According to the European Heart Journal, gastrointestinal diseases such as gastroesophageal reflux disease accounted for 42% of chest pain, ischemic cardiovascular disease 31%, musculoskeletal syndrome 28%, pericarditis 4%, pneumonia and pleurisy 2%, aortic aneurysm, aortic stenosis, and herpes zoster. Each of these was 1%, and the majority of patients who actually visited the hospital for chest pain did not show any abnormalities as a result of the examination, or considered it due to various factors such as neurological abnormalities or psychological factors.
Professor Won Ho-yeon of Cardiovascular and Arrhythmia Center at Chung-Ang University Hospital said, “Chest pain is a pain or discomfort felt in the chest, and the causes are very diverse and complex, from psychological reasons to cardiovascular diseases, lung diseases, digestive diseases, and musculoskeletal diseases. “In particular, recently, more and more people are visiting hospitals complaining of chest pain following being vaccinated once morest COVID-19, but if we do an actual test, vaccine-related myocarditis is found very rarely. “There are cases of serious diseases such as angina or tumors that can cause sudden death that you did not know well, so it is necessary to visit a hospital and perform an accurate examination,” he said.
Among the representative causes of chest pain, cardiovascular diseases include ‘ischemic cardiovascular disease’, ‘cardiomyopathy’, an abnormality in the heart muscle, valvular disease, ‘arrhythmia’, an abnormality in heart rate, pericardial disease occurring in the heart membrane, heart failure, and heart tumor. Ischemic cardiovascular disease can be divided into ‘angina pectoris’ and ‘acute myocardial infarction’.
Angina pectoris is caused by a narrowing of the coronary arteries due to arteriosclerosis, which results in insufficient blood supply to the heart muscle.
In addition, even if the coronary artery is not narrowed by atherosclerosis, if the coronary artery is blocked due to the rupture of the atherosclerotic plaque due to risk factors, and the coronary artery is blocked, acute myocardial infarction may occur, in which the heart muscle is necrotic.
Professor Won Ho-yeon said, “The chest pain caused by angina mainly occurs during exercise, and you feel a stiff pain in the left or central part of the chest, and radiating pain along the chin or left arm. Chest pain occurs even with little exercise, and usually disappears within a few minutes if you are immobile and stable.
Next, Professor Won Ho-yeon said, “In case of diabetic patients or the elderly, the nerves become dull and they do not feel pain at the initial stage, but are discovered only following it progresses to severe disease, so early examination is necessary. It occurs suddenly even while sleeping, lasts for more than 10 minutes, and in most cases it is severe, so people come to the emergency room. If you feel it, it is best to consult a doctor without delay.”
If you visit a hospital due to chest pain, the most basic method is to differentiate a serious disease through electrocardiogram and chest X-ray examination. , 24-hour electrocardiography and echocardiography can be performed.
If accurate diagnosis is difficult with only these tests, cardiac disease can be diagnosed through catheterization and coronary angiography.
In addition, in the case of arrhythmias, in which the heartbeat is irregular and abnormal, it appears temporarily or is difficult to detect. By implanting an ‘Implantable Loop Recorder (ILR)’ under the skin in the front of the heart, it can continuously measure the electrocardiogram to make an accurate diagnosis.
In the case of arrhythmias that are difficult to actually diagnose, an ‘implantable loop recorder (ILR)’ was implanted into the patient and the occurrence of arrhythmias was followed up. By doing so, we were able to escape the risk of sudden death.
About 40% of chest pain is caused by digestive system diseases such as reflux esophagitis.
Gastroesophageal reflux disease (GERD) is a disease that causes stomach acid to reflux into the esophagus, causing inflammation in the esophageal mucosa and pain in the esophageal muscle.
Professor Won Ho-yeon said, “Many of the patients who come to the hospital due to chest pain have reflux esophagitis. There is,” he said.
In addition, if there are diseases such as respiratory infection, pulmonary embolism in which blood is not supplied to the lungs due to thrombus in the blood vessels supplying blood to the lungs, pleurisy caused by inflammation of the membrane surrounding the lungs, and pneumothorax due to inflammation of the diaphragm, chest pain and difficulty breathing occur. Chest pain can also get worse when coughing.
In addition, one of the most common causes of chest pain is thoracic musculoskeletal disorders. When coughing or deep breathing due to a rib fracture or costochonditis due to a shock to the chest, the chest pain is felt. , or changes in posture.
Professor Won Ho-yeon said, “Amidst various causes of chest pain, among the patients who come to the hospital, there is no abnormality in the examination. , “If the chest pain persists even following a period of time and cannot be diagnosed on examination, it is also necessary to consider neuropsychiatric drug treatment or treatment.”
He continued, “Even if the chest pain is caused by the same cause, symptoms may vary from person to person,” he said.
