Chest pain
| Chest pain | |
|---|---|
| Synonyms | pectoralgia, stethalgia, thoracalgia, thoracodynia |
| Classification and external resources | |
| ICD-10 | R07 |
| ICD-9-CM | 786.5 |
| DiseasesDB | 16537 |
| MedlinePlus | 003079 |
| MeSH | D002637 |
Chest pain may be a symptom of a number of serious disorders and is, in general, considered a medical emergency. Even though it may be determined that the pain is noncardiac in origin (does not come from a heart problem), this is often a diagnosis of exclusion made after ruling out more serious causes of the pain. Cardiac (heart-related) chest pain is called angina pectoris.
Chest pain is a common presenting problem, as the following numbers illustrate:
Causes of chest pain range from non-serious to serious to life-threatening.DiagnosisPro lists more than 440 causes on its website.
In adults the most common causes of chest pain include: gastrointestinal (42%), coronary artery disease (31%), musculoskeletal (28%), pericarditis (4%) and pulmonary embolism (2%). Other less common causes include: pneumonia, lung cancer, and aortic aneurysms.
Chest pain in children differs from adults in that there can be congenital causes and syndromes. In children the most common causes for chest pain are musculoskeletal and unknown.
Knowing a patient's risk factors can be extremely useful in ruling in or ruling out serious causes of chest pain. For example, heart attack and thoracic aortic dissection are very rare in healthy individuals under 30 years of age, but significantly more common in individuals with significant risk factors, such as older age, smoking, hypertension, diabetes, history of coronary artery disease or stroke, positive family history (premature atherosclerosis, cholesterol disorders, heart attack at early age), and other risk factors. Chest pain that radiates to one or both shoulders or arms, chest pain that occurs with physical activity, chest pain associated with nausea or vomiting, chest pain accompanied by diaphoresis or sweating, or chest pain described as "pressure," has a higher likelihood of being related to acute coronary syndrome, or inadequate supply of blood to the heart muscle, but even without these symptoms chest pain may be a sign of acute coronary syndrome.
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