What are the common causes of upper chest and shoulder pain. How can you differentiate between various conditions causing this discomfort. When should you seek immediate medical attention for chest and shoulder pain.

Understanding the Complexity of Chest and Shoulder Pain

Pain in the upper chest near the shoulder can be a perplexing and sometimes alarming experience. This discomfort may stem from various sources, including the heart, lungs, or other internal organs. In some cases, the pain may be referred, meaning it’s felt in the chest and shoulder but originates elsewhere in the body. Given the potential seriousness of certain underlying causes, it’s crucial to recognize when immediate medical attention is necessary.

Key Characteristics of Chest and Shoulder Pain

• Location: Can be felt in the upper chest, extending to the shoulder
• Intensity: May range from mild discomfort to severe pain
• Duration: Can be acute (short-term) or chronic (long-lasting)
• Associated symptoms: May include shortness of breath, nausea, or dizziness

Understanding these characteristics can help healthcare providers determine the underlying cause and appropriate treatment. Now, let’s explore some of the most common conditions associated with chest and shoulder pain.

Angina: When Your Heart Cries for Help

Angina is a term used to describe chest pain resulting from reduced blood flow to the heart muscle. This condition occurs when the coronary arteries become narrowed or clogged, limiting the oxygen supply to the heart.

Types of Angina

1. Stable angina: Follows a predictable pattern, often triggered by physical activity or stress
2. Unstable angina: Occurs suddenly, even at rest, and may last longer than 20 minutes

Can angina be life-threatening? While stable angina is generally not immediately life-threatening, unstable angina can be a medical emergency and requires prompt attention. It’s essential to recognize the symptoms and seek help when necessary.

Recognizing Angina Symptoms

• Chest pain or discomfort, often described as pressure or tightness
• Pain that may radiate to the left shoulder or arms
• Shortness of breath
• Fatigue or weakness
• Nausea or indigestion
• Sweating

If you experience these symptoms, especially if they’re new or worsening, it’s crucial to consult a healthcare professional for proper evaluation and treatment.

Heart Attack: A Medical Emergency Requiring Immediate Action

A heart attack, also known as myocardial infarction, occurs when blood flow to a part of the heart muscle is blocked, usually by a blood clot. This blockage can cause permanent damage to the heart muscle if not treated promptly.

Heart Attack Symptoms: Beyond the Hollywood Portrayal

Are heart attack symptoms always dramatic and sudden? Contrary to popular belief, heart attack symptoms can vary in intensity and onset. While some people experience sudden, intense chest pain, others may have more subtle symptoms that develop gradually.

• Chest pain or pressure that may spread to the neck, shoulders, or arms
• Shortness of breath
• Cold sweat
• Fatigue
• Indigestion or heartburn
• Dizziness or lightheadedness

Gender Differences in Heart Attack Symptoms

Do men and women experience heart attacks differently? Research has shown that while chest pain is the most common symptom for both genders, women are more likely to experience symptoms that may not be immediately associated with a heart attack.

• Unusual fatigue lasting several days
• Sleep disturbances
• Anxiety
• Indigestion or gas-like pain
• Jaw or back pain
• Gradual onset of symptoms

Understanding these differences can be crucial in recognizing a heart attack and seeking timely medical attention, regardless of gender.

Gallbladder Issues: When Tiny Stones Cause Big Problems

The gallbladder, a small organ located beneath the liver, plays a crucial role in digestion by storing and releasing bile. However, this organ can sometimes develop gallstones, which are hardened deposits of digestive fluid that can range in size from tiny grains to larger masses.

Risk Factors for Gallstone Formation

• Female gender
• Age over 40
• Overweight or obesity
• Pregnancy

Why do some people develop gallstones while others don’t? The exact cause isn’t always clear, but certain factors can increase the risk. Understanding these risk factors can help individuals take preventive measures and recognize potential symptoms early.

Gallstone Symptoms: More Than Just Stomach Pain

Can gallstones cause pain in the chest and shoulder? While gallstone pain is often associated with the abdomen, it can indeed radiate to the chest and shoulder areas, particularly the right side. This referred pain can sometimes be mistaken for heart-related issues, making accurate diagnosis crucial.

• Pain in the right upper abdomen
• Discomfort below the breastbone
• Pain in the right shoulder or between shoulder blades
• Nausea or vomiting
• Fatigue

If you experience these symptoms, especially after eating fatty foods, it’s important to consult a healthcare provider for proper evaluation and treatment options.

Pericarditis: When the Heart’s Protective Sac Becomes Inflamed

Pericarditis is the inflammation of the pericardium, the thin, two-layered sac that surrounds and protects the heart. This condition can cause significant chest pain and discomfort, often extending to the shoulder area.

Understanding Pericarditis

• Usually starts suddenly
• Can last from a few days to several weeks
• Often caused by viral infections

How does pericarditis differ from other heart conditions? Unlike conditions like angina or heart attacks, which involve the heart muscle itself, pericarditis affects the protective layer around the heart. This distinction is important for proper diagnosis and treatment.

Recognizing Pericarditis Symptoms

• Sharp or dull chest pain, often in the center or left side
• Pain that may spread to the shoulder blade
• Discomfort that worsens when lying down or breathing deeply
• Pain that improves when leaning forward
• Mild fever
• Fatigue and weakness

If you experience these symptoms, particularly if they’re accompanied by fever or persist for more than a few days, it’s important to seek medical attention for proper diagnosis and treatment.

Pancreatitis: When Digestive Processes Go Awry

The pancreas, located behind the stomach near the small intestine, plays a crucial role in digestion and blood sugar regulation. Pancreatitis occurs when this organ becomes inflamed, leading to various symptoms, including upper abdominal pain that can sometimes radiate to the chest and shoulder.

Types of Pancreatitis

1. Acute pancreatitis: Sudden onset, typically resolves within a few days with proper treatment
2. Chronic pancreatitis: Long-term inflammation that can lead to permanent damage

Can pancreatitis be life-threatening? While mild cases of acute pancreatitis often resolve with treatment, severe cases or chronic pancreatitis can lead to serious complications. Prompt medical attention is crucial for proper management.

Recognizing Pancreatitis Symptoms

• Upper abdominal pain that may radiate to the back or chest
• Pain that worsens after eating
• Nausea and vomiting
• Fever
• Rapid pulse
• Tenderness when touching the abdomen

If you experience severe abdominal pain, especially if accompanied by fever or vomiting, seek immediate medical attention to rule out pancreatitis or other serious conditions.

Differential Diagnosis: Unraveling the Mystery of Chest and Shoulder Pain

Given the various conditions that can cause chest and shoulder pain, accurate diagnosis is crucial for proper treatment. Healthcare providers use a combination of patient history, physical examination, and diagnostic tests to determine the underlying cause.

Common Diagnostic Tools

• Electrocardiogram (ECG): Measures the heart’s electrical activity
• Blood tests: Can detect markers of heart damage or inflammation
• Imaging studies: Such as chest X-rays, CT scans, or ultrasounds
• Stress tests: Evaluate heart function during physical activity

How do doctors differentiate between various causes of chest and shoulder pain? By combining information from the patient’s symptoms, physical examination findings, and results from diagnostic tests, healthcare providers can often pinpoint the underlying cause and develop an appropriate treatment plan.

Red Flags: When to Seek Immediate Medical Attention

While not all chest and shoulder pain is a medical emergency, certain symptoms warrant immediate medical attention:

• Sudden, severe chest pain
• Shortness of breath or difficulty breathing
• Pain accompanied by nausea, sweating, or dizziness
• Loss of consciousness
• Chest pain lasting more than a few minutes

If you experience these symptoms, don’t hesitate to call emergency services or seek immediate medical care. Prompt attention can be life-saving in cases of heart attacks or other serious conditions.

Treatment Approaches: Tailoring Care to the Underlying Cause

Treatment for chest and shoulder pain varies depending on the underlying cause. Once a diagnosis is established, healthcare providers can recommend appropriate interventions to address the specific condition and alleviate symptoms.

Common Treatment Strategies

• Medications: May include pain relievers, anti-inflammatory drugs, or specific treatments for heart conditions
• Lifestyle modifications: Such as dietary changes, stress reduction, or smoking cessation
• Surgical interventions: In some cases, procedures like angioplasty or gallbladder removal may be necessary
• Physical therapy: Can help improve mobility and reduce pain in some conditions
• Ongoing monitoring: Regular check-ups to track progress and adjust treatment as needed

How is the treatment plan determined? Healthcare providers consider factors such as the specific diagnosis, severity of symptoms, overall health status, and patient preferences when developing a treatment strategy. This personalized approach helps ensure the most effective care for each individual.

The Role of Prevention in Managing Chest and Shoulder Pain

While not all causes of chest and shoulder pain can be prevented, certain lifestyle modifications can help reduce the risk of developing some conditions:

• Maintaining a healthy diet rich in fruits, vegetables, and whole grains
• Engaging in regular physical activity
• Managing stress through relaxation techniques or counseling
• Avoiding tobacco use and limiting alcohol consumption
• Keeping up with regular health check-ups and screenings

By adopting these healthy habits, individuals can potentially lower their risk of developing conditions that cause chest and shoulder pain, promoting overall well-being and quality of life.

Living with Chronic Chest and Shoulder Pain: Strategies for Coping

For some individuals, chest and shoulder pain may become a chronic condition requiring ongoing management. While this can be challenging, there are strategies to help cope with persistent pain and improve quality of life.

Coping Mechanisms for Chronic Pain

• Pain management techniques: Such as relaxation exercises or mindfulness meditation
• Physical therapy and exercise: To improve strength and flexibility
• Support groups: Connecting with others who have similar experiences
• Psychological support: Counseling or cognitive-behavioral therapy to address the emotional impact of chronic pain
• Complementary therapies: Such as acupuncture or massage, when appropriate

How can individuals maintain a positive outlook while dealing with chronic pain? Developing a strong support network, setting realistic goals, and focusing on activities that bring joy and fulfillment can help maintain emotional well-being despite physical challenges.

The Importance of Open Communication with Healthcare Providers

Effective management of chronic chest and shoulder pain often requires ongoing collaboration between patients and their healthcare team. Open and honest communication is key to ensuring that treatment plans remain effective and aligned with the patient’s needs and goals.

• Regular follow-up appointments to assess progress
• Discussing any changes in symptoms or new concerns
• Being transparent about the effectiveness of current treatments
• Exploring alternative options if current strategies are not providing adequate relief

By maintaining open lines of communication, patients and healthcare providers can work together to optimize pain management strategies and improve overall quality of life.

Emerging Research and Future Directions in Chest and Shoulder Pain Management

As medical science continues to advance, new insights and treatment options for chest and shoulder pain are constantly emerging. Staying informed about these developments can provide hope and potentially new avenues for managing pain and underlying conditions.

Promising Areas of Research

• Targeted therapies for specific types of pain
• Advanced imaging techniques for more accurate diagnosis
• Minimally invasive surgical procedures
• Regenerative medicine approaches
• Personalized medicine based on genetic profiles

How might future developments change the landscape of chest and shoulder pain management? As research progresses, we may see more tailored treatment approaches, improved diagnostic accuracy, and potentially even preventive strategies based on individual risk factors.

The Role of Patient Participation in Research

Individuals experiencing chest and shoulder pain can play a crucial role in advancing medical knowledge by participating in clinical trials or research studies. These opportunities not only contribute to scientific understanding but may also provide access to cutting-edge treatments.

• Discussing research participation options with healthcare providers
• Staying informed about ongoing studies in relevant areas
• Understanding the potential benefits and risks of research participation
• Sharing experiences to help shape future research directions

By actively engaging in the research process, patients can become partners in advancing medical knowledge and improving care for themselves and others facing similar challenges.

Chest and Shoulder Pain: Symptoms, Causes, and Diagnosis

Pain from your chest to your shoulder can have many causes. Your heart, lungs, or other internal organs may be involved. If your pain is sudden or severe, it’s very important to get immediate medical care.

The pain may also be referred. This means it’s felt in your chest and shoulder but is actually caused by pain in another part of your body.

In this article, we’ll look at some of the most common causes of chest and shoulder pain and the treatment options for these causes.

Pain in the chest and shoulder can have many causes. Some can be more serious than others. The conditions listed below are some of the most common culprits of this kind of pain.

Angina is the name for chest pain that results from clogged and narrowed arteries around your heart. When this happens, your heart muscle isn’t able to get enough oxygen-rich blood.

It’s not a heart attack. Rather, it’s a sign you have a heart condition. Physical activity often triggers the pain, when you need more oxygen. Emotional stress can trigger it, too.

Angina can be stable. This means it follows a predictable pattern and typically occurs when you’re doing something, or when you’re stressed. With stable angina, symptoms usually go away within a few minutes.

Angina can also be unstable. This type of angina tends to occur suddenly or while you’re at rest. With unstable angina, symptoms can last longer than 20 minutes and may return. The pain may also get worse over time.

An unstable angina attack can be life threatening and requires emergency medical attention.

Symptoms

Chest pain is the main symptom of both stable and unstable angina. Pain usually starts behind the breastbone. Pain may be referred to your left shoulder or arms.

Other common symptoms include:

• fatigue
• shortness of breath
• light-headedness
• nausea or indigestion
• sweating
• weakness

A heart attack happens when a blockage in an artery in your heart stops or reduces the blood flow to your heart muscle. It’s also called a myocardial infarction.

Symptoms can start suddenly or come on slowly. People with gradual symptoms may not seek medical care right away.

If you think you’re having a heart attack, call 911 or get emergency medical help immediately.

Symptoms

Heart attack symptoms can vary in intensity.

Common heart attack symptoms include:

• a feeling of tightness or pressure in your chest
• chest pain that spreads to your neck, shoulders, one or both arms, or back
• faintness or dizziness
• shortness of breath
• cold sweat
• fatigue
• indigestion, stomach pain, or heartburn

While chest pain is the most common symptom for men, women are more likely to have symptoms other than chest pain. Some of the symptoms women often experience that happen less frequently with men include:

• unusual fatigue that lasts for several days or extreme fatigue that comes on suddenly
• sleep disturbances
• anxiety
• indigestion or gas-like pain
• jaw or back pain
• symptoms that come on more gradually

Your gallbladder is a small organ on your right side that sits below your liver. Its purpose is to release bile into the small intestine. Bile helps the digestive process by breaking down the fats in the food you eat.

Gallstones are little masses that form out of hardened digestive fluid in the gallbladder. Gallstones can range in size, from grains of sand to pingpong balls.

Why some people develop gallstones isn’t clear. But risk factors include:

• being female
• being over 40 years old
• having overweight
• being pregnant

Symptoms

Sometimes gallstones don’t cause any symptoms. But gallstones can cause intense pain when they block a bile duct or when you eat fatty foods. Pain can last up to several hours.

Pain may occur on:

• your right side, above the stomach
• in the center of your stomach, below the breastbone
• in your right shoulder
• between your shoulder blades

You may also have fatigue, nausea, or vomiting.

Pericarditis is the inflammation of the pericardium, the thin sac that surrounds your heart. The two-layered pericardium protects your heart and holds it in place. Fluid between the pericardium layers prevents friction when your heart beats.

Pericarditis usually starts suddenly. It can last from a few days to a few weeks. A viral infection is thought to cause most cases.

Symptoms

The main symptom is sharp or dull pain in the center of your chest or on the left side.

Other common symptoms include:

• pain that spreads from your chest to the shoulder blade
• pain that worsens when you lie down or take a deep breath
• pain that decreases when you lean forward
• weakness
• mild fever
• fatigue

Your pancreas is located behind your stomach near the first part of your small intestine. It releases fluids that help break down the food in your intestine. It also controls your body’s blood sugar by regulating the release of insulin.

Pancreatitis is an inflammation of the pancreas. It can be chronic or acute. Acute pancreatitis can come on suddenly and usually gets better with treatment. Chronic pancreatitis gets worse over time.

The most common cause of acute pancreatitis is gallstones.

Symptoms

Symptoms of pancreatitis can vary, depending on the type of pancreatitis. The main symptom of both acute and chronic pancreatitis is pain in your upper abdomen, as well as pain that radiates to your back.

Acute pancreatitis symptoms include:

• mild or severe pain that lasts for several days
• abdominal pain that gets worse after eating
• fever
• nausea and vomiting
• fast pulse
• swollen or tender stomach

Chronic pancreatitis symptoms include:

• pain in your upper abdomen
• nausea or vomiting
• weight loss without trying
• oily stools that smell bad

Pleurisy is an inflammation of the thin layer of tissues, called pleura, that separate your lungs from your chest wall.

The most common cause of pleurisy is a viral infection in the lungs.

Symptoms

The most common symptoms of pleurisy include:

• sharp chest pain that gets worse when you breathe, cough, laugh, or sneeze
• pain in your shoulders or back
• shortness of breath
• muscle or joint pain
• headaches

Some people may also experience a cough or fever.

Chest pain with shoulder pain isn’t always an emergency, but it can be very hard to tell. That’s why it’s important to pay attention to any other symptoms you may have.

Call 911 or go to an emergency room if you have:

• severe chest and shoulder pain
• have an existing heart condition
• think you’re having a heart attack

Other symptoms that can be a sign you need immediate medical attention are:

• escalating chest and shoulder pain
• difficulty breathing
• fainting or dizziness
• extreme weakness

A 2019 review looked at the most common causes of chest pain for people who went to an emergency room. The review found that:

• 31 percent of the causes were due to acute coronary syndrome, which included angina and other heart problems
• 30 percent of chest pain causes were due to acid reflux
• 28 percent of causes were due to a musculoskeletal condition

See your doctor if you have unexplained chest and shoulder pain. Any time you have chest pain, it’s important to get a proper diagnosis and appropriate treatment.

Because there are many possible causes for chest and shoulder pain, diagnosis can be challenging.

Your doctor will take a full medical history to find out about any other health conditions you may have. They’ll also ask if your family members have heart disease or other types of conditions.

Your doctor will ask about your symptoms, when they started, how long they lasted, and if they changed.

Once your doctor knows more about your symptoms and any other health conditions, they’ll do a physical exam and listen to your heart and lungs.

There are many diagnostic tests your doctor may use to determine what’s causing your shoulder and chest pain. Common diagnostic tests include:

• an X-ray of your lungs, heart, gallbladder, or other organs
• an electrocardiogram (EKG) to look at how your heart is beating
• an echocardiogram to look at your heart muscle and how it’s working
• blood tests to look for signs of a heart attack or specific enzyme levels for certain conditions, like pancreatitis
• a stress test to see how your heart functions when you exercise
• a coronary angiography to find out if you have a blockage in a coronary artery
• a heart CT scan, also known as CT angiography, to look at your heart and blood vessels and to check for blood clots or other problems
• an MRI to look at heart movement and blood flow, or to get a more detailed view of your gallbladder or pancreas
• a biopsy of lung tissue if pleurisy is suspected
• a pancreatic function test to see if your pancreas is responding normally to specific hormones

Treatment for shoulder and chest pain depends on what’s causing the pain.

Because there can be so many variables, treatment plans for the same condition may be different from one person to the next. Some factors that may influence your treatment plan include:

• your age
• other health conditions you may have, including overweight
• whether or not you smoke

Heart problems

For heart problems, your doctor may prescribe:

• aspirin
• nitroglycerin
• blood thinners to prevent clots
• clot-busting drugs (thrombolytics)
• antibiotics for pain caused by an infection
• fluid drainage for pericarditis

For life threatening situations, you may need surgery, such as bypass surgery or angioplasty.

Your doctor will likely recommend lifestyle changes, including changes to your diet, physical activity, and stress management.

Gallstone attack

Depending on the frequency of your gallstone attacks, your doctor may recommend surgery to remove your gallbladder. This is usually done laparoscopically.

For a less serious gallstone condition, your doctor may prescribe a drug called ursodiol. This drug may help dissolve the gallstones over time. Your doctor may also put you on a low fat diet to help prevent further gallstone development.

Some people have success with natural remedies for gallstones. Be sure to talk to your doctor before trying any at-home treatments for gallstones.

Pleurisy

Treatment for pleurisy will depend on the cause.

Your doctor may prescribe antibiotics if you have a bacterial infection. Viral infections often clear up without treatment. Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) may help relieve chest pain.

If you have a lot of fluid buildup, known as pleural effusion, your doctor may want to drain it. This is done with local or general anesthetic. It may require a hospital stay.

A hospital stay may also be necessary if you have other health conditions that make your pleurisy more difficult to treat.

Pancreatitis

Your doctor will give you medications to help reduce the pain. You may also have to fast for a couple of days to give your pancreas a rest. You may need intravenous fluids to prevent dehydration.

You may be hospitalized if your pancreatitis is severe.

Other treatment may include surgery to drain your pancreas, or surgery to remove your gallbladder if gallstones caused your pancreatitis.

Longer-term treatments may include:

• diet changes
• limiting alcohol use
• taking pancreatic enzyme supplements to aid digestion

Other chest pain causes

For chest pain conditions that aren’t related to your heart or coronary arteries, you doctor may prescribe:

• acid suppressing drugs to reduce acid reflux
• antidepressants or therapy to help control panic attacks

Pain in your chest and shoulder can have many causes. Some of the most common include angina or other heart conditions, gallstones, pericarditis, pleurisy, or pancreatitis.

Unexplained pain that occurs in both your chest and shoulder should always be checked out by your doctor.

If the pain is severe or lasts longer than a few minutes, immediately go to the emergency room or call 911. For many conditions, the earlier you receive treatment, the better your outcome is likely to be.

Chest and Shoulder Pain: Symptoms, Causes, and Diagnosis

Pain from your chest to your shoulder can have many causes. Your heart, lungs, or other internal organs may be involved. If your pain is sudden or severe, it’s very important to get immediate medical care.

The pain may also be referred. This means it’s felt in your chest and shoulder but is actually caused by pain in another part of your body.

In this article, we’ll look at some of the most common causes of chest and shoulder pain and the treatment options for these causes.

Pain in the chest and shoulder can have many causes. Some can be more serious than others. The conditions listed below are some of the most common culprits of this kind of pain.

Angina is the name for chest pain that results from clogged and narrowed arteries around your heart. When this happens, your heart muscle isn’t able to get enough oxygen-rich blood.

It’s not a heart attack. Rather, it’s a sign you have a heart condition. Physical activity often triggers the pain, when you need more oxygen. Emotional stress can trigger it, too.

Angina can be stable. This means it follows a predictable pattern and typically occurs when you’re doing something, or when you’re stressed. With stable angina, symptoms usually go away within a few minutes.

Angina can also be unstable. This type of angina tends to occur suddenly or while you’re at rest. With unstable angina, symptoms can last longer than 20 minutes and may return. The pain may also get worse over time.

An unstable angina attack can be life threatening and requires emergency medical attention.

Symptoms

Chest pain is the main symptom of both stable and unstable angina. Pain usually starts behind the breastbone. Pain may be referred to your left shoulder or arms.

Other common symptoms include:

• fatigue
• shortness of breath
• light-headedness
• nausea or indigestion
• sweating
• weakness

A heart attack happens when a blockage in an artery in your heart stops or reduces the blood flow to your heart muscle. It’s also called a myocardial infarction.

Symptoms can start suddenly or come on slowly. People with gradual symptoms may not seek medical care right away.

If you think you’re having a heart attack, call 911 or get emergency medical help immediately.

Symptoms

Heart attack symptoms can vary in intensity.

Common heart attack symptoms include:

• a feeling of tightness or pressure in your chest
• chest pain that spreads to your neck, shoulders, one or both arms, or back
• faintness or dizziness
• shortness of breath
• cold sweat
• fatigue
• indigestion, stomach pain, or heartburn

While chest pain is the most common symptom for men, women are more likely to have symptoms other than chest pain. Some of the symptoms women often experience that happen less frequently with men include:

• unusual fatigue that lasts for several days or extreme fatigue that comes on suddenly
• sleep disturbances
• anxiety
• indigestion or gas-like pain
• jaw or back pain
• symptoms that come on more gradually

Your gallbladder is a small organ on your right side that sits below your liver. Its purpose is to release bile into the small intestine. Bile helps the digestive process by breaking down the fats in the food you eat.

Gallstones are little masses that form out of hardened digestive fluid in the gallbladder. Gallstones can range in size, from grains of sand to pingpong balls.

Why some people develop gallstones isn’t clear. But risk factors include:

• being female
• being over 40 years old
• having overweight
• being pregnant

Symptoms

Sometimes gallstones don’t cause any symptoms. But gallstones can cause intense pain when they block a bile duct or when you eat fatty foods. Pain can last up to several hours.

Pain may occur on:

• your right side, above the stomach
• in the center of your stomach, below the breastbone
• in your right shoulder
• between your shoulder blades

You may also have fatigue, nausea, or vomiting.

Pericarditis is the inflammation of the pericardium, the thin sac that surrounds your heart. The two-layered pericardium protects your heart and holds it in place. Fluid between the pericardium layers prevents friction when your heart beats.

Pericarditis usually starts suddenly. It can last from a few days to a few weeks. A viral infection is thought to cause most cases.

Symptoms

The main symptom is sharp or dull pain in the center of your chest or on the left side.

Other common symptoms include:

• pain that spreads from your chest to the shoulder blade
• pain that worsens when you lie down or take a deep breath
• pain that decreases when you lean forward
• weakness
• mild fever
• fatigue

Your pancreas is located behind your stomach near the first part of your small intestine. It releases fluids that help break down the food in your intestine. It also controls your body’s blood sugar by regulating the release of insulin.

Pancreatitis is an inflammation of the pancreas. It can be chronic or acute. Acute pancreatitis can come on suddenly and usually gets better with treatment. Chronic pancreatitis gets worse over time.

The most common cause of acute pancreatitis is gallstones.

Symptoms

Symptoms of pancreatitis can vary, depending on the type of pancreatitis. The main symptom of both acute and chronic pancreatitis is pain in your upper abdomen, as well as pain that radiates to your back.

Acute pancreatitis symptoms include:

• mild or severe pain that lasts for several days
• abdominal pain that gets worse after eating
• fever
• nausea and vomiting
• fast pulse
• swollen or tender stomach

Chronic pancreatitis symptoms include:

• pain in your upper abdomen
• nausea or vomiting
• weight loss without trying
• oily stools that smell bad

Pleurisy is an inflammation of the thin layer of tissues, called pleura, that separate your lungs from your chest wall.

The most common cause of pleurisy is a viral infection in the lungs.

Symptoms

The most common symptoms of pleurisy include:

• sharp chest pain that gets worse when you breathe, cough, laugh, or sneeze
• pain in your shoulders or back
• shortness of breath
• muscle or joint pain
• headaches

Some people may also experience a cough or fever.

Chest pain with shoulder pain isn’t always an emergency, but it can be very hard to tell. That’s why it’s important to pay attention to any other symptoms you may have.

Call 911 or go to an emergency room if you have:

• severe chest and shoulder pain
• have an existing heart condition
• think you’re having a heart attack

Other symptoms that can be a sign you need immediate medical attention are:

• escalating chest and shoulder pain
• difficulty breathing
• fainting or dizziness
• extreme weakness

A 2019 review looked at the most common causes of chest pain for people who went to an emergency room. The review found that:

• 31 percent of the causes were due to acute coronary syndrome, which included angina and other heart problems
• 30 percent of chest pain causes were due to acid reflux
• 28 percent of causes were due to a musculoskeletal condition

See your doctor if you have unexplained chest and shoulder pain. Any time you have chest pain, it’s important to get a proper diagnosis and appropriate treatment.

Because there are many possible causes for chest and shoulder pain, diagnosis can be challenging.

Your doctor will take a full medical history to find out about any other health conditions you may have. They’ll also ask if your family members have heart disease or other types of conditions.

Your doctor will ask about your symptoms, when they started, how long they lasted, and if they changed.

Once your doctor knows more about your symptoms and any other health conditions, they’ll do a physical exam and listen to your heart and lungs.

There are many diagnostic tests your doctor may use to determine what’s causing your shoulder and chest pain. Common diagnostic tests include:

• an X-ray of your lungs, heart, gallbladder, or other organs
• an electrocardiogram (EKG) to look at how your heart is beating
• an echocardiogram to look at your heart muscle and how it’s working
• blood tests to look for signs of a heart attack or specific enzyme levels for certain conditions, like pancreatitis
• a stress test to see how your heart functions when you exercise
• a coronary angiography to find out if you have a blockage in a coronary artery
• a heart CT scan, also known as CT angiography, to look at your heart and blood vessels and to check for blood clots or other problems
• an MRI to look at heart movement and blood flow, or to get a more detailed view of your gallbladder or pancreas
• a biopsy of lung tissue if pleurisy is suspected
• a pancreatic function test to see if your pancreas is responding normally to specific hormones

Treatment for shoulder and chest pain depends on what’s causing the pain.

Because there can be so many variables, treatment plans for the same condition may be different from one person to the next. Some factors that may influence your treatment plan include:

• your age
• other health conditions you may have, including overweight
• whether or not you smoke

Heart problems

For heart problems, your doctor may prescribe:

• aspirin
• nitroglycerin
• blood thinners to prevent clots
• clot-busting drugs (thrombolytics)
• antibiotics for pain caused by an infection
• fluid drainage for pericarditis

For life threatening situations, you may need surgery, such as bypass surgery or angioplasty.

Your doctor will likely recommend lifestyle changes, including changes to your diet, physical activity, and stress management.

Gallstone attack

Depending on the frequency of your gallstone attacks, your doctor may recommend surgery to remove your gallbladder. This is usually done laparoscopically.

For a less serious gallstone condition, your doctor may prescribe a drug called ursodiol. This drug may help dissolve the gallstones over time. Your doctor may also put you on a low fat diet to help prevent further gallstone development.

Some people have success with natural remedies for gallstones. Be sure to talk to your doctor before trying any at-home treatments for gallstones.

Pleurisy

Treatment for pleurisy will depend on the cause.

Your doctor may prescribe antibiotics if you have a bacterial infection. Viral infections often clear up without treatment. Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) may help relieve chest pain.

If you have a lot of fluid buildup, known as pleural effusion, your doctor may want to drain it. This is done with local or general anesthetic. It may require a hospital stay.

A hospital stay may also be necessary if you have other health conditions that make your pleurisy more difficult to treat.

Pancreatitis

Your doctor will give you medications to help reduce the pain. You may also have to fast for a couple of days to give your pancreas a rest. You may need intravenous fluids to prevent dehydration.

You may be hospitalized if your pancreatitis is severe.

Other treatment may include surgery to drain your pancreas, or surgery to remove your gallbladder if gallstones caused your pancreatitis.

Longer-term treatments may include:

• diet changes
• limiting alcohol use
• taking pancreatic enzyme supplements to aid digestion

Other chest pain causes

For chest pain conditions that aren’t related to your heart or coronary arteries, you doctor may prescribe:

• acid suppressing drugs to reduce acid reflux
• antidepressants or therapy to help control panic attacks

Pain in your chest and shoulder can have many causes. Some of the most common include angina or other heart conditions, gallstones, pericarditis, pleurisy, or pancreatitis.

Unexplained pain that occurs in both your chest and shoulder should always be checked out by your doctor.

If the pain is severe or lasts longer than a few minutes, immediately go to the emergency room or call 911. For many conditions, the earlier you receive treatment, the better your outcome is likely to be.

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Chest contusion: degrees, first aid, treatment
Consultation with a specialist:

Any injury to the chest is dangerous to life and health, so all victims, even in a satisfactory condition, require a detailed examination. Diagnosis is confirmed by chest x-ray. Depending on the type of injury, conservative or surgical treatment is prescribed.

Which organs can be damaged by bruising of the chest

With a chest injury, the skin is more often injured, muscles, subcutaneous tissue, internal organs and bones are not damaged. The lesion can be isolated or, in high-energy trauma, combined with damage to the ribs, lungs, heart, blood vessels, mammary glands, fracture of the sternum, thoracic vertebrae, hemothorax and pneumothorax.

Chest contusion is more common among young people. The mortality rate is 5-6%, and is associated with the risk of violation of the integrity and functions of the internal organs located in the chest area. With timely medical care, a high percentage of favorable outcomes.

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Causes of chest contusion

A bruise of the chest most often occurs due to a blow with a blunt object, compression of the sternum, a fall. The most common circumstances of damage to soft tissues in the sternum area are domestic and industrial injuries, sports activities. Less commonly, chest contusion is diagnosed as a result of fights, car accidents, natural disasters, and gunshot injuries. The number of victims among children increases during the summer holidays.

Damage to the internal organs is of a secondary nature, and is associated with their traumatization by sharp fragments of broken ribs.

Symptoms of chest contusion

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• Orthopedist
• Traumatologist
• Surgeon
• Pediatric orthopedist
• Pediatric traumatologist

Immediately after hitting the chest, the victim feels pain. Depending on the strength of the traumatic agent, the pain is dull, sharp, aggravated with a deep breath, during physical activity. Minor bruises sometimes remain unidentified.

Soft tissues react to injury with edema, bruising, and the formation of hematomas of various sizes. In the first days, hematomas are bright purple, after a week they acquire a purple-cyanotic hue, and after 7–10 days they become greenish-brown. In some cases, with extensive bruises, an increase in temperature is possible.

With a strong traumatic impact, the traumatologist must exclude a fracture of the ribs. If the pain does not increase when pressing the chest with two palms, the likelihood of a fracture is minimal.

A fracture of the ribs can be assumed if the chest on the side of the lesion lags behind when breathing, when palpating the damaged ribs, a crunch of bone fragments is heard, the skin in the sternum is pale, cyanotic, breathing is superficial.

A fracture of the sternum is manifested by intense pain, which increases with pressure and breathing, cough, swelling, hemorrhage, and painful palpation. Signs of chest compression – choking, shallow breathing, blue skin in the head, neck, upper chest. In some cases, there is a loss of consciousness, a temporary decrease in visual acuity, hearing.

Displaced fragments of ribs, sternum can violate the integrity of internal organs. As a result of damage to the pleura and lungs, hemothorax (accumulation of blood) and pneumothorax (accumulation of air) develop.

Symptoms of hemothorax:

• respiratory failure,
• shortness of breath,
• breathing pain,
• hemoptysis,
• heart palpitations..

When blood accumulates in the chest from 500 ml or more, the patient’s condition worsens, the pulse quickens, breathing is shallow, the skin becomes cyanotic. The patient assumes a forced sitting position with support on his hands.

The clinical picture of pneumothorax is a dry cough, weakened breathing, pain at the time of deep inspiration, shortness of breath, suffocation, cyanosis of the skin and mucous membranes.

Degrees of chest contusion

The severity of the bruise is determined by the strength of the traumatic factor – speed, weight, the nature of the surface, and bone density, the state of the blood coagulation system.

Taking into account the mechanism of injury, damage to soft tissues and organs, there are four degrees of chest contusion:

• I degree – characterized by injury to muscles and fatty tissue. It is manifested by edema, slight soreness. External signs disappear on their own in 3-7 days.
• II degree – damage to muscles and blood vessels is accompanied by edema, hematoma formation. The recovery period varies between 10-14 days.
• III degree — soft tissue injury complicated by damage to internal organs. Symptoms depend on which organ or bone was affected. The recovery period is from two weeks to a month or more.
• IV degree – diagnosed in violation of the integrity and functions of internal organs. Such injuries threaten the life and health of the patient, and require urgent hospitalization. The length of the rehabilitation period depends on the severity of the injury.

First aid for chest contusion

At the stage of first aid, it is necessary to provide the victim with peace, give an analgesic, apply cold to the site of injury to reduce swelling, pain and bruising. It can be a heating pad with cold water, an ice pack. In an emotionally unstable state, offer water, sedatives, provide a flow of fresh air.

Important! In the first 3-4 days after the injury, it is forbidden to take a hot bath, visit a sauna, a bath, as heat increases swelling and the risk of developing hemarthrosis.

Even with a minor injury, a satisfactory condition, the patient needs an urgent examination by a traumatologist, since damage to internal organs at the initial stage may be asymptomatic. It is better to transport the victim in a sitting or semi-sitting position.

A bruise of the chest is diagnosed on the basis of external signs, subjective sensations of the patient. To exclude trauma to the internal organs, a chest x-ray is required. The study allows you to assess the state of bone structures, establish the location of fractures, identify the level of fluid and gas in the pleural cavity and lung tissue.

Treatment and prevention of chest contusion

With an isolated injury to the sternum without damage to the internal organs and bones, conservative therapy will be sufficient. To reduce the intensity of pain, analgesics are prescribed, for coughing – bronchodilators. Well stop pain and inflammation, restore muscle tone physiotherapy:

• electrophoresis,
• laser therapy,
• ultrasound therapy,
• CMW-therapy (exposure to centimeter electromagnetic waves),
• inductothermy (treatment with magnetic fields).

With severe pain for a short time, a chest bandage is performed. All patients are recommended a balanced diet, exercise therapy, physical rest, breathing exercises.

Important! In case of severe injury to the sternum, it is recommended to sleep in a half-sitting position or lying down with the headboard raised high.

A small amount of blood, air in the pleura resolves on its own.