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Atherosclerosis is the most common cause of stenosis (narrowing of the blood vessels) of the heart's arteries and, hence, angina pectoris. Some people with chest pain have normal or minimal narrowing of heart arteries; in these patients, vasospasm is a more likely cause for the pain, sometimes in the context of Prinzmetal's angina and syndrome X.
An upsloping, convex ST segment is highly predictive of a myocardial infarction (Pardee sign) while a concave ST elevation is less suggestive and can be found in other non-ischaemic causes. [1] Following infarction, ventricular aneurysm can develop, which leads to persistent ST elevation, loss of S wave, and T wave inversion.
"It can lead to chest pain, trouble breathing, low oxygen levels and a fast heart rate," Martin adds. The condition, which can be life-threatening, often starts elsewhere in the body.
Psychogenic causes of chest pain can include panic attacks; however, this is a diagnosis of exclusion. [12] In children, the most common causes for chest pain are musculoskeletal (76–89%), exercise-induced asthma (4–12%), gastrointestinal illness (8%), and psychogenic causes (4%). [13] Chest pain in children can also have congenital causes.
Benign early repolarization (BER) or early repolarization is found on an electrocardiogram (ECG) in about 1% of those with chest pain. [2] It is diagnosed based on an elevated J-point / ST elevation with an end-QRS notch or end-QRS slur and where the ST segment concave up. It is believed to be a normal variant. [2]
Burning, pain, or pressure in the chest or upper abdomen that can travel to the arm or jaw can also be experienced in females, but females less commonly report it than males. [32] Generally, females experience symptoms 10 years later than males. [33] Females are less likely to recognize symptoms and seek treatment. [28]
The most common symptom is centrally located pressure-like chest pain, often radiating to the left shoulder [2] or angle of the jaw, and associated with nausea and sweating. Many people with acute coronary syndromes present with symptoms other than chest pain, particularly women, older people, and people with diabetes mellitus. [3]
The cardinal symptom of critically decreased blood flow to the heart is chest pain, experienced as tightness, pressure, or burning. [5] Localisation is most commonly around or over the chest and may radiate or be located to the arm, shoulder, neck, back, upper abdomen, or jaw. [5] This may be associated with sweating, nausea, or shortness of ...