Chest Pain and Heart Attack
A wide range of illnesses, strains and injuries may cause the victim to feel chest pains. Lung problems that cause pain include illnesses such as asthma; chronic obstructive pulmonary disease; pneumonia and inflammation of the lining of the lungs in pleuritis or pleurisy. Damage to the lungs is usually cumulative and irreversible. The sudden onset of unexplained chest pain will immediately set the alarm bells ringing that the sufferer is having a heart attack, but many lung conditions will also cause chest pain. According to the British Heart Foundation, a staggering 37% of heart attack victims first called their doctor before being admitted to a hospital emergency department; only 26% of victims called the emergency services directly themselves. Since in heart attacks, it is vital to get prompt assistance, here is a check-list of heart attack symptoms quoted from further information source 5:
The most common symptoms of a heart attack include:
- Central chest pain
- The pain can spread to the arms, neck or jaw
- Some people can feel sick or sweaty as well as having central chest pain
- Some people can feel short of breath as well as having central chest pain
The less common symptoms of a heart attack include:
- a dull pain, ache or ‘heavy’ feeling in the chest
- a mild discomfort in the chest that makes you feel generally unwell
- the pain in the chest can spread to the back or stomach
- some people say that the chest pain feels like a bad episode of indigestion
- some people can feel a bit light-headed or dizzy as well as having chest pain
Having dispensed with the most likely source of serious and potentially fatal source of chest pain, let’s look at other potential lung problems that cause chest pain.
Coughs and the Quality of Pain
The term “chest pain” is so broad as to be of no diagnostic use of itself. It encompasses everything from agonizing pain which makes breathing extremely difficult, to sensations of pressure, tightness, choking, or numbness. The symptoms can be transient, lasting for seconds, to chronic where the patient has no respite from their pain for weeks on end.
Lung problems that cause pain may be experienced as either localized pain or diffuse (general) pain. They may be constant or can increase with respiration and cover the spectrum of pain from mild to excruciating. For example, pleurisy can cause very severe chest pain whenever the victim inhales, but the pain subsides almost completely when they exhale.
The function of a cough is to clear the airways of material and in so doing, protect the lungs. A cough can clear phlegm (a mixture of dead cells, mucus, and debris) or inhaled particles from the lung. A cough may be associated with chest pain, particularly if the lungs are inflamed (for instance in bronchitis). A severe bout of coughing (or an illness involving chronic cough) can strain the chest muscles and this will cause discomfort for days afterwards.
There is no doubt that smoking is major cause of health problems. It is also the case that virtually all primary lung cancer cases (i.e. cancers that originate in the lungs rather than spread to the lungs from tumours elsewhere in the body) are found in smokers. Lung cancer can cause great pain in the lungs as the tumour mass presses against the organ. The pain may be acute or chronic in nature. Usually, lung cancer is treated surgically to remove the affected lobe of the lung and, hopefully, prevent the spread of the cancer. Subsequent phases of the treatment are likely to involve chemotherapy and/or radiotherapy to destroy any remaining tumours that could not be excised surgically. Patients are likely to experience pain following the operation (due to the trauma to the chest) although this would normally be managed by administration of analgesic medicine.
If air invades the pleural cavity, it may result in the collapse (or partial collapse) of a lung; a condition known as a pneumothorax. Pneumothorax may be caused by a traumatic injury to the chest (traumatic pneumothorax) such as a blow to the chest or a penetrating chest wound. A tension pneumothorax is caused when air entering the lung is at a higher pressure than atmospheric pressure (diving or mountaineering accidents for instance). Primary and secondary spontaneous pneumothorax can occur in smokers and in those suffering from diseases such as tuberculosis; cystic fibrosis; pneumonia or lung cancer, respectively.