Chest Pain, Chronic

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Many problems can cause symptoms in the chest area, such as discomfort, shortness of breath or pain with swallowing. Follow this chart for more information.

SYMPTOMS DIAGNOSIS SELF-CARE
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1. Is the affected person an infant or child?


Yes

See Chest Pain in Infants and Children.

No

2. Do you have shortness of breath?


Yes

Go to Question 8.*

No

3. Does your chest ache along the edges of your breastbone, and does your pain get worse when you cough or take a deep breath?


Yes

You may have COSTOCHONDRITIS, an inflammation of the joints in your chest.

Costochondritis usually goes away on its own. Try an anti-inflammatory medicine to relieve the pain. Heat may also help. See your doctor if the pain doesn't get better with these treatments.

No

4. Do physical activities, emotional stress or extreme temperatures cause a feeling of pressure under the breastbone?


Yes

Your pain may be from a heart problem called stable ANGINA.

See your doctor. Angina is a sign that a person has a higher risk of serious heart problems, such as heart attack.

No

5. Do you have fullness and pain under your breastbone or in the upper right side of your abdomen after eating a greasy or fatty meal?


Yes

The pain you have may be from a GALLBLADDER problem.

See your doctor. Also, avoid fatty foods.

No

6. Do you have a burning sensation in your chest that either feels worse when you eat or drink, or feels better when you eat or drink but gets worse a few hours later?


Yes

You may have an ULCER, IRRITATION OF THE ESOPHAGUS or SPASM of the muscles of the esophagus.

If the discomfort is in your upper stomach, and gets worse when you lean forward or lie down, you may have a HIATAL HERNIA. This is a common problem in which the top of the stomach is pushed into the lower chest after eating.

Limit your alcohol intake, eat smaller meals, and avoid fatty foods. Try an antacid to help relieve your discomfort. Sleeping on 2 or 3 pillows or a foam wedge, or raising the head of your bed, may also help.

If these steps don't relieve your symptoms, see your doctor.

No

7. Do you have stinging or burning pain that started after you had a case of SHINGLES?


Yes

Your pain may be caused by POSTHERPETIC NEURALGIA, a condition that can remain after the shingles infection.

See your doctor. In many cases, postherpetic neuralgia can be treated with over-the-counter pain medicines and capsaicin cream.

No

*8. Do you have episodes of wheezing and a cough that won't go away?


Yes

Your chest discomfort and shortness of breath may be caused by ASTHMA.

See your doctor right away. Asthma is very treatable, but it can be a serious condition.

No

9. Do you have a tight feeling in your chest and on ongoing cough that produces a lot of mucus?


Yes

These symptoms may be caused by CHRONIC BRONCHITIS, especially if you smoke.

See your doctor. If you smoke, STOP SMOKING. Also, avoid breathing in anything that can irritate your lungs.

No

10. Do you have an ongoing, mild cough, has your shortness of breath been increasing slowly for years, and have you been a smoker or been exposed to dust and fumes where you work?


Yes

EMPHYSEMA may be the cause of your problem.

See your doctor. If you smoke, STOP SMOKING. Also, avoid breathing in anything that can irritate your lungs.

No

11. Do you have a fever, chills or night sweats, or are you coughing up bloody mucus?


Yes

You may have an infectious illness, such as TUBERCULOSIS, or a FUNGAL INFECTION. A more serious problem, such as LUNG CANCER, could also be the cause.

See your doctor right away.

No

For more information, please talk to your doctor. If you think your problem is serious, call your doctor right away.

This tool has been reviewed by doctors and is for general educational purposes only. It is not a substitute for medical advice. The information in this tool should not be relied upon to make decisions about your health. Always consult your family doctor with questions about your individual condition(s) and/or circumstances. Source: American Academy of Family Physicians. Family Health & Medical Guide. Dallas: Word Publishing; 1996.

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