Chest pain has various causes and requires differentiation: An analysis from angina to aortic dissection

Chest pain is not always coronary heart disease, and indiscriminate medication use can be dangerous: When chest pain is mentioned, many people immediately think of myocardial ischemia and coronary heart disease, and rush to take nitroglycerin. In reality, there are many causes of chest pain. Blindly using medication without a proper diagnosis can have adverse effects, not only failing to relieve symptoms but potentially causing the opposite of the desired effect.

Angina pectoris: This is a relatively common type of chest pain. The main cause is coronary artery stenosis, leading to myocardial ischemia and causing pain. Its main characteristics are paroxysmal, squeezing pain in the anterior chest (similar to a dull ache caused by a large stone pressing down), often occurring after exertion or emotional excitement. Each attack lasts 3-5 minutes and can be relieved by rest or taking nitroglycerin.

Myocardial infarction: This is a serious type of coronary heart disease, caused by the sudden blockage of a blood vessel supplying the heart. The pain is more severe than angina pectoris, with a feeling of impending death, and lasts longer, and cannot be relieved by medication.

Aortic dissection: This occurs when the inner lining of the aorta ruptures, allowing blood to flow into the aortic wall, causing the vessel wall to separate and resulting in chest pain. The pain is throbbing, tearing, or stabbing, often accompanied by profuse sweating, nausea, vomiting, and fainting. The pain is extremely severe, unbearable, and difficult to relieve with painkillers. This condition is very dangerous; most patients have high blood pressure. If a patient experiences these symptoms at home, they should immediately stop their activity and call 120 for emergency medical assistance.

Pulmonary embolism: This is a condition caused by a detached thrombus in the lower extremities, leading to pulmonary artery blockage. Symptoms include severe chest pain, often accompanied by difficulty breathing, sometimes with hemoptysis and fainting. Patients often have a history of lower extremity swelling or lower extremity venous thrombosis. This condition is also very dangerous, being one of the most serious medical emergencies with a high mortality rate.

Other chest pains: Intercostal neuralgia: Damage to the thoracic nerve roots due to various reasons causes pain that is often described as needle-like, sometimes with tenderness, and often accompanied by symptoms that worsen with breathing and coughing.

Chest pain accompanied by cough often suggests tracheal or bronchial disease.

Chest pain accompanied by difficulty swallowing often suggests esophageal disease.

Chest pain accompanied by hemoptysis (coughing up blood) often suggests tuberculosis, lung cancer, or pulmonary embolism.

Therefore, chest pain is not necessarily angina, and patients should never self-medicate when experiencing chest pain at home.