After work, while working on a treadmill at the gym for a quick walk following work, Mr. Kim fainted following feeling stiff, pounding, and dizzy, and was taken to the emergency room by an ambulance. He did a variety of tests, from an electrocardiogram at the hospital, but he had no choice but to return home as he said there was nothing wrong.
Everyone experiences sudden chest pain once in a while, and some go to the hospital for treatment and tests, but often they go home following hearing that there is nothing wrong with the hospital. 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%. In fact, most of the patients who visited the hospital for chest pain showed no abnormalities as a result of the examination, or various causes such as nervous system abnormalities or psychological factors.
Ho-yeon Won, Professor of Cardiovascular Medicine at Chung-Ang University Hospital Cardiovascular and Arrhythmic Center “In particular, recently, more and more people are visiting the hospital complaining of chest pain following being vaccinated once morest COVID-19. There are cases of serious diseases such as angina pectoris or tumor that can lead to sudden death that we have not been aware of until now, so it is necessary to visit a hospital for an accurate examination,” he said.
Among the representative causes of chest pain, cardiovascular diseases include ‘ischemic cardiovascular disease’, ‘cardiomyopathy’, which is an abnormality in the heart muscle, valvular disease, ‘arrhythmia’, an abnormality in heartbeat, pericardial disease occurring in the pericardium, heart failure, and heart tumor. Among these, ischemic cardiovascular disease is divided into ‘angina pectoris’ and ‘acute myocardial infarction’. Angina pectoris is caused by a narrowing of the coronary arteries due to atherosclerosis, resulting in insufficient blood supply to the heart muscle. Usually, chest pain occurs for a few seconds to a few minutes during exercise, and then the pain disappears when you rest. In addition, even if the coronary artery is not narrowed by arteriosclerosis, if the coronary artery is blocked due to the rupture of the atherosclerotic plaque due to risk factors, the coronary artery is blocked, and acute myocardial infarction can occur, causing severe chest pain and necrosis of the heart muscle.
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 minutes if you are immobile and stable.
He continued, “In diabetic patients or the elderly, the nerves are dull, so there are cases in which pain is not felt at the initial stage, but is discovered only following it has progressed to a serious condition, so early examination is necessary. Occurrence lasts more than 10 minutes and most cases are severe, so they come to the emergency room. However, some elderly patients end up in heart failure following taking painkillers or Cheongsimhwan, and eventually come to the hospital. It is best not to do it, but to consult a doctor.”
Ho-yeon Won, Professor of Cardiovascular Arrhythmia Center at Chung-Ang University Hospital, is providing treatment.When you visit a hospital for chest pain, the most basic method is an electrocardiogram and chest X-ray to differentiate serious diseases. However, in general, ECG may appear normal in some cases of angina pectoris or acute myocardial infarction, so exercise stress test, 24-hour electrocardiogram, and echocardiography are performed as needed. If accurate diagnosis is difficult with only these tests, cardiac disease can be diagnosed through catheterization and coronary angiography.
Arrhythmias, in which the heartbeat is irregular and abnormal, appears temporarily or is difficult to recognize. Therefore, it is often difficult to diagnose with an electrocardiogram or Holter electrocardiogram, which is tested for 24 hours or several days. At this time, an ‘Implantable Loop Recorder (ILR)’ implanted in the body for testing can be implanted under the skin in the front of the heart to continuously measure the electrocardiogram to make an accurate diagnosis. In the case of arrhythmias that are difficult to actually diagnose, an ‘implantable loop recorder’ was implanted into the patient and the occurrence of arrhythmias was followed. might get away from
▶ Habit of lying down right following eating increases chest pain
About 40% of the causes of chest pain are caused by diseases of the digestive system such as reflux esophagitis. Gastroesophageal reflux disease (GERD) is a disease in which stomach acid refluxes into the esophagus, causing inflammation in the esophageal mucosa and pain in the esophageal muscles. It is especially common when lying down right following eating.
Professor Won Ho-yeon said, “Many of the patients who come to the hospital due to chest pain are reflux esophagitis. ” 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 blood clots in the blood vessels supplying the lungs, pleurisy in which the membrane surrounding the lungs becomes inflamed, and pneumothorax due to inflammation of the diaphragm, chest pain and difficulty breathing occur. Chest pain can also get worse when coughing.
In addition to these, one of the most common causes of chest pain is thoracic musculoskeletal disorders. Pain is felt when coughing or breathing deeply due to a rib fracture or costochonditis caused by an impact to the chest.
Professor Won said, “Amidst various causes of chest pain, there are many cases where patients who come to see the doctor do not have any abnormalities in the examination. “It is also necessary to consider neuropsychiatric drug treatment or treatment when chest pain persists over time and cannot be diagnosed even with tests,” he said.
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