Skip to content

Chest pain: how to distinguish between cardiac and noncardiac causes

  • by

#drmagesht #sriradhabaiclinic #kknagarchennai

Hello guys i’m doctor magesto i welcome you all back to this news session i know it’s been a long time since i made my last video uh because i just got held up at my work because of crazy co-weed and now here i am uh let’s make this a session today useful and the topic for today’s discussion is chest pain uh why i’m making this chest pain serious is because from

My previous video on chest pain a lot of people you know have asked me so many questions you know how to differentiate your spin from heart or from lungs or from the other organs in your chest and when to go see a doctor how to get it managed at home and things like that so this topic is for that okay you want to get all the answers uh to your question so please

Make sure you watch this video without skipping all right so if you are not subscribed to my channel yet please go ahead and hit the subscription button do like this video or leave a comment down below if you like this channel or video okay chest pain uh chest pain like you know it’s the most common complaint that most people uh you know complained of when they

Come into clinic whether the pain is coming from the heart lungs or from the bone skins they do not know they just have only complaint of chest pain and we just as a doctor we have to make sure you know what this patient is complaining of whether the chest pain is coming from the skin or from the bones or from the nerves or from the muscles or from the lungs or

From the covering of the lungs or from the heart itself things like that there are so many organs in our chest right and you go from superficial to the deep we have a skin and then under skin we have a cute fatty layer and then we have a rib cage’s bones and then we have a brush bones like a sternum we have here and down below that we have both sides lungs and

Uh with covering of the lungs pleura and then in between the lungs we have a heart and it’s hot layer okay these are the sources when any of these organs are get inflamed or infected or something goes wrong you get pain okay so when i see a patient with chest pain i would always you know put in some leading questions uh to navigate or to differentiate or narrow

Down the possible causes of chest pain any time when patient complains of pain or chest pain or headache whatever stomach pain leg pain any pain we have to uh put these leading questions to our patient you have to remember the sick aura sight is more important okay where the pain is whether it is in the left side of the heart or on the right side of the chest

Whether the pain is like so severe or dull pain or tabbing pain or short pain or pressure like kind of discomfort something like that and the intensity of pain is very important s i q o r a s for sight and eye for intensity of the pain you know we always ask we ask our patient to grade the pain on a scale of one to ten where one being the least or ten being

The worst pain you ever had so so one two ten a patient would say doc you know yesterday it was uh two two over ten now it is six over ten which means that the pain has gotten worse so that gives us a clue and next thing is q q is quality of pain when you try to mention the quality patient would say doctor you know this pain feels like a stabbing pain as you

Feel you get stabbed by a knife or some people would say there’s a pricking kind of pain doctor it just comes in and then goes comes and goes like that or sometimes they would say pressure like you know as i feel like someone is standing on my chest that is a quality and onset of pain yes i q o o is onset when did the pain start okay whether the pain started

Us gradually or the pain started right away onset is a slow or the fast onset some people they complain of pain starts slowly and then builds up or some people they say uh pain started right at eight or over ten some people would say a pain started at a one to one over ten and then it slowly progressed to six over ten that’s what they would say and then the

Radiation sikora or stands for radiation whether the pain radiates elsewhere sometimes what happens in a chest pain that comes from the heart that pain may radiate into the jaw or sometimes may read it into the neck or may read it into the left arms okay things like that and associated factors saqo or ea is a social factor so we always have to put in this kind of

Questions and do you have any other associated symptoms with this chest pain like a nausea or vomiting or shortness of breath because shortness of breath are more most commonly associated with your pain that comes from your heart nausea vomiting can also be associated with the heart and that nausea vomiting can also be associated with your tummy stomach problems

So nausea vomiting shortness of breath or excessive sweating or palpitation whether you feel that your heart is beating too fast or any tiredness and uh or giddiness these are the associated symptoms and the second ea is alleviating factor what makes your pain go away does anything make your pain better things like you are taking some medication that does it go

Does it make your pain getting better or the other the third year is aggravating factor what makes your pain worse like when you are doing some work or when you climb stretch so when you exert yourself does the pain get worse so these are the things s-a-q-o-r-a-a-a sikora okay when you’re done with it so whether the pain comes from the heart the causes of chest

Pain from the heart there are many causes emergency causes are like a heart attack which what we call it is a myocardial infarction or myocardial ischemia okay this kind of a pain patient would come complain of a burning or a pressure like discomfort that starts slowly and then i it builds up this kind of heart pain does not come right away and goes off it won’t

Come just like that it just comes and stays there for like at least 20 minutes or even more than longer than that okay and they always have associated conditions like associated symptoms like uh nausea vomiting will be there sometimes they have also complain of shortness of breath or palpitation when they feel that the heart is beating too fast or and associated

With the excessive sweating and the dizziness or giddiness they will complain of okay this is one of the uh causes of your heart related chest pain and uh there is other condition called aortic dissection in which iotic dissection means the iota it’s a big blood vessel that comes right off your heart what happens in iotic dissection the there is a crack in the

Layers of your blood vessel so what happens is the blood because of high blood pressure it try to sips into the crack in between the layers and then the crack goes deeper and deeper and extends down that causes a severe chest pain okay and uh other mild causes like angina angina is a medical term in which people get to spin when they work out or when they do some

Work when they exert themselves they get that chest pain when the seat and relax they don’t get any pain that is called angina this antenna can be stable or unstable okay the difference between angina and a heart attack heart attack happens because of total loss of blood supply to the hot muscles but in angina there is a poor blood supply because blood supply is

Half but in hot attack there is a total loss of blood supply in angina there is a poor blood supply to the heart muscles and this there are some there are many other causes uh that hot can cause to spine like a myocardial infarction that is heart attack and there’s a dissection of iota and some there there’s another condition called a pericarditis pericarditism

A layer of heart that gets inflamed and causes pain when you change your body position many people say that their pain gets better when they lean forward okay so it could happen in pericarditis and what are the other organ related causes for chest pain when you take lung related causes pulmonary embolism pulmonary embolism means there is a clot gets detached

Somewhere and then goes into the blood vessels in your lungs and sits somewhere and blocks the blood supply to the distant lung tissues in a short manner there is a blood clot in the blood vessels of your lungs that causes loss of blood supply in your lungs that is called pulmonary embolism this is emergency condition or there may be other causes like simple

Pneumonia inflammation of lungs can cause chest pain or it can be pleurisy like inflammation of your coverings of your lungs that can be a cause of chest pain and stomach causes digestive causes like a uh or acid reflux then there is a connection between your um throat and your stomach which is a food pipe at the end of the food pipe we have something called

Low eraser sphincter that prevents the acid coming up from the uh stomach into your food pipe this can be a digestive causes of chest pain this is like a g or d or sometimes there can be a infection or inflammation in your gallbladder or things like that that are called lithius we call it a gas stones or that can be a problem in your food pipe itself there can

Be an inflammation or infection of a food pipe so hot digestive causes and your lung cancers are over and there are other causes of chest pain as well it could be a simple uh on a panic attack people comes in with a panic attack to emergency department they complain of chest pain and then they also have excessive sweating and they also complain of heart beating

Too fast in addition to this they also have a complaint of fear of dying okay this panic attack can happen in a young age like mostly male or female female is a predominant and there is another cause of chest pain uh what do you call it as shingles this shingles is a reactivation of the chickenpox viruses because of that what happens uh these people develop

Chest pain in addition to chest pain they also have us my small small blisters in a form of band in this area or this area okay that is called a reactivation of the chickenpox viruses i hope i have discussed a little bit about chest pain and i would like to continue this uh session in our next video we’ll discuss on uh how do we diagnose and how do we manage

This uh chest pain uh so i’ll see you all back in our next session so until then i’m signing out it’s dr mahesh tanaka bye bye guys see you soon

Transcribed from video
Chest pain: how to distinguish between cardiac and noncardiac causes By Dr.G Bhanu Prakash Animated Medical VideosliveBroadcastDetails{isLiveNowfalsestartTimestamp2020-07-20T173103+0000endTimestamp2020-07-20T174414+0000}