Chest Pain in Women
|How Is Chest Pain Treated?
The treatment is largely determined by the results of the chest pain diagnosis. What is the underlying cause and is treatment required to control the symptoms of chest pain? The causes of chest pain can divide into two categories: (1) Those caused by an underlying heart disorder and (2) those caused by non-heart related conditions. We will discuss the treatment options in both instances below.
Heart Related Chest Pain: Treatment
Condition: A heart attack occurs when blood supply to the heart muscle is cut off due to a blockage in one or more of the coronary arteries (the blood vessels which supply the heart). Typically it is associated with a severe crushing pain on the left side of the chest which can extend down the arm, back and towards the jaw. Heart attacks in women are not always as easy to spot because in 33 percent of cases women do not experience the classical sign of chest pain.
Treatment: While waiting for an ambulance, patients will be advised to chew one adult sized aspirin, which acts as an anticoagulant medication (blood thinner). In emergency the priority is to unblock the blood vessel causing the stoppage of blood flow to the heart. Thrombolytic treatment may be administered and/or coronary angioplasty may be performed. If you have been diagnosed with a heart disorder or have significant risk factors for heart disease, it is worth checking out chest pain clinics in your area in the event of a heart attack. You have a better chance of being treated more rapidly at one of these specialized units.
Condition: Angina is a symptom of CHD caused by narrowing of the arteries. An angina attack typically presents as chest pain which builds up in intensity over a few minutes and then subsides.
Treatment: Angina treatment typically involves the use of nitrate meds which dilate the blood vessels to improve blood flow. Other possible medications include the use of aspirin therapy and beta blockers. If the condition becomes unstable (unpredictable indicating a worsening), then surgery such as angioplasty and even heart bypass surgery may be recommended.
Condition: This is a type of heart disease which causes the left ventricle of the heart to thicken so that the heart has to work harder to pump blood around the body. It can lead to chest pain, fainting and palpitations.
Treatment: Medications such as beta blockers and calcium blockers help to relax the heart muscle, thus allowing it to fill better and pump more effectively. Surgery to remove part of the thickened muscle may be suggested (septal myectomy) or the patient may be implanted with an implantable cardioverter defibrillator (ICD) to prevent sudden cardiac death.
Condition: This is an inflammation of the tissue surrounding the heart which is often caused by an infection. It can cause severe chest pain.
Treatment: Antibiotics and/or aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs).
Heart Valve Disorders
Condition: The valves are the tiny 'doors' which open and close in the heart to regulate blood flow. A lot of things can go wrong with those valves, and these conditions are grouped under heart valve disorders. Disorders include conditions such as aortic stenosis and mitral valve prolapse, both of which can cause severe chest pain.
Treatment: Treatment will vary depending on the seriousness of the disorder. A doctor may recommend lifestyle changes like following a healthy diet and quitting smoking to relieve symptoms. Eventually however surgery to replace or repair a damaged valve may be necessary (such as balloon valvuloplasty).
Non-Heart Related Chest Pain
Condition: Pleurisy is an inflammation of the membranes (thin tissue) surrounding the lungs. It can cause sharp chest pain, particularly after coughing or when you breathe in. Pleurisy is more common in women than men and pleuritic pain can be felt in the shoulders, neck and stomach.
Treatment: Antibiotics, aspirin, ibuprofen, or NSAIDs.
Condition: Pneumonia is a respiratory condition caused by an infection in the lungs. It can produce a dull pain in the chest. If it is accompanied by pleurisy there may also be a sharp, stabbing pain as the person breaths in, as well as shortness of breath, coughing and fever.
Treatment: Antibiotics or antivirals, depending on the cause of the condition.
Muscles Or Bone Problems
Condition: Muscle strain can be caused by unaccustomed exercise, excessive coughing or lifting a heavy object. Unlike pain associated with the heart or lungs, muscle strain pain worsens with movement or by pressing the affected area with a fingertip.
Treatment: It usually disappears on its own after a few days of rest. Hot compresses or aspirin can help relieve the pain in the meantime.
Condition: Costochondritis is an inflammation in the area between the ribs and their cartilage which is caused by strain to the chest (due to exercise, coughing etc). Much more common in women than men it can cause a dull tender pain in the chest or a sudden sharp pain which worsens with movement.
Treatment: Usually symptoms clear by themselves if physical activity is avoided. However women over 50 who suddenly develop costochondritis should request heart disease testing to rule out the possibility of an underlying disorder.
Condition: Cracked or broken ribs can cause severe pain in the chest, particularly with movement of the upper body.
Treatment: Fractured ribs usually heal without treatment. If the ribs were not cracked due to physical trauma a doctor should investigate in case they cracked due to an underlying disorder such as severe osteoporosis or cancer.
Osteoarthritis of the Spine
Condition: Spine deformities caused by osteoarthritis can put pressure on the nerves running from the backbone to the chest. The resulting pain is sometimes described as similar to symptoms of angina. The only difference is that angina pain improves by resting whereas osteoarthritis of the spine worsens after long periods of sitting or lying down.
Treatment: Osteoarthritis treatment usually involves the use of drugs to treat and prevent a worsening of the condition. Pain can be relieved by painkillers, massage, orthopedic supports and arthritis aids.
Condition: Fibromyalgia is a syndrome which means it is a collection of medical symptoms which occur together but do not have an identifiable cause. 90 percent of people with the condition are female, and they report widespread pain and fatigue. A fibromyalgia diagnosis requires that pain be experienced in at least 11 of 18 specified fibromyalgia tender points in the body. Two of those points are in the chest.
Treatment: As there is no 'cure', treatment revolves around managing symptoms as best as possible. This includes the use of fibromyalgia drugs, following a healthy fibromyalgia diet plan and practicing fibromyalgia exercises.
Gastrointestinal Tract Problems
Condition: Also known as GERD or acid indigestion, heartburn can produce a burning sensation in the chest, symptoms can be similar to an angina attack. It accounts for 30 to 60 percent of chest pain in women with normal coronary arteries.
Treatment: Finding out chest pain is due to heartburn rather than something more serious can be a tremendous relief. Antacids help neutralize excess stomach acid which relieves heartburn, brands include Tums, Rolaids and Maalox. Prescription medications include acid blockers, proton pump inhibitors and promotility agents.
Esophageal Motility Disorders
Condition: Esophageal disorders result in pain caused by some abnormality in the way food passes down the esophagus to the stomach.
Treatment: Drugs such as nitrate medications or calcium channel blockers may be prescribed. If pain continues and is severe an operation to cut some of the muscle tissue in the esophagus may be necessary. Alternative remedies such as biofeedback may be helpful.
Condition: Irritable bowel syndrome commonly affects more women than men. Symptoms of IBS include stomach pain and changing bowel habits. Although it is associated with exaggerated contractions in the large intestine muscle, it can produce a similar effect on the muscle of the esophagus which accounts for the occasional intermittent chest pain.
Treatment: Treatment of IBS includes following an IBS diet plan, and medications like antispasmodics and antidepressants.
Peptic Ulcer Disease
Condition: This disease erodes the lining of the stomach causing a burning pain which can reach the chest. It is more common in women who overuse NSAIDs and those who smoke.
Treatment: Antibiotics are usually prescribed to kill the H. pylori bacterium which causes the condition as well as other medications to reduce levels of acid in the digestive system. This encourages healing.