall painFor
chest wall pain caused by strained muscles or
ligaments or a fractured rib: - Rest. Rest and protect
an injured or sore area. Stop, change, or take a break from any activity that
may be causing your pain or soreness.
- Ice.
Cold will reduce pain and swelling. Apply an
ice or cold pack immediately to prevent or minimize swelling. Apply the ice
or cold pack for 10 to 20 minutes, 3 or more times a day. After 48 to 72 hours,
if swelling is gone, apply
warmth
to the area that hurts.
- Do not wrap or tape
your ribs for support. This may cause you to take smaller breaths, which could
increase your risk for developing
pneumonia or partial lung collapse
(atelectasis).
- Medicated creams that you put on the skin (topical)
may soothe sore muscles.
- Gentle stretching and massage may help
you get better faster. Stretch slowly to the point just before discomfort
begins, then hold the stretch for 30 to 60 seconds. Do this 3 to 4 times a day.
It is really helpful after the use of heat.
- As your pain gets
better, slowly return to your normal activities. Any increased pain may mean
that you need to rest a while longer.
Medicine you can buy without a prescription| Try a nonprescription
medicine to help treat your fever or pain: |
|---|
Talk to your child's doctor before switching back and
forth between doses of acetaminophen and ibuprofen. When you switch between two
medicines, there is a chance your child will get too much medicine. | Safety tips| Be sure to follow
these safety tips when you use a nonprescription medicine: |
|---|
- Carefully read and follow all
directions on the medicine bottle and box.
- Do not take more than
the recommended dose.
- Do not take a medicine if you have had an
allergic reaction to it in the past.
- If
you have been told to avoid a medicine, call your doctor before you take
it.
- If you are or could be pregnant, do not take any medicine other
than acetaminophen unless your doctor has told you to.
- Do not give aspirin to anyone younger than age 20 unless your doctor tells you to.
| If you have other symptoms along with your minor chest pain, see the Related Information section for topics that
relate to your other symptoms. Symptoms to watch for during home treatmentCall your doctor if any of the following occur during home
treatment: - You have increased difficulty
breathing.
- Chest discomfort lasts longer than 1 week.
- Symptoms become more severe or frequent.
PreventionThe following tips may prevent chest problems or injuries. - Stay in good overall physical shape. Do stretching and range-of-motion (ROM) exercises for
your arms and shoulders.
- Maintain good posture. Stand straight and
relaxed, without slumping.
- Warm up well and stretch before any
activity.
- Wear protective gear during contact sports or recreational
activities, such as hockey or football.
- Wear your seat belt
when in a motor vehicle.
- Make sure your child's backpack is the right size with
good support. Carrying heavy backpacks may increase his or her risk of chest
problems or injury.
Preparing For Your AppointmentTo prepare for your appointment, see the topic Making the Most of Your Appointment. You can help your
doctor diagnose and treat your condition by being prepared to
answer the following questions: - When did the chest pain begin?
- How long does the pain last?
- How
often does the pain occur?
- How severe is the pain?
- What
does the pain feel like?
- Where is the pain located?
- Does the pain change or get worse when you take a deep breath?
- What were you doing when it started? Is the pain
related to activity? Is it related to eating? Is it related to body
position?
- Does the pain start in the chest and spread to another
part of the body? Or does it start somewhere else and spread to the chest?
- Did you have other symptoms with the chest pain? What are the
other symptoms?
- Has this ever happened before? If so, did you see a
doctor?
- What was the diagnosis?
- What
tests were done?
- How was it treated?
- Have you had a chest injury or a fall?
- How and when did an injury
occur?
- Have you had any chest injuries in the past? Do you have any
continuing problems because of the previous injury?
- What activities make your symptoms better or
worse?
- What home treatment have you tried to relieve the pain? Did
it help?
- What nonprescription medicines have you taken? Did they
help?
- Do you have any
health risks?
CreditsByHealthwise Staff
Primary Medical ReviewerWilliam H. Blahd, Jr., MD, FACEP - Emergency Medicine
E. Gregory Thompson, MD - Internal Medicine
Adam Husney, MD - Family Medicine
Kathleen Romito, MD - Family Medicine
Specialist Medical ReviewerKathleen Romito, MD - Family Medicine Current as ofMarch 20, 2017 Current as of:
March 20, 2017 Last modified on: 8 September 2017
|
|