1. CHEST PAIN

2. Introduction Introduction Causes Causes Effects Effects Solutions Solutions Conclusion Conclusion Any questions Any questions

3. Introduction What is chest Pain What is chest Pain Any pain or discomfort felt in the upper body, from the neck down to ribs and the back. Any pain or discomfort felt in the upper body, from the neck down to ribs and the back. Can be caused by any of the organs or tissues in the chest ; i.e. or Can be caused by any of the organs or tissues in the chest ; i.e. Heart, lungs, muscles, ribs, tendons or nerves

4. Why Chest Pain The chest houses organs that are vital to life The chest houses organs that are vital to life 700,000 A&E attendances per year in England and Wales. (acute chest pain) 700,000 A&E attendances per year in England and Wales. (acute chest pain)

5. Types Of Chest Pain Cardiovascular:- due to problems with heart and blood vessels ( e.g. Angina, Coronary thrombosis and Heart Attack) Cardiovascular:- due to problems with heart and blood vessels ( e.g. Angina, Coronary thrombosis and Heart Attack) Pulmonary:- due to problems with the lungs (e.g. Pleurisy and Pneumothorax Pulmonary:- due to problems with the lungs (e.g. Pleurisy and Pneumothorax Digestive Problems (Heartburn or dyspepsia) Digestive Problems (Heartburn or dyspepsia) Other ( Muscle Strain, Medications and Anxiety Other ( Muscle Strain, Medications and Anxiety

6. CARDIOVASCULAR ANGINA ANGINA - Tight, gripping and dull pain at centre - Tight, gripping and dull pain at centre of the chest of the chest - Induced by exercise - Induced by exercise - Relieved by rest - Relieved by rest - May spread to the jaw and arms - May spread to the jaw and arms

7. Angina-Causes Angina-Causes Oxygen demand by heart muscles exceed amount supplied by coronary arteries. Oxygen demand by heart muscles exceed amount supplied by coronary arteries. Shortfall due to coronary atheroma (i.e. plaques and scar tissues causing degradation of arterial walls Shortfall due to coronary atheroma (i.e. plaques and scar tissues causing degradation of arterial walls

8. Angina - Solutions Unavoidable Factors:- Predisposing factors (e.g. age) and Precipitating Factors ( e.g. Infection) Unavoidable Factors:- Predisposing factors (e.g. age) and Precipitating Factors ( e.g. Infection) Avoid Environmental Trigger Factors Avoid Environmental Trigger Factors

9. Angina –Solutions contd. Diet rich in animal fat - Refined Sugar - Refined Sugar - Obesity - Obesity - Smoking - Smoking - Excessive Drinking - Excessive Drinking Exercise Exercise

10. Angina – Solutions Contd On onset call 999 immediately

11. Coronary Thrombosis Pain is identical to that of angina Pain is identical to that of angina More severe More severe More prolonged More prolonged Not brought on by exercise Not brought on by exercise

12. Coronary thrombosis - causes Formation of fatty plaques and scar tissues in the walls of artery Formation of fatty plaques and scar tissues in the walls of artery Degeneration of arterial walls Degeneration of arterial walls Blood clots (thrombus ) form in coronary artery Blood clots (thrombus ) form in coronary artery Obstruction of blood flow to the heart cells and tissues Obstruction of blood flow to the heart cells and tissues Effects:- Death (i.e. infarction) of heart muscle Effects:- Death (i.e. infarction) of heart muscle Solutions :- as for angina above Solutions :- as for angina above

13. Heart Attack Pain is sharp and severe Pain is sharp and severe May spread to arm and throat prolonged and may occur at rest May spread to arm and throat prolonged and may occur at rest Pain may occur at rest Pain may occur at rest

14. Heart Attack - Causes Caused by formation of blood clot in the coronary artery Caused by formation of blood clot in the coronary artery Interruption of blood supply to specific part of the heart. Interruption of blood supply to specific part of the heart. Death of a segment of the heart (usually left ventricle – ventricular fibrillation) Death of a segment of the heart (usually left ventricle – ventricular fibrillation) Result:- Fatality Result:- Fatality

15. PULMONARY Pleurisy:- Inflammation of the pleura (i.e. covering of the lungs and inner surface of the chest

16. Pleurisy Knife-like pain in the chest Knife-like pain in the chest Pain is localised Pain is localised Aggravated by breathing or coughing Aggravated by breathing or coughing

17. Pleurisy -Causes Pneumonia (i.e. Bacterial infection of the lungs) Pneumonia (i.e. Bacterial infection of the lungs) Pulmonary Embolism (i.e. blood clot from elsewhere in the body lodging in pulmonary artery) Pulmonary Embolism (i.e. blood clot from elsewhere in the body lodging in pulmonary artery) Solution:- Seek medical attention immediately Solution:- Seek medical attention immediately

18. Pneumothorax Sudden, sharp, pain in the chest on the side of affected lung Sudden, sharp, pain in the chest on the side of affected lung Pain does not occur at the centre of the chest Pain does not occur at the centre of the chest Does not worsen with breathing Does not worsen with breathing

19. Pneumothorax -Causes Small leakage on the lung surface of the lung or chest wall Small leakage on the lung surface of the lung or chest wall Air enters Pleural cavity causing lung to collapse. Air enters Pleural cavity causing lung to collapse. Solution:- Contact A&E Solution:- Contact A&E

20. Digestion Dyspepsia (Indigestion) Dyspepsia (Indigestion) Pain or discomfort in the lower chest or abdomen Pain or discomfort in the lower chest or abdomen Pain is poorly localised Pain is poorly localised Brought on by certain foods, excess food, alcohol or medication (e.g. Aspirin) Brought on by certain foods, excess food, alcohol or medication (e.g. Aspirin)

21. Dyspepsia -Causes Gas in the stomach irritates the lining of the stomach, oesophagus and upper part of the abdomen. Gas in the stomach irritates the lining of the stomach, oesophagus and upper part of the abdomen. Acid in the stomach escapes back into the oesophagus Acid in the stomach escapes back into the oesophagus Could symptom of underlying medical condition e.g. gastric ulcer Could symptom of underlying medical condition e.g. gastric ulcer Solution :-OTC medication e.g. Gaviscon, see your GP if symptoms persist after 5 days

22. Other Strained Muscle Pain between ribs Pain between ribs Occurs after coughing Occurs after coughing Caused by injury or violent cough Caused by injury or violent cough

23. Other- Contd. Stress/Anxiety Stress/Anxiety Drugs e.g. Alcohol Drugs e.g. Alcohol Medications e.g. irritant solutions used to treat varicose veins Medications e.g. irritant solutions used to treat varicose veins

24. Thanks You For Your Time ANY QUESTION?