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Pain Problems » Chest » Heart attack

Most heart related pain is secondary to reduced blood supply to heart. Whether this is due to reduced blood supply, block of supply or inefficient supply the complaints may be similar: crushing midchest pain, a feeling of tightness, constriction and heaviness that may become progressively more severe or intense. The pain frequently radiates to the left side of chest, left shoulder, arm, and neck, and there may be an accompanying feeling of impending doom. Acute Infection of heart or lungs can also present in a similar way. 

  1. Emergency Medical Management
  2. Coronary revascularisation

A substantial proportion of patients referred to heart specialists do not have underlying heart problem, but are disabled by symptoms identical to heart attack. The condition referred to as Syndrome X represents a group of such patients who demonstrate abnormalities of ECG on exercise testing but have normal blood supply to heart on angiography. In such patients the cause of pain has been variously described as due to small blood vessels occlusion or hyper reactability of blood vessels. These patients are amenable to the management strategies outlined above, with the added opportunity to address the patient's complaints, as they would be in any other condition where the pain is not indicative of a life threatening condition. As expected, the patient with non-cardiac chest pain or Syndrome X presents with symptoms of psychological distress. A link between anxiety disorders and non-cardiac chest pain has been demonstrated, as has the high prevalence of panic disorder and depressive illness.