Chest pain is a difficult subject because there are a wide variety of symptoms and presentations for chest-related ailments.

The type of chest pain that is most concerning to both the general public and medical staff is cardiac chest pain.  Cardiac chest pain spans a spectrum of angina (partial blockages) to a heart attack.  As physicians, it is our goal to catch it when it is still angina rather than progressing to the "Big One."  Symptoms of cardiac chest pain are shortness of breath, aching pressure-like pain in the midline or to the left of center, shoulder or arm pain or numbness, nausea, clammy skin, and pain that worsens with exertion.  If you experience these symptoms, you should immediately seek medical evaluation.

Additionally, there are several risk factors that increase the likelihood of chest pain being cardiac and these include a strong family history, diabetes, high cholesterol, male gender, high blood pressure, tobacco use, and cocaine use.  Obviously, age is also a factor since young people are less likely to have developed occluding plaques.

Other types of chest pain include pulmonary emboli which are caused by a clot forming, typically in the legs and breaking free.  It then travels downstream to the lungs where it becomes lodged producing sharp stabbing pain that is worsened by breathing.  Shortness of breath, leg swelling, coughing up blood and dizziness can also be seen.  Risk factors include a history of heart failure, inactivity such as prolonged airplane flights, tobacco, genetic predispositions, pregnancy and birth control pills.

Pneumonia, pneumothorax (collapsed lung), costochondritis (inflammation of the cartilage that connects the ribs to the breastbone), gastro-esophageal reflux, and dissection of the thoracic aorta are all additional causes of chest pain.