Is chest pain a sign of heart disease? Doctors remind you: These diseases can cause chest pain

This article was reviewed by Li Jiehui, deputy chief physician, Fuwai Hospital, Chinese Academy of Medical Sciences

The phrase most often heard by cardiovascular doctors in outpatient clinics is "chest pain". This symptom is common and complex because many diseases can cause chest pain, but the treatments are not the same, and some are even completely opposite.

Tearing pain in chest and back

Aortic dissection

Ma Liang, Director of the Department of Cardiovascular Surgery at the First Hospital of Zhejiang University: The aorta is the largest artery in the human body. When the inner membrane is damaged, high-speed, high-pressure blood flows through the rupture into the gap between the inner and outer membranes, forming an aortic dissection. Once a dissection occurs, the weak outer membrane will find it difficult to withstand the high-pressure blood flow for a long time and is very likely to rupture, endangering life.

Winter is the peak season for aortic dissection. The low temperature causes blood vessel contraction, and the blood pressure rises, making it easier for blood flow to break through the inner membrane and form a dissection. In recent years, the number of patients with aortic dissection has become younger and younger. One thing young patients have in common is that their blood pressure is not well controlled. Young people who like to eat late-night snacks, coupled with fatigue and poor rest, are increasingly suffering from high blood pressure.

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Special reminder

If you experience severe pain such as tearing back pain, chest pain, abdominal pain, etc., go to the hospital immediately. When you have chest pain, you usually think of myocardial infarction. The treatment of myocardial infarction and aortic dissection are two completely opposite methods. Aspirin used for myocardial infarction is an anticoagulant drug, while dissection surgery requires blood flow to be as slow as possible.

Recurrent angina pectoris

Coronary artery spasm

There is a kind of recurrent angina pectoris that troubles many people, especially middle-aged women. Because "there are symptoms but no evidence", all the tests have been done, and the blood vessels are smooth and not narrowed, but no abnormalities can be found. In fact, it is coronary artery contraction spasm.

Zhang Jian, chief physician of the Heart Center of Beijing Chest Hospital: Some patients in the Heart Center, especially middle-aged women, will have symptoms similar to myocardial infarction or severe myocardial ischemia. Some call 120 for angina pectoris, but when they go to the hospital for examination, they find that their blood vessels are quite unobstructed. It is very common in clinical practice, and it belongs to unstable states such as coronary contraction and spasm. Contraction causes the inner cavity and blood supply area of ​​the coronary artery to decrease, and coronary spasm causes blood supply interruption. These are two different degrees. Most of them occur in diseased coronary arteries. Under the action of external forces, such as sympathetic vagal excitement and other factors, contraction or spasm occurs. It can also occur in some completely normal coronary arteries, which is the result of changes in the internal environment of the body.

Special reminder

To distinguish whether myocardial ischemia is caused by coronary artery stenosis or vasospasm, examinations such as CT, coronary angiography, and intracavitary imaging examinations such as OCT can be performed. Young women without a genetic background will not have coronary artery disease, which may come from temporary changes in the internal environment.

Chest pain, weakness, difficulty breathing -

Pulmonary embolism

During the year-end cleaning or family gatherings to play mahjong, if you experience leg pain and always feel chest tightness and difficulty breathing, and also have pain on both sides of your back, this unexplained "tiredness" and chest pain may be due to pulmonary embolism. People who usually sit for a long time and like to rest need to pay special attention.

Song Bin, chief physician of vascular surgery at Zhengzhou Central Hospital affiliated to Zhengzhou University: The main cause of pulmonary embolism is the formation of deep vein thrombosis in the lower extremities. Although many middle-aged and elderly people like to keep fit, they generally focus on resting with moxibustion, scraping, etc., and as they age, they like to play with their mobile phones and play mahjong, and keep the same action for a long time, which slows down the blood circulation in the lower extremities and forms venous thrombosis. The symptoms of pulmonary embolism are also very typical, with sudden onset. Patients suddenly experience unexplained collapse, pale complexion, cold sweats, difficulty breathing, chest pain, coughing, syncope, etc. Patients will become extremely anxious, nauseous, and convulsed.

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Special reminder

People who sit for long periods of time can enhance blood circulation in their legs by doing more braking movements when watching computers, playing with mobile phones, or playing mahjong. They must exercise more and drink a normal amount of water to get the blood flowing, so as to avoid blood clots.

Squeezing pain in the chest

Acute Coronary Syndrome

Acute coronary syndrome is a syndrome caused by acute myocardial ischemia and is the most common fatal chest pain in clinical practice. Typical angina pectoris is compressive or stuffy, and the pain is usually located behind the sternum.

Wang Xiangrui, chief physician of the Pain Department of Shanghai Oriental Hospital: The common symptom is squeezing pain in the chest, which can radiate to the shoulder, left forearm, and neck. The chest pain lasts for 2 to 10 minutes and can be relieved after 3 to 5 minutes of rest or taking nitroglycerin. Fatigue, a full meal, cold, and emotional excitement can induce it. When a myocardial infarction occurs, the patient's chest pain often lasts for more than 30 minutes, and may be accompanied by nausea, vomiting, etc., which cannot be effectively relieved by nitroglycerin.

Special reminder

The symptoms of the elderly, diabetic patients, etc. may be atypical and need to be carefully identified. Timing is the key to rescue acute coronary syndrome, and patients with suspected symptoms should be sent to the hospital immediately.

Chest pain with heartburn

Gastroesophageal reflux

A bad stomach can also cause chest pain. The most typical symptoms of gastroesophageal reflux disease are chest pain and acid reflux and heartburn. Smoking and drinking, Helicobacter pylori infection, mood swings, irregular work and rest, lack of exercise... Each of these is a heavy pressure on the "stomach and esophagus", and gastroesophageal reflux disease has become a common disease.

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Zhou Dongsheng, chief physician of the Department of Gastroenterology at the Fifth Hospital of Xiamen, Fujian Province: The typical symptoms of gastroesophageal reflux disease are heartburn, reflux, and chest pain. Reflux can cause damage to the esophagus, manifested as erosive esophagitis; it can also cause damage to tissues other than the esophagus, such as the throat and airway. When gastroesophageal reflux occurs, the first thing to do is to improve your lifestyle. Eat until you are 80% full, take a walk after a meal, avoid lying flat or lying prone, and people with abdominal obesity need to lose weight. On this basis, medication or minimally invasive surgery can also be used.

Special reminder

People with gastroesophageal reflux should not drink too much porridge. Porridge produces a lot of stomach acid, and liquid food is more likely to reflux. Don't eat 2 hours before going to bed at night. If the symptoms are severe, you can raise the head of the bed.

Source: Health Times

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