Chest pain: Possible causes, diagnosis and treatment

There are many different possible causes of chest pain, and diagnosing the problem is the first step in receiving the appropriate treatment. In his latest online article, renowned consultant cardiologist Dr Naveen Mudalagiri offers his expert insight into chest pain, and answers his patients' most frequently asked questions.

What are the most common causes of chest pain?

There are numerous different possible causes of chest pain. Within the chest, numerous organs and structures exist, any of which can potentially cause discomfort at some point in an individual's life. I am particularly interested in addressing chest pain stemming from the heart, as this type of pain can have significant implications.

Typically described as a tightness or heaviness in the chest, heart-related chest pain can radiate to the arm, neck, or jaw, especially worsening during physical activity. This type of pain, known as angina, occurs due to insufficient blood flow to the heart. However, chest pain can also originate from the chest wall, often attributed to muscular or skeletal issues. Additionally, infections and oesophageal problems are among the various other causes of chest pain. Consequently, the list of potential causes is extensive, and the key lies in identifying and isolating the underlying issue.

What is the best way to relieve chest pain at home?

The most effective method of alleviating chest pain at home begins with self-assessment. Ask yourself a series of questions:

• When did the pain start?
• How long have I experienced it?
• How severe is it?
• Are there accompanying symptoms such as sweating, nausea, or vomiting?
• Does the pain intensify with specific activities like deep breathing, arm movements, bending, or after eating?

By conducting this basic evaluation, you can often gauge potential causes. However, if the pain is severe and accompanied by worrisome symptoms like sweating or nausea, it is advisable to consult a healthcare professional promptly. Contacting your general practitioner or calling emergency services can aid in determining the cause of the pain and receiving appropriate assistance. Ultimately, the choice of action depends on the specific symptoms and underlying cause.

When should you see a doctor with chest pain?

Deciding when to seek medical attention for chest pain can be challenging. However, severe pain or pain accompanied by symptoms such as nausea, vomiting, or shortness of breath warrants immediate attention. Additionally, individuals with a history of heart disease or heart attacks should not hesitate to seek medical assistance if concerned. It's crucial to address worrisome symptoms promptly by contacting emergency services, consulting with your general practitioner, or seeking specialised advice.

Which tests can a specialist carry out?

Specialists employ various tests to investigate heart-related issues. Common procedures include coronary angiography, where a small tube is inserted through the wrist to visualise the heart arteries via X-ray. This procedure serves as the gold standard for assessing heart artery health and identifying significant blockages.

Depending on the findings, treatment options may include medications or interventions such as stents to open narrowed arteries. For more extensive disease or in patients with additional risk factors like diabetes, surgical revascularisation, such as coronary artery bypass grafting, may be considered. The choice of test and subsequent interventions depends on the individual patient's condition and the extent of their disease.

Dr Naveen Mudalagiri is a renowned consultant cardiologist based in London, Keighley, Kent & Orpington. If you would like to book a consultation with Dr Mudalagiri, you can do so today via his Top Doctors profile.