Pain, in the chestal region. Pleuritic chest pain is, very specifically a sharp, inspiratory pain. If it's no sharp, it ain't pleuritic. If it's not inspiratory, it ain't pleuritic. So there.
The commonest cause of chest pain is probably reflux, or ischaemic heart disease. The cause of the pain in these situations is very different. In the former, irritation of the bottom of the oesophagus causes pain, in the latter, ischaemia of muscles causes a deep sensation of pain.
Clinical and Associated Features
- Huge amounts of pain
- That radiates down arms or neck.
- A deep dull pain, like someone sitting on your chest.
- A terrifically sharp, tearing pain.
- Shortness of breath
- Nausea and vomiting.
Less worrying symptoms
- Mild pain
- Sore throat
- Relieved by antacids
- Pain originally brought on by an abnormal muscle movement, or made worse on physical movement.
The following 6 causes can be fatal, so you should probably know how to diagnose them!
- Acute coronary syndrome - ie. angina, unstable angina, myocardial infarction
- Pulmonary embolism
- Tension pneumothorax
- Aortic dissection
Urgent but not emergency
- Ischaemic heart disease
- Pleurisy (pleural infection) from pneumonia, or pulmonary infarction.
- Neuromuscular - nerve root pain, fibromyalgia.
Not even urgent
Investigations and Management
If it is obviously something non serious, you obviously deal with the underlying problem.
However, if you have been admitted to A&E, the first thing they will do is ABC. If you are seriously short of breath, they will put you on high flow oxygen, setting up vitals statistics for blood pressure and heart rate.
That should give you enough to narrow it down to one of acute coronary syndrome, pulmonary embolism, tension pneumothorax, pericarditis or aortic dissection. Go to those pages for management of those.