Severe Pain in Chest. What are the Causes?

Chest pain is one of the most common problems which a common man may experience. It could be as serious as myocardial infarction ( to understand heart attack in simple language click here) or just muscular pain.
Chest pain may occur due to the pathology of structures present on and inside the chest.
The chest is composed of skin, muscles, ribcage and important organs present inside the rib cage.
Following important organs are present inside the chest cavity, and any damage to these organs may give rise to chest pain.
- Intercostal Muscles,
- Heart
- Lungs
- Blood vessels
- Oesophagus
- Nerves
- Bones and Joints.
- Breasts
- Lymph nodes
The following structures are not present in the chest cavity but are covered by the ribcage.
- The upper end of the stomach
- liver
Now any abnormality or disease of the above structure can cause chest pain.
Severe and localized chest pain, in which the patient can tell the exact location of the pain is mostly muscular in origin, which resolves spontaneously after some time,
Squeezing, tight, and heavy and uncomfortable feeling can occur due to cardiac (heart) disease or stomach or oesophagal ulcers.
The burning feeling is mostly due to the reflex of acidic stomach contents into the oesophagus.
Whenever a patient comes to you with chest pain, exclude the following causes of chest pain by asking relevant questions.

Cardiac Causes of Chest Pain.

Angina	Pericarditis
Myocardial Infarction	Hypertrophic Cardiomyopathy
Aortic Stenosis	Myocarditis

Pulmonary Causes of Chest Pain.

- Pleuritis
- Pneumonia (lung infection) ( see an article on Pneumonia )
- Pneumothorax

Musculoskeletal Causes of Chest Pain

- Cervical Disc Disease
- Costochondritis
- Arthritis of Shoulder or spine.

Vascular Causes of Chest Pain

- Pulmonary embolism ( pulmonary embolism causes )
- Aortic Dissection

Gastrointestinal Causes of Chest Pain

- Reflux esophagitis
- Esophageal Spasm (see article on reflux esophagitis)
- Peptic Ulcer ( see an article on peptic ulcer )

Other Causes of Chest Pain

- Disorders of Breast
- Herpes Zoster
- Emotional

So whenever a patient comes to you with chest pain, think about the above causes, there is a specific history of each cause,  for example, chest infections are associated with cough with yellow sputum, cardiac pain is usually associated with, dyspnea, sweating, vomiting and oedema, Musculoskeletal pain is localized patient can tell you the exact location of pain. gastrointestinal pain is usually associated with food intake and bitter taste in mouth. Aortic dissection gives unequal radial pulses.