Severe Chest Pain – Causes and Dangers

Chest pain is a common symptom often concerns most people, and for good reason. With heart disease being one of the leading causes of death in developed nations, chest pain may be a sign of a serious underlying condition. Most people tend to associate the seriousness of a condition with the intensity of the pain. However, this can be misleading. Severe chest pain may not necessarily be caused by serious and life threatening diseases.

Meaning of Severe Chest Pain

Irrespective of the location of pain, it is difficult to isolate the cause just by the presence of pain. Other symptoms need to be considered alongside the chest pain. Severe chest pain on its own can occur with any of the organs within the chest such as the heart, lungs and esophagus or arise from the chest wall. However, the presence of severe chest pain should be taken seriously especially in adults due to the possibility of a heart attack or other serious conditions.

For example, severe chest pain with shortness of breath may be due to a heart or lung condition. In another situation where severe chest pain occurs with belching and nausea, it is possibly due to acid reflux. Despite the presence of other symptoms,  it can sometimes still be difficult to identify the exact cause. Therefore further diagnostic investigation is usually recommended.

Some of the diagnostic investigations that may be considered immediately includes:

  • Chest x-ray
  • Angiography
  • Blood tests
  • CT scan
  • MRI

Not all of these tests may be done depending on the doctor’s assessment and severity of the condition.

Dangers of Severe Chest Pain

Depending on the underlying cause, severe chest pain may signal a serious and even life threatening condition. There are certain warning signs of a danger since severe chest pain alone is not a reliable indicator. The pain along with the following symptoms should prompt immediate medical attention. It is a possible medical emergency.

× Severe chest pain with shortness of breath.

× Severe chest pain with dizziness.

× Severe chest pain with confusion.

× Severe chest pain with arm or jaw pain.

× Severe chest pain with excessive sweating.

× Severe chest pain with loss of consciousness.

Causes of Severe Chest Pain

Even with the presence of other signs and symptoms it can be difficult to diagnose the cause of severe chest pain without further tests and scans. Chest pain should be assessed and diagnosed by a medical professional. Howevere, some of the signs and symptoms may be helpful for a quick differential diagnosis.

With Shortness of Breath

  • Angina pectoris which is a reduced blood supply to the heart muscle. It is temporary. It usually starts with exertion and eases with rest. However, medication like nitrates may be necessary.
  • Heart attack is one of the more serious causes of severe chest pain. Here a portion of the heart muscle may die due to the lack of adequate blood supply.
  • Pulmonary embolism where a blood clot blocks the pulmonary artery. This blocks blood flow between the heart and lungs. The clot usually arises from the deep vein of the leg.
  • Aortic dissection where a there is a tear in the inner wall of the aorta leading to blood accumulation within the layers of the wall.

These are not the only conditions that will cause chest pain with shortness of breath. For example, pleuritis, bronchitis, pneumonia and asthma may also be cause severe chest pain with shortness of breath. However, the conditions discussed above are among the more serious conditions that should be excluded as soon as possible.

With Nausea

  • Acid reflux is one of the leading causes of chest pain. While it typically causes heartburn (burning chest pain), sometimes the pain may not be typical and can be mistaken for other conditions.
  • Heart attack
  • Hiatal hernia is where a portion of the stomach pushes through into the chest cavity. The upper part of the stomach may slip in and out routinely.

With Coughing

  • Pulmonary embolism
  • Pleuritis is inflammation of the lining around the lungs which is known as the pleura. It is often due to an infection and may accompany some of the other infections below.
  • Pneumonia is inflammation of the lung that is usually associated a lung infection. It often extends to the pleura as well (pleuritis).
  • Bronchitis is inflammation of the bronchi which carries air to the lungs. This is a common condition and acute bronchitis can follow from infections like the flu.
  • Lung cancer is one of the more serious causes of severe chest pain. It is common among smokers and one of the deadliest types of cancer.

Emergency Care for Severe Chest Pain

Immediate medical attention should be sought for severe chest pain, irrespective of the presence of other sign and symptoms. However, a few simple measures can help reduce any further stress and possibly save a life until professional medical care is available.

  • Sit down immediately or lie flat. Reduce the amount of physical activity by sitting or lying which also eases the strain on the heart. Lying on the side may also be helpful.
  • Drink water and try an antacid. This will flush out any acid in the esophagus and help to neutralize the stomach acid that may have rise into the esophagus. It is only helpful in the event of acid reflux.
  • Take slow deep breaths. Deep breathing will increase blood oxygenation and is also useful to calm down a person. The latter may be relevant to chest pain that occurs due to an anxiety attack.
  • Do not smoke or drink alcohol. Some people may opt to use these substances as a means of calming down or relieving pain. These substances should be avoided and immediate medical care sought.
  • Avoid eating. Until the exact cause of chest pain is identified, food intake should be avoided. In serious cases, emergency surgery may be necessary and eating immediately before a procedure can be a problem.
  • Start CPR if unconscious and not breathing. A person who complains of severe chest pain and loses consciousness may be at risk of death. If breathing stops then CPR should be commenced.


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