Chest Pain - Diagnosis, SymptomsIntroduction
Chest pain is one of the complaints of the most common that will bring a patient to the emergency. Seek immediate treatment may be lifesaving, and public education has really done to get patients to access medical care when chest pain strikes. While patients may worry about heart attacks, there are many other causes of chest pain that doctors will need to consider it. Some diagnoses are life threatening, while others are less harmful.
Deciding the cause of chest pain is sometimes very difficult and may require blood tests, x-rays, CT scans and other tests to sort out the diagnosis. Often, history is taken carefully by a physician is probably all that is needed to find answers.
Chest Pain Resources
Source of pain may arise from the diversity of potential sources:
* Chest wall including the ribs, muscles, and skin;
* Back including the spine (spine), nerves, and muscles of the back;
* Lung, pleura (lining of the lungs) or trachea;
* Heart including the pericardium (sac surrounding the heart);
* Aorta;
* Esophagus;
* Diaphragm, a flat muscle that separates the chest cavity and abdominal cavity;
* Pain referred from abdominal organs such as stomach, gallbladder, and pancreas.
While each source of chest pain may have a classical presentation of the signs and symptoms, there is significant overlap between the symptoms of each condition, and symptoms may also be influenced by age, sex and race (nation) .
What causes chest pain
Pain can be caused by almost every structure in the chest. Different organs can produce the types of pain are different but unfortunately the pain is not specific to any cause. Each of the following causes are described in detail in this article:
* Bone-Bone Ribs The Broken or Bruising
* Or Pleurisy Pleurisy
* Pneumothorax
* Shingles
* Pneumonia
* Pulmonary embolus
* Angina
* Heart Attack (Myocardial Infarction)
* Pericarditis
* Aorta and Aortic Dissection
* Esophagus and reflux esophagitis
* Who Referred abdominal pain
Diagnosing chest pain
The key to the diagnosis remains the history. Learn about the nature of pain will give way to the doctor diagnoses which are worth considering, and what is worthy to be ruled out. Understand the quality and quantity of pain, symptoms associated with it and risk factors for disease, may help clinicians to access the possibility of potential diagnoses which must be considered and which should be discarded.
Diagnosis is different is the process of thinking that doctors use to consider and then eliminate potential causes for the disease. As more information accumulated, both from history and physical examination or testing, a list of potential diagnoses are narrowed until the final answer is achieved. Likewise, the patient's response to therapy can expand or narrow the list of different diagnoses. In patients with chest pain, a lot of potential diagnoses may be present, and doctors will want to first consider the life-threatening. Tests to rule out heart attack, pulmonary embolus, or aortic dissection may be unnecessary; as skills clinics and a decision may be all that is required to consider or discard the diagnosis.
Patients may be asked for the diversity of questions to help the physician understand the patient's pain. Patients use different words to describe the pain, and it is important that clinicians have an accurate impression of the situation. Questions may also be asked in different ways.
Questions Asked May Chest Physicians About Pain
* When did the pain start?
* Quality of the pain?
* How long does the pain last?
* Does the pain come and go?
* What makes the pain better?
* What is a worsening of pain?
* Is the pain spread (moving to another area of the body)?
* Are there any previous illnesses?
* Are there any previous trauma?
* Are there any episodes of similar pain in the past?
Questions About Symptoms Related
* Shortness of breath?
* Fever or chills?
* Cough?
* Nausea or vomiting?
* Sweating?
Questions About Risk Factors for Disease
Risk Factors For Heart Disease
* Smoking
* High blood pressure
* High cholesterol
* Diabetes
* Family history
Risk factors for pulmonary embolus (blood clot in lung)
* Inactivity long as bed rest, trips, car trips or airplane that long
* The operation recently
* Fractures
* The use of birth control pills (especially if the patient smokes cigarettes)
* Cancer
Risk Factors for Aortic Dissection
* High blood pressure (hypertension)
* Marfan Syndrome
* Ehlers-Danlos syndrome
* Polycystic disease kidney
* Use of Cocaine
* Pregnancy
Physical examination helps filter out the different diagnoses. While chest pain may be the initial complaint, often the whole body needs to be checked. Examples of components of the physical examination may include:
Vital Signs
* Blood pressure, pulse rate or pulse rate (PR), respiratory rate (RR), temperature, and
* Saturation of oxygen (O2 sat)
Head And Neck* Looking for distension or bulging neck veins
* Listening bruits (abnormal sounds) or murmurs (rustling sound) in the carotid arteries
Chest wall
* Fingering rib or muscle sensitivity
* Looking for rashes
Lungs
* Listen to abnormal lung sounds or reduced air entry
Heart
* Listen to the sounds of muffled heart
Stomach
* Fingering sensitivity or masses
* Listen to the aortic bruits
Legs-Feet And Hands
* Feeling the pulse of the pulse
Philosophy Approach In Diagnosis Of Chest Pain
While there are many causes of chest pain, the doctor will put forward and that is potentially lethal in their evaluation of patients who present with chest pain. The big three - heart attack (myocardial infarction), pulmonary embolus, and aortic dissection - should be considered briefly with each patient, although most of the time their presence can be discarded based on clinical decisions.
History and physical examination are key in deciding which path to follow in diagnosing chest pain. For someone who fell and injured the bones of the damage, the track has been well characterized. For an old comes with a vague discomfort and risk factors for disease, significant testing may be necessary to prove that the diagnosis given is incorrect.
Aside the concept of diagnosis is difficult to understand for some patients. Instead of proving what was happening, the doctor is charged with proving that sometimes life-threatening diagnosis was not present. "Proving what is not" time-consuming and technology. The combination of blood tests and imaging studies may take many hours to confirm or deny the diagnosis.
These tests are often done in an emergency, and treatment may be started even without a definitive diagnosis. For example, if a patient presents with chest pain that doctors believe may be angina, and medications beginning to protect the heart will start at the same time, diagnostic tests performed. Since some cardiac tests will take many hours to complete, the present philosophy is that the heart muscle should not be placed at risk while waiting for a diagnosis. If the heart proved normal, then medication was discontinued, and patients can be reassured that heart disease has been ruled out. Other diagnoses to be considered at the same time tests are being performed heart, but exclude a diagnosis does not confirm the others.
Diagnosis And Treatment For Chest Pain causes
Treatment for chest pain depends on the cause. Many times, situations require evaluation, diagnosis and treatment occurred at the same time, but when the opportunity arose, the sequence of history, physical examination, testing, diagnosis, and treatment should be followed. Here is the Synopsis (summary) of the presentations and general treatments of chest pain.
Chest wall
Bone-Bone Ribs The Broken or Bruising
The bones are bruised or broken ribs are common injuries. Symptoms of the ribs are broken or bruised, including:
* The sensitivity over the site of injury
* Broken ribs can be palpated (the doctor can fracture a rib feel moves when pressed)
* Pain tends pleuritic (it hurts to take a deep breath and can be associated with shortness of breath).
* Due to the surrounding muscles go into spasm, there is pain with any movement of the torso.
The doctor will want to hear the chest to ensure that no lung damage associated with it. Chest X-ray may be done to look for pneumothorax (collapsed lung) or pulmonary contusion (bruised lung). Special X-rays to look for rib fractures is not necessary because of the presence or absence of dejection will not alter the healing. Particular attention will be given to the upper abdomen because the ribs protect the spleen and liver, weeks to ensure no injuries associated with it.
The main complication of a rib injury is pneumonia. The lungs work like a puff-puff. Normally, when a person takes a breath, the ribs swing out and diaphragm move down, sucking air into the lungs. Because painful to take a deep breath, this mechanism is changed, and the underlying lung injury may not fully dilated. The result is a potential breeding ground for infection (pneumonia).
Rib injury care:
* Control pain with medications anti-inflammatory such as ibuprofen and narcotic pain medications.
* Use ice on the affected area and periodically take a deep breath. Incentive spirometer may be provided to help show the number of breaths taken.
* The bones of the ribs are no longer covered or bandaged to help comfort because of the risk of pneumonia.
* What is a broken or bruised rib injuries take 3-6 weeks to heal.
Costochondritis
Sometimes the joints and cartilage tulng where the ribs attach to sternum (breastbone) may become inflamed. Pain tends to hurt with a deep breath, and there are sensitivities that can be felt when the sides of the sternum felt or touched. If there is swelling and inflammation associated with sensitivity, it is known as Tietze's syndrome.
The most common cause for costochondritis are idiopathic, or unknown, which means there is no explanation for the pain. Other causes include trauma to the area, infection (often viral), and fibromyalgia.
Although painful, the symptoms disappear with symptomatic treatment, including ice compresses and / or warm and drug-anti-inflammatory drugs (eg, ibuprofen). As with other chest wall pain, healing may take weeks. Taking deep breaths to prevent the risk of pneumonia is very important.
Pleuritis or pleurisy?
Lung sliding along the wall of the chest when taking a deep breath. Both surfaces have a thin layer called the pleura to allow the launch of this happening. Occasionally, viral infections can cause the pleura becomes inflamed, and then instead glide smoothly, the two layers scratch / erode with each other, causing pain. This pain hurts to breath deep and described as pleuritic.
Viral infections are a common cause of pleurisy, although there are many other infectious causes, including tuberculosis. Other diseases that can cause inflammation of the pleura include:
* Collagen vascular diseases such as sarcoidosis and systemic lupus erythematosus
* Cancer
* Kidney failure
* Rheumatoid arthritis
* Complications of radiation therapy
* Complications of chemotherapy
* Complications of surgery
Physical examination may be relatively unremarkable, revealing only the friction at the site of pleural inflammation. If a significant amount of fluid leaking from the inflammation, the space between the lung and chest wall (pleural space) may be filled with fluid, known as an effusion. When heard with a stethoscope, there may be a reduction in intake air in the lungs.
Often the chest x-ray done to access the lung tissue and the presence or absence of fluid in the pleural cavity.
Pleurisy is usually treated with anti-inflammatory drugs. It will also often treat effusion. If the effusion is large and causing shortness of breath, Thoracentesis (Thora = chest + centesis = withdrawal of fluid) may be performed. To Thoracentesis, the needle is placed in the pleural space and fluid is pulled out.
Pneumothorax
Lung held against the chest wall by negative pressure in pleura. If the seal is broken can be shrunk or collapsed lung (known as pneumothorax). This may be associated with a rib injury, or it may occur spontaneously. Although generally seen in those with high and thin, other risk factors for lung deflate including emphysema or asthma. Small bleb or bleb-places of the weak in the lungs may rupture and cause the air to break the negative pressure leak.
The most common presentation is acute onset of sharp chest pain associated with shortness of breath, in the absence of disease or warnings that preceded it. Physical examination revealed decreased air entry on the affected side. Chest X-ray confirmed the diagnosis.
Treatment depends on the percentage of the lung is deflated. If the numbers are small and stable vital signs with a normal O2 sat, pneumothorax may be allowed to inflate by itself with strict monitoring. If there is a greater deflation, the chest tube may be placed into the pleural space through the chest wall to suck air back out and reverse the negative pressure. Occasionally, thoracoscopy (thoraco = chest + scopy = to see with a camera) may be considered to identify the bleb and to close the wire snap (stapler).
Shingles
The rash of shingles is caused by the varicella zoster virus, the same that causes chickenpox (chickenpox). Once the virus enters the body, he was hibernating (winter sleep) in nerve roots of the spinal column, only to appear sometime in the future. The rash is diagnostic when he follows the nerve root when he left his back, and rotate forward from the chest, but did not cross the midline.
Once the rash appears, the diagnosis is relatively easy for physicians. Unfortunately, the pain of shingles may begin several days before the rash appears and can be confusing to both patients and physicians, because of pain and burning sensation may seem out of proportion to findings on physical examination.
Treatment for shingles includes antiviral drugs like acyclovir (Zovirax) along with pain control medication. Because is a nerve that has become inflamed, the pain can be very severe. Some patients may develop postherpetic neuralgia, or chronic pain from an inflamed nerve, which may persist long after the infection has disappeared / net. The diversity of strategies of pain control are available drug-stimulator to stimulator pain to surgery.
LungPneumonia
Infection of the lungs is called pneumonia, in which inflammation can cause a buildup of fluid in the segment of lung tissue, reducing its ability to transfer oxygen from the air into the bloodstream.
Pneumonia present with symptoms typical of infection:
* Fever
* Chills
* Malaise (feeling unwell)
There may also be:
* Cough
* Shortness of breath, and
* Production of sputum (mucus petrifies).
Is pleuritic chest pain, pain when taking deep breaths.
Physical examination may find the patient has vital signs are abnormal consistent with infection. PR (pulse rate) and RR (respiratory rate) may increase. Fever may be present. Listening to the chest may reveal air intake is reduced in areas of infection associated with crackles and sometimes wheezing due to inflammation and narrowing of the bronchial tubes.
Chest X-rays help make the diagnosis, although an x-ray sometimes left behind by one or two days behind the clinical findings. Blood tests may be used to access the severity of the disease and may include a number of white blood cells (the amounts are clearly rising or abnormally low may indicate more severe disease) and arterial blood gas levels to access the pulmonary function.
Pneumonia may be caused by viruses or bacteria. The latter were treated with antibiotics, orally or in hospital with intravenous infusion. Overall health and medical history from patients may guide the decision whether inpatient treatment or outpatient therapy is most appropriate.
Pulmonary Embolism
Blood clots in the lungs can be fatal and is one of the diagnoses that must always be considered when patients present with chest pain.
While there is a classic presentation for a pulmonary embolus from pleuritic chest pain, shortness of breath, and coughing up blood (hemoptysis), a more common presentation is far more subtle, and diagnosis may be missed easily and is unavoidable.
Risk factors for pulmonary embolus include:
* Prolonged inactivity such a long journey in car or plane
* Operas or dejection recently
* Birth control pills (particularly those associated with smoking)
* Cancer
* Pregnancy
Thrombophilia (thrombo = clot + philia = attraction) consists of a large group of blood clotting disorders that put patients at risk for pulmonary embolus.
Pulmonary embolus began in veins anywhere in the body, usually the legs, although it can occur in the pelvis, arms, or the major veins in the abdomen. When a thrombus or blood clot to form, he has the potential to be removed (it is now called an embolus) and floats into estuary, back to the heart. He can pass through the heart and lungs into the circulatory system, eventually caught on the branches of the pulmonary artery (pulmonary artery) and stop / block the blood supply to part of the lung. Reduced blood flow does not allow enough blood to pick up oxygen in the lungs, and patients can clearly be shortness of breath.
As mentioned above, common complaints include:
* Pleuritic chest pain from the inflamed lung,
* Bloody sputum, and
* Shortness of breath.
Patients may also have fears and excessive sweating. Depending on the size of the clot, the initial presentation may be fainting (syncope).
Depending on the severity of pulmonary embolus and the amount of tissue at risk, patients may present a critical illness with vital signs are clearly abnormal, or it may appear somewhat normal. Physical examination may be useless, and the diagnosis made on clinical suspicion based on history and risk factors.
Diagnosis may be made directly with the depictions (imaging) of the lungs or indirectly by finding clots elsewhere in the body. The strategy used to make the diagnosis will depend on the situation of each individual patient, but there are some common tools that are available.
D-dimer is a blood test that can measure the breakdown products of blood clots in the body but can not distinguish a pulmonary embolus from scar healing from surgery, or bruises from falling. If the test is negative, then it can usually be ruled out pulmonary embolus.
The lungs can be imaged (imaged) with ventilation-perfusion scan or CT scan to look for clots / clumps. Each test has its benefits and limitations, and the use of these tests depends on the clinical situation. If there are technical things so that the lungs can not be imaged, ultrasound of the legs may be performed to look for thrombus; concept is that if symptoms of pulmonary embolus is present and found a clot in the leg, then the diagnosis can be inferred. Sometimes direct angiography of the pulmonary arteries may be performed.
Treatment for pulmonary embolus is anticoagulation with heparin or enoxaparin (Lovenox) initially, then switch to warfarin (Coumadin) for long-term care. Travel the usual treatment for anticoagulation for pulmonary embolus is three to six months.
The lungs and heart can stop working if there is a fairly large clot burden. With the exception of the basics of oxygen, intravenous fluids, and medications to support blood pressure, thrombolytic or clot busting therapy may be considered. In cases of a rare and extreme, Lytic agents may be directly injected into the area of the clot.
Pulmonary embolus should always be considered as life-threatening diseases.
Angina and Heart Attack (Myocardial Infarction)
Concern for patients and physicians is that all chest pain may originate from the heart. Angina is the term given to pain that occurs because the blood vessels to the heart muscle narrow and reduce the amount of oxygen that can be delivered to the heart itself. This can cause the classic symptoms of chest pressure or tightness with radiation to the arm or neck associated with shortness of breath and sweating.
Unfortunately, many people do not present with classic symptoms, and pain may be difficult to describe - or in some people may not even be present. Instead of angina or chest pressure typical, anginal equivalent (which they can be symptoms instead of chest pain) they might be indigestion, shortness of breath, or weakness and malaise (not feeling well). The women and the elderly are at higher risk to have an atypical presentation of cardiac pain (not typical).
If one of the blood vessels to the heart (coronary arteries) is blocked completely, then the muscle is supplied blood by him at risk for death. This is a heart attack or myocardial infarction. In most circumstances, this pain is more severe than angina is routine, but again, there are many variations in signs and symptoms.
Is a clinical diagnosis of angina. After the doctor took the history with care and access to factors of potential risk, the diagnosis is pursued properly or he was considered absent. If angina is a potential diagnosis, further evaluation may include electrocardiograms (EKG or ECG) and blood tests.
Cardiac enzymes can be measured in the bloodstream when heart muscle is irritated or damaged. If chemicals are not present, may be feasible to conduct studies of cardiac imaging in a variety of ways depending on the patient's past history:
* The tests in which the stress electrocardiogram were monitored during exercise
* Echocardiography (ultrasound evaluation) of the structure and function of the heart
* Computerized cardiac angiography where a CT scan can image blood vessels of heart
* Coronary catheterization, where the tubes inserted through the major blood vessels into the heart and dye (dye) is used to directly image the blood vessels of the heart looking for obstacles / blockages
Purpose of making a diagnosis of angina is to restore normal blood supply to the heart muscle before the heart attack occurred and permanent muscle damage occurs. In addition to minimizing risk factors by controlling blood pressure, cholesterol, and diabetes, and smoking cessation, medications can be used to make the heart beat more efficiently (eg, beta blockers), to enlarge / dilate blood vessels (eg, nitroglycerin ) and to make blood less likely to clot / clot (aspirin).
Acute heart attack (myocardial infarction) is a true emergency, because of blockage of blood supply fully will cause part of the heart muscle dies and is replaced by scar tissue. This reduces the heart's ability to pump blood to meet the necessities of the body. Likewise, an injured heart muscle is irritated and can cause electrical disturbances such as ventricular fibrillation, a condition where the heart of the shake like Jello (food gelatin) and do not beat in a coordinated way. This is the cause of sudden death in heart attack. Cause of acute heart attack is the rupture of cholesterol plaque in the coronary arteries. This causes blood clots to form and clog arteries.
Treatment for heart attack is the restoration (restoration re) emergency supply of blood. Two options (choices), including the use of drugs such as TPA or TNK to dissolve blood clots (thrombolytic therapy) or emergency cardiac catheterization and using a balloon to open the blocked area (angioplasty) and hold it open with a mesh cage called stent.
Coronary artery bypass surgery be considered when there is arterial disease spread that can not be accounted for in angioplasty and stenting.
Pericarditis
Heart filled in a sac called the pericardium. Just as in pleurisy, these pockets can become inflamed and cause pain. In contrast with angina, the pain is sharp and tends to be caused by an inflamed pockets rubbing against the outer layers of the heart.
The most common cause of pericarditis is a viral disease or unknown (idiopathic). Inflammatory diseases of the body (rheumatoid arthritis, systemic lupus erythematosus), kidney failure, and cancer are other conditions that can cause pericarditis. Trauma, especially of injuries car steering wheel in vehicle accidents can cause pericarditis.
Pain with pericarditis is a strong, sharp, tends to worsen when lying down, and relieved by leaning forward. Because the pain can become so severe, spread to Langan or neck, and causing some shortness of breath, he was sometimes mischaracterized as angina, pulmonary embolus, or aortic dissection. The symptoms include fever and malaise associated (malaise).
History is useful in making the diagnosis, look for viral disease recently and asked about past medical history. Physical examination may reveal the friction when listening to heart sounds.
Electrocardiogram may show changes consistent with pericarditis, but sometimes, the ECG may mimic an acute heart attack. Echocardiogram is useful if there is fluid in the pericardial sack which relate to inflammation.
Anti-inflammatory drugs like ibuprofen is the treatment for pericarditis. Indicate the underlying cause will also direct therapy.
Cardiac tamponade is a complication of pericarditis. Pressure from the buildup of excess fluid in the pericardial sack is so large that it prevents the blood to return to the heart. Diagnosis is made clinically by the triad of (Beck's triad):
* Low blood pressure (hypotension)
* Inflate the neck veins, and
* Tones are muffled heart.
Care is putting a needle into the pericardium to draw out fluids and / or surgery to open a window in the pericardium to prevent fluid buildup in the future.
Aorta and Aortic Dissection
The aorta is the large blood vessel that comes out of the heart and deliver blood to the body. He is composed of layers of muscles that need to be strong enough to withstand the pressure generated by the beating heart. In some people, a tear can occur in one layer of the aortic wall, and blood can enter the path between the wall muscles. This is called an aortic dissection and is potentially life threatening. This type of dissection and treatment depends on where the dissection occurs in the aorta. Dissection-dissection type A is located on the ascending aorta (aortic rise above) that runs from the heart to the aortic arch (aortic arch) in which the vessels that supply blood to the brain and arms out. Dissection-dissection type B is located on the descending aorta (aorta is coming down).
The majority of aortic dissections occur as long-term consequences of high blood pressure is controlled poorly. Other conditions associated include:
* Marfan's syndrome
* Trauma
* Pregnancy
* Complications after surgery than open heart surgery
The pain of aortic dissection occurs suddenly and is often described as a strong punctured or torn. He may be constant, or pain may be pleuritic (worse with breathing in). Sometimes it spreads to the back. The pain of dissection is often confused with pain from a heart attack, esophagitis, or pericarditis.
Diagnosis based on history, review of risk factors, physical examination, and clinical suspicion. Physical examination may reveal loss or delay of the veins on the wrist or leg when comparing one side to the other. New heart murmur may be detected if the dissection involves the aortic valve (aortic valve), where the aorta leaves the heart. If the blood vessels that exit from the aorta was involved in the area of dissection, the organs supplied by them may be at risk. Stroke and paralysis can be found on dissection. Blood supply to the kidneys and colon, and into the arms and legs may be lost.
The diagnosis of aortic dissection is confirmed by imaging (imaging), most commonly by CT angiography of the aorta.
Type A dissection-dissection of ascending aorta were treated with surgery in which damaged parts of the aorta is removed and replaced with artificial grafts (artificial graft). Occasionally the aortic valve needs to be repaired or replaced if it is damaged.
Type B dissection-dissection initially treated with medications to control blood pressure and maintain it within normal limits. Medications beta blockers and calcium channel blockers are commonly used. If medical therapy fails, surgery may be needed.
If the dissection tear completely through all three layers of the aortic wall, the aortic rupture. This is a catastrophe, and more than 50% of affected patients die before reaching hospital. Overall deaths from aortic rupture is greater than 80%.
Esophagus and reflux esophagitis
Esophagus is a muscular tube that transports food from the mouth to the stomach. Lower esophageal sphincter (LES) is a special file of the muscle at the lower end of the esophagus that functions as a valve / valve to withstand stomach contents spilled back into the esophagus. If the valve fails, the contents of the stomach, including digestive juices are acidic, can flow back (reflux) and irritate the lining of the esophagus. While the stomach has a protective barrier layer to protect it from digestive juices are normal, this protection does not exist in the esophagus.
Reflux esophagitis (also referred to as GERD, gastroesophageal reflux disease) can present with a burning sense of the chest and upper abdominal pain that spreads to the esophagus and may be associated with a sour taste in the back of the throat called waterbrash. He may be present after meals or bedtime when the patient is lying flat. Significant seizures can occur from the muscles of the esophagus, and the pain can be a powerful menjad. Pain from reflux esophagitis can be mistaken for angina, and vice versa (vice versa).
Physical examination is usually not helpful, and clinical diagnosis is often made without further testing. Endoscopy may be performed to examine the lining of the esophagus and stomach. If symptoms last longer, they may be associated with, or caused, precancerous changes in cells lining the lower esophagus. Manometry can be performed to measure changes in pressure in the esophagus and stomach to decide whether the LES to work properly. Barium swallow with fluoroscopy or gastrograph is a type of x-ray patterns in which the ingestion of the esophagus can be evaluated.
The treatment for reflux esophagitis include:
* Changes in diet and lifestyle to limit the amount of acid from the stomach can splash back.
* Raising the head pillow allows gravity to keep acid to flow back.
* Sizes smaller meals may limit the distension of the stomach.
* Alcohol, drugs, anti-inflammatory drugs, and smoking are irritants (things that irritate) the lining of the stomach and esophagus and should be avoided.
* Barrier-acid barrier such as omeprazole (Prilosec) or lansoprazole (Prevacid) can reduce the amount of stomach acid produced, and antacids such as Maalox or Mylanta can help to bind the excess acid.
Complications of drainage back (reflux) of acid depends on the severity and duration. Chronic reflux can cause changes in the lining of the esophagus (Barrett's esophagus) that may lead to cancer. Reflux may also bring the contents of acid into the back of the mouth into the larynx (voice box) and cause hoarseness, voice hoarseness, or cough. Aspiration pneumonia can be caused by acid and food particles are inhaled into the lungs.
Stomach Pain That Referred
The conditions in the abdomen can present as pain referred to the chest, especially if there is inflammation around the diaphragm. Inflammation of the stomach, spleen, liver, or gallbladder can initially present with complaints of nonspecific pain that may be associated with chest discomfort vague. Physical examination and time to allow the disease process to reveal itself often allows a precise diagnosis made. He also is the reason that the entire body is checked, even if the initial complaint was chest pain.
* In the same way, upper abdominal pain may initially present as abdominal pain.
* Myocardial infarction of the inferior or bottom of the heart can present as indigestion (indigestion).
* Pneumonia may present as upper abdominal pain, especially if pulmonary inflammation adjacent to the diaphragm.
* Aortic dissection can present with chest pain, abdominal pain, or both, depending on where the dissection occurs.
0 comments:
Post a Comment