It is not always possible to be certain about the origin of chest pain just by its characteristics as the variation between individuals is quite a bit. A medical opinion should be sought in case of any significant chest pain so that important ailment is not missed. There can be a lot of overlap between symptoms due to heart disease and disease of other nearby organs.
Still some general observations are possible regarding chest pain originating from the heart. The typical pain of cardiac origin is a central chest pain which occurs on walking or other forms of exercise, known as effort angina. This pain is caused by insufficient supply of oxygenated blood to a region of the heart muscle.
Effort angina is commonly due to significant obstruction to a blood vessel (coronary artery) supplying a part of the heart muscle. The pain can spread to the neck, lower jaw, arms and upper part of the tummy. Occasionally, pain may be felt only at these regions, without pain in the chest. Then it is known as anginal equivalent.
A heavy meal may also bring out similar pain as the heart has to pump more blood to the stomach and intestine for the digestive process. Pain is likely to be more if you are walking after a heavy meal. Pain occurring after a meal is likely to be mistaken to be a disorder of the stomach.
Pain of effort angina will be more when you are walking uphill rather than downhill, due to the higher level of exertion. It can also be more when you are walking against the wind and while carrying a load. If pain starts occurring at a lower level of activity than before, it means that the obstruction in the blood vessel is progressing.
A fall in level of hemoglobin in the blood due to loss of blood from any part of the body can also increase the pain. Effort angina is usually promptly relieved by rest or medications which enlarge the blood vessel if it has been prescribed earlier.
Pain of a heart attack occurs in a similar location as effort angina but is more severe. A pain lasting more than 30 minutes is usual. Chest pain may be associated with undue sweating, anxiety and sometimes undue awareness of heart beats known as palpitation. But these symptoms can also occasionally occur due to severe anxiety and panic. Chest pain of heart attack is not relieved by rest unlike effort angina.
Though it may start after an unaccustomed exertion, it will not stop on taking rest. Prolonged chest pain calls for early hospitalization and you have to attend the hospital emergency room. Travel should preferably be in a well-equipped ambulance as it will ensure emergency care en route and faster reception at the emergency room. Driving alone to the hospital should be avoided at all costs as it can be catastrophic.
Another type of pain originating from the heart is due to an inflammation of its covering known as pericarditis. This pain occurs continuously and may increase on deep breathing like pain originating from the pleura, the covering of the lungs. Pain may be relieved on leaning forwards. Pain of pericarditis can increase on swallowing and mimic pain from the food pipe. This is because the food pipe is just behind the heart and food traveling through the food pipe presses on the outer covering of the heart.
A still rare, but very dangerous condition is breaks in the inner lining of the aorta, the largest blood vessel supplying oxygenated blood to the whole body. This condition is known as dissection of aorta and causes severe pain in the upper part of chest or more often in upper back. Pain of aortic dissection is tearing type and is most severe in the beginning. As it is a very severe disease process with high mortality unless early surgery is done, emergency hospitalization is needed.
The general rule is that no chest pain should be ignored, in order to avoid missing a major illness, which need not be of the heart itself. Very transient catching type of chest pain could be insignificant and occur from the muscles of the chest wall. Pain originating from the muscles, bones and joints are usually aggravated by local movements or manual pressure.
Passive movement of the part will also produce pain. In case of pain originating from the heart, pain occurs even when you exert with the legs, while pain originating from the chest muscles is unlikely to increase with leg exercise. Pain from the chest muscles can increase with arm exercise as some major muscles needed for arm exercise are attached to the chest.
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