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Angina should be suspected in people presenting tight, dull, or heavy chest discomfort that is: [41] Retrosternal or left-sided, radiating to the left arm, neck, jaw, or back. Associated with exertion or emotional stress and relieved within several minutes by rest. Precipitated by cold weather or a meal.
This may include the neck, left or right arms, cervical spine, back, and upper abdomen. [9] Other associated symptoms with chest pain can include nausea, vomiting, dizziness, shortness of breath, anxiety, and sweating. [8] [1] The type, severity, duration, and associated symptoms of chest pain can help guide diagnosis and further treatment.
Chest pain due to coronary ischemia commonly radiates to the arm or neck. [7] Certain individuals such as women, diabetics, and the elderly may present with more varied symptoms. [8] If blood flow through the coronary arteries is stopped completely, cardiac muscle cells may die, known as a myocardial infarction, or heart attack. [9]
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Women more often present without chest pain and instead have neck pain, arm pain or feel tired. [11] Among those over 75 years old, about 5% have had an MI with little or no history of symptoms. [12] An MI may cause heart failure, an irregular heartbeat, cardiogenic shock or cardiac arrest. [3] [4] Most MIs occur due to coronary artery disease. [3]
Costochondritis, also known as chest wall pain syndrome or costosternal syndrome, is a benign inflammation of the upper costochondral (rib to cartilage) and sternocostal (cartilage to sternum) joints. 90% of patients are affected in multiple ribs on a single side, typically at the 2nd to 5th ribs. [1]