Used to describe any pain/discomfort in the

chest, neck, or upper abdomen.

A common symptom that can result from a
number of causes.
Cardiac

Vascular

Respiratory

Musculoskeletal

GI disorders

Accompany anxiety.
 Chest pain: Chest pain:

Acute MI
Angina Pectoris
Substernal chest Severe
discomfort, tightness, Prolonged (> 30 min.)
heaviness, pressure, Unrelieved by
burning sensation sublingual nitroglycerin.
Pain is nonfocal Accompanied by nausea
Radiate to the left and diaphoresis
shoulder or the arms, or Commonly occurs at
to the neck and jaw. rest.
Cause: Cause:
Myocardial O2 demand An underlying acute
, which cant be met thrombosis at the site of
through coronary blood an ulcerated
flow due to stenotic atherosclerotic plaque.
atherosclerosis.
 Chest pain: Chest pain:

Pericarditis

Acute Aortic Dissection

Sharp. Sudden in onset
Involves the substernal or Intense
precordial area. Prolonged
Radiates to the neck, left May radiate to back.
shoulder, or trapezius Tearing in quality
ridge.
Worst pain I have ever
May also be a steady, experienced
oppressive substernal
Hypertension history
discomfort.
Worsened by inspiration
and recumbent position.
Lessened by leaning
forward while in the
sitting position.
Sudden.
 Pain: Pain:

Gastroesophageal Reflux

Peptic Ulcer Disease

Epigastric & substernal Typically localized in the
area. epigatrium area.
Diffuse burning sensation May radiate to the back
Associated w/ frank and substernal area.
esophageal spasm Gnawing, aching, or dull.
substernal discomfort Relieved by food or
(similar to discomfort in antacids.
angina pectoris) Occurs at night.
Radiate to throat and left Also may be precipitated
arm. by eating.
Provoked by large meals,
recumbent position after
meal, leaning forward.
 Pain: Pain:

Biliary Colic

Pancreatitis
Episoding steady Usually localized to the
discomfort. epigastric or
Sudden, aching, periumbilical areas.
pressure-like. May radiate to the
Typically in the chest and back, also to
epigastrium or RUQ. the flank and lower
May radiate to abdomen.
scapular area. Constant and often
Persists for 1 hr to severe
several hours. Worsened by supine
Nausea and vomiting. position.
Nausea and vomiting
usually present.
Chostocondritis
Pain:
Sharp, brief, or dul ache
Last for hours to days
Localized muscle spasm contribute to the discomfort.
Worsten by chest movement or deep inspiration
May be caused by a minor trauma or a new/unusual activity.
Cervical Spine Dse
Localized to the neck and back of the head
May radiate to the arm and shoulder (sometimes confused
with angina pectoris)
Herpes Zoster
Chest discomfort in its prevesicular phase.
Arise from inflammation of adjacent pleural
surfaces.

Pain:
Sharp, or catchlike, and is often unilateral.
Radiate to the shoulder (diaphragmatic pleura
involvement).
Exacerbated by deep inspiration or cough.
Fever and productive cough (in pneumonia)
Abrupt chest pain with dyspnea (pneumothorax)
With hemoptysis (pulmonary infection secondary to
embolism or lung ca.)
 Focal and precordial in location
Constant ache for hours or longer
Unpredictable fleeting or jabbing pain,
unrelated to effort
Chest tenderness
Palpitations
Hyperventilation
Related to emotional stress