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Symptom/Sign: Chest pain
Classifications and external resources
ICD-10 R07.
ICD-9 786.5

In medicine, chest pain is a symptom of a number of serious conditions and is generally considered a medical emergency, unless the patient is a known angina pectoris sufferer and the symptoms are familiar (appearing at exertion and resolving at rest, known as "stable angina"). A symptom' (from Greek σύμπτωμα, "accident misfortune that which befalls" from συμπίπτω, "I befall" from A Sign is an indication of some fact or quality and a medical sign is an objective indication of some medical fact or quality that is detected by a Physician The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify Diseases The International Statistical Classification of Diseases and Related Health Problems 10th Revision ( ICD -10) is a coding of diseases and signs symptoms abnormal findings R00-R69 - Symptoms and Signs (R00-R09 Circulatory and Respiratory systems ( Abnormalities of Heart beat The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify Diseases The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. Medicine is the art and science of healing It encompasses a range of Health care practices evolved to maintain and restore Human Health by the A symptom' (from Greek σύμπτωμα, "accident misfortune that which befalls" from συμπίπτω, "I befall" from A medical emergency is an Injury or Illness that is acute and poses an immediate risk to a person's life or long term health Angina pectoris, commonly known as angina, is severe Chest pain due to Ischemia (a lack of blood and hence Oxygen supply of the heart When the chest pain is not attributed to heart disease, it is termed non-cardiac chest pain.

Contents

Causes

Cardiopulmonary

Important cardiovascular and pulmonary causes of chest pain:

Other causes

Other causes of chest pain include:

High abdominal pain may also mimick chest pain. Carbon monoxide poisoning occurs after the inhalation of Carbon monoxide gas Lead poisoning (also known as saturnism, plumbism, or painter's colic) is a medical condition caused by increased levels of the metal Lead in Gastroesophageal reflux disease ( American English and Canadian English) or Gastro-oesophageal reflux disease ( British English, Hiberno-English Heartburn or pyrosis is a painful or burning sensation in the Esophagus, just below the breastbone usually associated with regurgitation of gastric acid A hiatus hernia or hiatal hernia is the protrusion (or Herniation) of the upper part of the Stomach into the Thorax through a tear or weakness Achalasia, also known as esophageal achalasia, achalasia cardiae, cardiospasm, dyssynergia esophagus, and esophageal aperistalsis Nutcracker esophagus is a disorder of the movement of the Esophagus, and is one of many Motility disorders of the esophagus including Achalasia and The esophagus or oesophagus (see American and British English spelling differences) sometimes known as the gullet, is an organ in Tietze's syndrome is a benign Inflammation of one or more of the Costal cartilages It was first described in 1921 by the German surgeon Alexander Tietze The term spinal nerve generally refers to the mixed spinal Nerve, which is formed from the dorsal and ventral roots that come out of the Spinal cord. Fibromyalgia (FM is a disorder classified by the presence of chronic widespread Pain and tactile Allodynia. The thoracic cavity (or chest cavity) is the chamber of the human body (and other animal bodies that is protected by the Thoracic wall ( Thoracic cage The breast is the upper Ventral region of an animal’s Torso, particularly that of Mammals including Human beings. Herpes zoster (or simply zoster) commonly known as shingles, is a Viral disease characterized by a painful skin rash with Blisters in a limited Panic attacks are sudden discrete periods of intense anxiety mounting Physiological arousal fear stomach problems and discomfort that are associated with a variety of Anxiety is a physiological and psychological state characterized by Cognitive, Somatic, Emotional and Behavioral components Major depressive disorder, also known as major depression, unipolar depression, unipolar disorder, clinical depression, or simply depression Somatization disorder (also Briquet's disorder or in antiquity hysteria) is a psychiatric diagnosis applied to patients who chronically and persistently Hypochondriasis (or hypochondria, sometimes referred to as health phobia) refers to an excessive preoccupation or worry about having a serious illness In Psychiatry, hyperventilation syndrome ( HVS) is an disorder that often presents with Chest pain and a tingling sensation of the fingertips ( Paresthesia Da Costa's syndrome, which was colloquially known as soldier's heart, is a Syndrome with a set of Symptoms that are similar to those of Heart disease Bornholm disease or pleurodynia is a Disease caused by the Coxsackie Virus. A virus (from the Latin virus meaning Toxin or Poison) is a sub-microscopic infectious agent that is unable Precordial Catch Syndrome (PCS also known as Texidor's twinge, is a common cause of Chest pain complaints in Children and Adolescence. Pleurisy, also known as pleuritis, is an Inflammation of the pleura the lining of the Pleural cavity surrounding the Lungs Pleurisy has a variety Abdominal pain can be one of the Symptoms associated with transient disorders or serious disease

Analysis

As in all medicine, a careful medical history and physical examination is essential in separating dangerous and trivial causes of disease, and the management of chest pain is often done on specialised units (termed medical assessment units) to concentrate the investigations. A rapid diagnosis can be life-saving and often has to be made without the help of X-rays or blood tests (e. X-radiation (composed of X-rays) is a form of Electromagnetic radiation. A blood test is a laboratory analysis performed on a Blood sample that is usually extracted from a Vein in the arm using a needle, or via g. aortic dissection). Occasionally, invisible medical signs will direct the diagnosis towards particular causes, such as Levine's sign in cardiac ischemia. Levine's sign is a clenched Fist held over the Chest to describe ischemic Chest pain. Generally, however, additional tests are required to establish the diagnosis.

An emergency medicine doctor will also focus on recent health changes, family history (premature atherosclerosis, cholesterol disorders), tobacco smoking, diabetes and other risk factors. Emergency Medicine is a speciality of Medicine that focuses on the Diagnosis and treatment of acute illnesses and injuries that require immediate medical attention Atherosclerosis is a Disease affecting arterial Blood vessels It is a chronic inflammatory response in the walls of arteries in large part due to the accumulation Cholesterol is a Lipid found in the Cell membranes and transported in the Blood plasma of all Animals It is an essential component of mammalian Tobacco Smoking is the inhalation of smoke from burned dried or cured leaves of the Tobacco plant most often in the form of a Cigarette. Diabetes mellitus (ˌdaɪəˈbiːtiːz or /ˌdaɪəˈbiːtəs/ /məˈlaɪtəs/ or /ˈmɛlətəs/ often referred to simply as diabetes ( Ancient Greek: grc

Features of the pain suggest of cardiac ischaemia are describing the pain as heaviness; radiation of the pain to neck, jaw or left arm; sweating; nausea; palpitations; the pain coming upon exertion; dizziness; shortness of breath and a "sense of impending doom. "

On the basis of the above, a number of tests may be ordered:

Interpretation

In finding the cause, the history given by the patient is often the most important tool. X-radiation (composed of X-rays) is a form of Electromagnetic radiation. Computed tomography (CT is a Medical imaging method employing Tomography. A ventilation/perfusion lung scan, also called a V/Q lung scan is a type of Medical imaging used to evaluate the circulation of air and blood within a patient's Lungs CT pulmonary angiogram (CTPA is a medical diagnostic test that employs Computed tomography to obtain an image of the pulmonary arteries. Pulmonary embolism (PE is a blockage of the Pulmonary artery or one of its branches usually occurring when a venous Thrombus (blood clot from a vein A blood test is a laboratory analysis performed on a Blood sample that is usually extracted from a Vein in the arm using a needle, or via A complete blood count ( CBC) also known as full blood count ( FBC) or full blood exam ( FBE) or blood panel, is An electrolyte is any substance containing free Ions that behaves as an electrically conductive medium Renal function, in Nephrology, is an indication of the state of the Kidney and its role in Renal physiology. Creatinine is a break-down product of Creatine phosphate in Muscle, and is usually produced at a fairly constant rate by the body (depending on muscle mass Liver function tests (LFTs or LFs which include liver enzymes, are groups of Clinical biochemistry laboratory blood assays designed to give information about the Creatine kinase (CK also known as creatine phosphokinase (CPK or phosphocreatine kinase, is an Enzyme ( expressed by various tissue types Troponin is a complex of three regulatory proteins that is integral to Muscle contraction in skeletal and Cardiac muscle, but not Smooth muscle Myocardium is the muscular tissue of the Heart. Relationship to other layers The other tissues of the heart are the Endocardium D-dimer is a Fibrin degradation product, a small protein fragment present in the blood after a blood clot is degraded by Fibrinolysis. Pulmonary embolism (PE is a blockage of the Pulmonary artery or one of its branches usually occurring when a venous Thrombus (blood clot from a vein In angina pectoris, for example, blood tests and other analyses are not sensitive enough (Chun & McGee 2004). Angina pectoris, commonly known as angina, is severe Chest pain due to Ischemia (a lack of blood and hence Oxygen supply of the heart The physician's typical approach is to rule-out the most dangerous causes of chest pain first (e. g. , heart attack, blood clot in the lung, aneurysm). By sequential elimination or confirmation from the most serious to the least serious causes, a diagnosis of the origin of the pain is eventually made. Often, no definite cause will be found, and the focus in these cases is on excluding severe diseases and reassuring the patient. If acute coronary syndrome ("unstable angina") is suspected, many patients are admitted briefly for observation, sequential ECGs, and determination of cardiac enzyme levels over time (CK-MB, troponin or myoglobin). An acute coronary syndrome (ACS is a set of signs and symptoms ( Syndrome) related to the Heart. Creatine kinase (CK also known as creatine phosphokinase (CPK or phosphocreatine kinase, is an Enzyme ( expressed by various tissue types Troponin is a complex of three regulatory proteins that is integral to Muscle contraction in skeletal and Cardiac muscle, but not Smooth muscle Myoglobin is a single-chain globular Protein of 153 Amino acids containing a Heme ( Iron -containing Porphyrin) Prosthetic On occasion, later out-patient testing may be necessary to follow-up and make better determinations on causes and therapies.

References

External links

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