Chest Pain Part 1 - What Is It, and What Are Its Causes?

From Richard N. Fogoros, M.D.
Few symptoms are more alarming than chest pain. In the minds of many people, chest pain equals heart pain. And while many other conditions can cause chest pain, cardiac disease is so common – and so dangerous – that the symptom of chest pain should never be dismissed out of hand as being insignificant.

What is chest pain?
“Chest pain” is an imprecise term. It is often used to describe any pain, pressure, squeezing, choking, numbness or any other discomfort in the chest, neck, or upper abdomen, and is often associated with pain in the jaw, head, or arms. It can last from less than a second to days or weeks, can occur frequently or rarely, and can occur sporadically or predictably. With such a broad definition the term “chest pain” is itself of little help to doctors.

What medical problems cause chest pain?
Chest pain is merely a symptom, not a diagnosis. Many medical problems can cause chest pain, and before the chest pain can be adequately treated, the actual underlying cause needs to be identified. The following is a list of the more common causes of chest pain, roughly in order of the frequency in which they are seen in the emergency room.
1. angina due to coronary artery disease
2. heart attack
3. heartburn
4. benign chest wall pain
5. anxiety or panic disorder
6. asthma, bronchitis, pneumonia, pleuritis
7. mitral valve prolapse
8. pericarditis
9. recent chest trauma
10. peptic ulcer
11. angina due to coronary artery spasm
12. angina due to cardiac syndrome X
13. aortic dissection
In young, healthy people presenting with chest pain, the condition "benign chest wall pain" is particularly common. This is a diagnosis that doctors do not understand very well, and consequently neither do their patients. Because this condition is completely harmless, the lack of understanding on the part of patients as to what is causing the pain often leads to months or years of needless worry or anxiety.