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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.
In contrast there is no evidence that blood pressure needs to be lowered rapidly in hypertensive urgencies, where there is no evidence of target organ damage; over-aggressive reduction of blood pressure is not without risks. [3] Use of oral medications to lower the BP gradually over 24 to 48h is advocated in hypertensive urgencies. [4]
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.
If someone with chest pain also has known risk factors for a heart attack (such as high blood pressure, high cholesterol, diabetes, or smoking), "the likelier it is that it could be a heart attack ...
Chest pain may occur due to increased workload on the heart resulting in inadequate delivery of oxygen to meet the heart muscle's metabolic needs. The kidneys may be affected, resulting in blood or protein in the urine, and acute kidney failure. People can have decreased urine production, fluid retention, and confusion. [citation needed]
Hypertension or high blood pressure affects at least 26.4% of the world's population. [15] Hypertensive heart disease is only one of several diseases attributable to high blood pressure. Other diseases caused by high blood pressure include ischemic heart disease, cancer, stroke, peripheral arterial disease, aneurysms and kidney disease.
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]
Cardiac symptoms of heart failure include chest pain/pressure and palpitations.Common noncardiac signs and symptoms of heart failure include loss of appetite, nausea, weight loss, bloating, fatigue, weakness, low urine output, waking up at night to urinate, and cerebral symptoms of varying severity, ranging from anxiety to memory impairment and confusion.