What is chest pain?

Chest pain ranges from a sharp stab to a dull ache. Sometimes it feels crushing or burning. In certain cases, the pain travels up the neck, into the jaw, and then radiates to the back or down one or both arms.

How bad is my chest pain?

Your clinic team will use this scale (see figure on right) to measure how bad your pain is.

Mild: Pain score of 3 or less on the VAS scale. This pain should not stop you from doing activities of daily life (preparing meals, managing money, shopping, doing housework, and using a telephone).

Moderate: Pain score of 4 to 6. This pain stops you from doing instrumental activities of daily life (medication management, housekeeping activities, ability to manage finances). Medical assistance is needed.

Severe: Pain score of 7 or higher. This pain is bad enough to stop you from even the most basic self-care activities of daily life (eating, dressing, getting into or out of a bed or chair, taking a bath or shower, and using the toilet). Medical treatment is required; hospitalization is needed.

How to manage mild chest pain?

Keep track of your pain levels using Ankr (myAnkr web portal or the Ankr app). It will help you describe the pain to your doctor or nurse.

• Lie down in a comfortable position with your head up.
• Stop doing activities that causes pain. Remain calm.
• If you have regular adult aspirin, chew one (as long as you are not allergic to aspirin). Chewing more than one will not do any good and may cause unwanted side effects.
• Antacids or certain procedures for acid reflux and heartburn, which may treat the symptoms
• Anti-anxiety medications, which may treat chest pain related to panic attacks

How to manage moderate to severe chest pain?

Seek emergency treatment immediately if you think you may be having a heart attack and especially if your pain is new, unexplained, or lasts more than a few moments. Call your doctor, if you have any of these symptoms along with the pain:

• A sudden feeling of pressure, squeezing, tightness, or crushing under your breastbone that spreads to your jaw, left arm, or back.
• Sudden, sharp pain with shortness of breath, especially after a long period of inactivity.
• Nausea, dizziness, rapid heart rate or rapid breathing, confusion, ashen color, or excessive sweating.
• Very low blood pressure or heart rate.
• Fever, chills, or coughing up yellow-green mucus.
• Dysphagia (Painful swallowing).
• Severe pain that does not go away.

What causes chest pain?

While it is a well-established sign of a heart attack, it can also be caused by many other less serious conditions.

Heart-related causes

The following are heart-related causes of pain:

• Heart attack
• Certain chemotherapy medications like 5-fluorouracil (5-FU).
• Angina, which is pain caused by blockages in the blood vessels leading to your heart.
• Pericarditis, which is an inflammation of the sac around the heart.
• Myocarditis (an inflammation of the heart muscle).
• Cardiomyopathy, which is a disease of the heart muscle.
• Aortic dissection (A rare condition involving a tear of the aorta, the large vessel that comes off of the heart).

Gastrointestinal causes

The following are gastrointestinal causes are

• Heartburn (GERD/Acid Reflux
• Swallowing problems related to disorders of the esophagus
• gallstones
• inflammation of the gallbladder or pancreas

Lung-related causes

The following are lung-related causes are

• pneumonia
• viral bronchitis
• pneumothorax
• a blood clot, or pulmonary embolus
• bronchospasm

Bronchospasms commonly occur in people who have asthma and related disorders such as chronic obstructive pulmonary disease (COPD).

Muscle- or bone-related causes

The following are causes related to the muscles or bones:

• bruised or broken ribs
• sore muscles from exertion or chronic pain syndromes
• compression fractures causing pressure on a nerve

Other causes

Shingles can cause pain. You may develop pain along your back or before the shingles rash becomes apparent. Panic attacks can also cause chest pain.