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Diagnosis of Chest Pain
When a patient presents with chest pain the possibilities for different diagnoses are present. There is a need to correctly assess the nature of the chest pain in order to give the best treatment possible.
Differential diagnosis is a method of evaluation used by the doctors to consider a potential diagnosis and then to eliminate it after suitable assessment. The first step toward evaluating chest pain is to rule out heart attack (myocardial infarction), pulmonary embolus, and aortic dissection. Towards this the medical history is documented by putting forward necessary questions to the patient.
Alongside this a clinical examination is also carried out. This is followed by an ECG and a blood test. If these steps show negative, further tests have to be conducted.
Rapid diagnosis of heart problem is necessary to rule out potential heart damage.
If life-threatening reasons are ruled out then the patient is observed for a while and referred back to the physician. In case of chronic and recurrent chest pain the primary suspect is angina arising from Coronary Artery Disease (CAD). It is important to take angina seriously as this could indicate CAD- a disease that could lead to a heart attack, stroke or even death.
In this case Coronary Angiogram or Cardiac Catheterization or Stress Testing using thallium may be necessary.
If chest pain is not due to the usual heart related diseases, then X rays, pulmonary function test or GI Endoscopy might be required depending upon the discretion of the doctor.
Some of the common diagnostic tests that may be carried out to detect the causes of chest pain include:
- Blood tests (complete and differential blood count, tests for LDH & its isoenzymes, CPK & its isoenzymes, troponin)
- ECG, exercise ECG
- X-rays of the chest
- Lung scan
- Cardiac Catheterization
Reference:
- Chest Pain or Discomfort - (https://www.ncbi.nlm.nih.gov/books/NBK416/)
- Gender Matters: Heart Disease Risk in Women - (https://www.health.harvard.edu/heart-health/gender-matters-heart-disease-risk-in-women)
- Chest Pain - Children - (https://www.cincinnatichildrens.org/health/c/chest)
- Angina (Chest Pain) - (https://www.heart.org/en/health-topics/heart-attack/angina-chest-pain)
- Musculoskeletal Chest Wall Pain - (https://www.racgp.org.au/afp/2015/august/musculoskeletal-chest-wall-pain/)
- Angina and Other Causes of Chest Pain - (http://www.secondscount.org/heart-condition-centers/info-detail-2/whats-causing-your-chest-pain-2#.XiWSKMgzbIU )
- Other Conditions May be Causes of Chest Pain - (https://www.health.harvard.edu/diseases-and-conditions/other-conditions-may-be-causes-of-chest-pain)
- Chest pain - (https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/chest-pain)
Hi. For my mother 53 years old, we have already consulted a cardiologist 2 years ago. Did echo test, treadmill test, ECG, all reports normal. Cardiologist diagnosed PSVT and given DILZEM-SR to take daily one tablet. Palpitation of heart stopped with that, but chest pain on left side is severe, feel too much heaviness in the chest while sleeping or lying down. Which specialist we should visit? Kindly advise.
I have been having pains in my left chest for over a year now and have not seen a doctor to complain!I am afraid of this!I have stopped smoking for two years now but still drinks
I have sudden sharp pain in my chest and then it goes away. It doesn't happen every day and it isn't associated with any other symptom. I plan to tell my doctor at my next visit, but he'll send me to the same old cardiologist who makes me feel like a waste of time.
it could be Precordial Catch Syndrome research it or angina
The typical symptoms of Chest pain are:
Chest “tightness,†“squeezing,†or “heaviness.†People describe this feeling as a weight or as a band being tightened around their chest. The pain is usually located on the left side of the chest above the bottom of the ribcage, but it’s often hard to define its exact location.
Shortness of breath. Sweating, nausea, and an anxious feeling
A pain in the left arm, neck and jaw.
The typical symptoms of chest pain in women are:
Chest “tightness,†“squeezing,†or “heaviness.†People describe this feeling as a weight or as a band being tightened around their chest. The pain is usually located on the left side of the chest above the bottom of the ribcage, but it’s often hard to define its exact location.
Shortness of breath.Sweating, nausea, and an anxious feeling
A pain in the left arm, neck and jaw.