What Causes Chest Pain?

Greetings. Welcome to HCM and thank you for your question. I understand your concern. Your age would help me a lot in constructing a differential diagnosis. However, I will explain some of the forms of chest pain, which we aim to exclude first, as the main and most dangerous organic causes of it. First, there is angina. Angina is a moderate-to-severe chest pain, more characterized like a heaviness or tenderness or squeezing feeling, localized in the mid chest, and then radiates to the both sides of the chest, the jaw, left shoulder and left arm. This is the pain originated from one or more blockages within the coronary arteries (arteries that supply the heart muscle with oxygen and nutrients). If this is your case, you should perform an EKG and an echocardiogram, and, depending on these two tests, a cardiac stress test. Second, there is sharp, stabbing pain. This kind of pain can come from an enlargement of the root of the aorta and/or from aortic aneurysm. It is severe in intensity, and radiates to the back, between the wings. Also, it can be caused by an acute or chronic inflammation to the linings within the rib cage, i.e. the pleura (lining of the lungs) and pericardium (the lining of the heart). This kind of pain - pleuritic pain - is less severe than that caused by aortic aneurysm, and relieves or aggravates from switching positions or the respiratory cycle. If this is the case, then echocardiogram (for pericardium and root of the aorta), chest X-ray (for the pleura and the lungs), and computed tomography of the aorta (in case we suspect that there is a problem with the aorta, higher than its root), should be performed. There is always a possibility of intercostal (between ribs) muscle or pectoral (chest) muscle soreness, and pain originated from problems with ribs and rib joints. If this is the case, you can use over the counter pain killers. I hope I was thorough with my answer. Best regards. Dr. Meriton