![]() ![]() However, damage to the organ capsule or direct injury to the deep tissue may be more easily localized. 16 Obstruction of hollow organs will produce a poorly localized, deep, cramping pain referred to multiple cutaneous sites. Combined with somatic input this often produces a poorly localized pain response. Noxious stimulus of these receptors activates a few unmyelinated afferent fibers which in turn activate many central neurons. 2 Visceral pain receptors are found in most of the viscera (thoracic, abdominal and pelvic) and its surrounding connective tissue. Visceral: there can be referred pain from the viscera that appears to be chest wall oriented. Nerve roots are also susceptible to viral infection and are a potential site for post-herpetic neuralgia. ![]() Alteration to the skeletal formation of the thoracic outlet can also cause neural impingement, resulting in thoracic outlet syndrome. If there is damage to the rib, rami, or coursing nerve, neural impingement may occur. These nerves course along the inferior border of the rib. Neurology: the anterior rami of the first 11 thoracic spinal nerves form the intercostal nerves. Equally, muscular strain/spasm will then restrict joints, creating discomfort at costochondral joints. Once dysfunction occurs, collateral dysfunction can occur in the musculature. Multiple bony areas are susceptible to fracture, and several joints and articulations can be injured. This integrated framework provides strength, support, and protection of the viscera. Musculoskeletal: the chest is bordered by 12 ribs bilaterally, 12 vertebrae posteriorly, the sternum and xiphoid anteriorly, 2 clavicles superiorly, and an overlay of musculature and fascia giving function to these structures. In adolescents, costochondritis accounts for 14% of chest wall pain. ![]() Among pediatric patients, 31% have nonspecific chest pain. Approximately 2% of patients have primary non-specified lung carcinomas (33%) or non-specific metastatic neoplastic disease (67%). ![]() Additionally, 83% of patients will also have associated comorbidity, including psychiatric dysfunction (50%), cardiovascular disease (33%), coronary disease (19%), and rheumatologic conditions (20.7%). CWPS is the principal cause of pain in 44.6% of patients who present with thoracic pain. It accounts for nearly 50% of all complaints in the ambulatory and emergency room setting. In the primary care setting, CWPS has a mean age ± SD of 50.3☑8 years, with nearly equal occurrence in men and women. This pain usually gets worse when you lie down.Chest-Wall-Pain-Syndrome-–-Table-2 Download Epidemiology including risk factors and primary prevention This can cause a sudden, sharp and stabbing pain in your chest. Pericarditis is inflammation of the sac surrounding your heart. This can cause sharp, stabbing chest pain that may get worse when you breathe in. Pulmonary embolismĪ pulmonary embolism is a blockage in the blood vessel that carries blood from the heart to the lungs. It usually gets better with rest after a few minutes. Heart attackĪ heart attack occurs when the blood supply to part of the heart is suddenly blocked.Ĭhest pain is more likely to be caused by a heart attack if it:Īngina is a condition where the blood supply to the muscles of the heart is restricted.Ĭhest pain caused by angina is usually triggered by physical activity (exertion). You should always seek medical advice to make sure you get a proper diagnosis.ĭepending on your symptoms and circumstances, you may need further investigation. There are a number of different conditions that can cause chest pain. ![]()
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