Chest Pain and Discomfort in Singapore | Dr Kua Jieli

Some heart-related causes of chest pain are:

• Angina. This is any chest pain due to reduced blood flow to the heart muscle. It is often described as squeezing, pressure, heaviness, tightness or pain in the chest. Angina is a symptom of coronary artery disease. Unstable angina can cause a heart attack or near heart attack.
• Heart attack. A heart attack happens when blood flow to the heart muscle is blocked. It can cause angina chest pain. Emergency treatment is needed for a heart attack to prevent death.
• Aortic dissection. This life-threatening condition involves the body’s main artery, called the aorta. If the inner layers of the aorta separate, blood is forced between the layers. This can cause the aorta to rupture.
• Inflammation of the sac around the heart, called pericarditis. This condition usually causes sharp pain that gets worse when taking a breath or lying down.

Chest pain can be caused by diseases or disorders of the digestive system, including:

• Gastroesophageal reflux disease (GERD). In this condition, stomach acid washes up from the stomach into the tube that connects the throat to the stomach. That tube is called the esophagus. GERD can cause a burning feeling in the chest, called heartburn.
• Swallowing disorders. Diseases that affect the esophagus can make swallowing difficult and even painful. This may lead to chest pain.
• Gallbladder or pancreas disease. Gallstones or inflammation of the gallbladder or pancreas can cause stomach pain that spreads to the chest.

Many lung conditions can cause chest pain, including:

• A blood clot in the lung, called a pulmonary embolism. A blood clot that gets stuck in a lung artery can block blood flow to lung tissue. Symptoms of a pulmonary embolism may feel like a heart attack.
• Irritation of the thin layers of tissue that separate your lungs from your chest wall, called pleurisy. This condition causes sharp chest pain that gets worse when you breathe in or cough.
• Collapsed lung. A collapsed lung happens when air leaks into the space between the lung and the ribs. It also is called a pneumothorax. Chest pain due a collapsed lung typically starts suddenly. It can last for hours. It usually causes shortness of breath.
• High blood pressure in the lung arteries, called pulmonary hypertension. This condition affects the arteries carrying blood to the lungs. It can cause chest pain or pressure.

Some types of chest pain are due to injury or damage to the structures that make up the chest wall. These conditions include:

• Costochondritis. This is inflammation of the cartilage that connects a rib to the breastbone. It can cause chest pain that might feel like a heart attack. The pain is most commonly felt on the left-hand side of the body.
• Injured ribs. A bruised or broken rib can cause chest pain.
• Long-term pain syndromes. Conditions such as fibromyalgia, which can make muscles sore, may cause long-term pain that affects the chest area.

Chest pain also can be caused by:

• Panic attack. If you feel intense fear with chest pain, you may be having a panic attack. Panic attack symptoms also include a fast, pounding heartbeat, fast breathing, a lot of sweating, shortness of breath, nausea and dizziness. It can be hard to tell the difference between a heart attack and a panic attack. Always get medical help if you aren’t sure of the cause of chest pain.
• Shingles. This is an infection caused by the varicella-zoster virus — the same virus that causes chickenpox. It can cause very bad pain and a band of blisters from the back around to the chest area.
• Nerve pain. Some people with pinched nerves in the middle back may feel chest pain.

Many cases of chest pain related to heart conditions in Mount Elizabeth can be managed without surgery. Non-surgical treatments focus on relieving symptoms, improving blood flow, and reducing strain on the heart.

• Medication management: Your cardiologist in Orchard may prescribe medications such as anti-anginal drugs, blood pressure medications, or cholesterol-lowering agents to help improve blood flow, reduce heart strain, and prevent chest pain episodes.
• Lifestyle modifications: Making heart-healthy lifestyle changes can significantly reduce chest discomfort. This includes following a balanced diet, engaging in regular physical activity, stopping smoking, managing stress, and maintaining a healthy weight.
• Cardiac rehabilitation: A supervised programme of exercise, education, and support designed to strengthen your heart, improve circulation, and reduce the risk of recurrent chest pain or other heart-related symptoms.

When medications and lifestyle changes aren’t sufficient, surgical procedures can restore proper blood flow to the heart and alleviate chest pain symptoms.

• Coronary angioplasty: A procedure that opens blocked or narrowed arteries using a small balloon inserted through a catheter. A tiny metal mesh tube called a stent is often placed to keep the artery open permanently.
• Pacemaker insertion: A surgical procedure to implant a small electronic device that helps regulate an arrhythmia (irregular heartbeat) that may be contributing to your symptoms. The pacemaker sends electrical impulses to maintain a steady, appropriate heart rate.