Chest pain, severe/wide area, see a doctor immediately


I think many people have experienced chest pain. There are various causes of chest pain, some of which can be life-threatening, such as myocardial infarction and aortic dissection, if not immediately treated. I want to deal with pain correctly.

If you are busy and tired or lack of sleep, you may feel chest pain. Some people may be able to wait for a while, but some people should call an ambulance to receive treatment immediately. There are two points of chest pain that require urgent attention: "widespread pain" and "severe pain".

Chest pains that cause sudden death and require prompt treatment are myocardial infarction, acute aortic dissection, and pulmonary thromboembolism. "The chest pain caused by such a serious illness is painful in a wide range, and there are many cases in which it cannot be indicated as painful," said Ken Uezuma, a circulatory organ doctor at Teikyo University School of Medicine in Itabashi, Tokyo.

Myocardial infarction is a disease in which the coronary artery, which is a blood vessel that covers the surface of the heart and nourishes it, is blocked and the myocardium necroses. I often feel severe pain and tightness, such as a tight chest. Pain may be felt in the left shoulder, throat, jaw, and arms. "If these symptoms last for 15 to 30 minutes, it's best to call an ambulance without hesitation."

Even if the coronary arteries do not become blocked, angina causes narrowing of blood flow and chest pain. My chest hurts for a few minutes after doing some light exercise such as going up and down stairs. If you rest and the pain disappears, you can wait and see, but if you repeat it often, you may have unstable angina before the myocardial infarction, and you should see your doctor immediately.

Emergency response is also essential for aortic dissection. The aorta is the thickest blood vessel in the human body through which blood from the heart first passes. The wall of blood vessels is composed of three layers, from the inside to the intima, media and adventitia. In aortic dissection, the intima is injured and blood flows between the media and adventitia, causing a fissure to spread. The adventitia is ruptured, the aorta is ruptured, and blood vessels are occluded, which threatens life.

In addition to severe chest pain, back pain is often given, and pain may occur in the abdomen or lower back depending on the location of dissection. According to Minoru Tabata, director of cardiovascular surgery at the Urayasu Ichikawa Medical Center in Tokyo Bay (Urayasu, Chiba Prefecture), "there are many elderly people, but in recent years the number of men in their 40s to 50s has been increasing," he said.

In particular, aortic dissection at the site from the heart to the head is said to increase the fatality rate by 1% per hour, and surgery to replace the torn aorta with an artificial blood vessel is required. "If you hesitate, it may be too late, so if you have any symptoms, see a doctor immediately, day or night," Tabata warns.

Pulmonary thromboembolism is a disease in which blood clots clog the arteries of the lungs. It is characterized by chest pain and dyspnea, and the lower limbs may also hurt. It tends to occur when you are not moving for a long time.

All of these are diseases in which the blood vessels become clogged or weakened, "many people with high blood pressure" (Mr. Tabata). Preventive measures are to treat chronic diseases such as hypertension and dyslipidemia that impose a burden on blood vessels. Also note the change in temperature that causes a rapid rise in blood pressure. One of the causes of the increase in these diseases is a change in lifestyle such as westernization of eating habits. Smoking, obesity, lack of exercise, stress, and lack of sleep increase risk. I would like to treat sleep apnea.

On the other hand, chest pain often occurs due to causes other than vascular disorders of the heart and lungs. Tension pneumothorax, reflux esophagitis, intercostal neuralgia, herpes zoster. It is characterized by tight pain and the ability to show the location.

Many do not need to call an ambulance, but need to see a medical institution as soon as possible. Reflux esophagitis and the like increase with age. "If I thought I had reflux esophagitis, I might have had angina, so consult my doctor," Kamizuma advises.


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