Friday, November 14, 2014

Non-Cardiac Chest Pain

My part of the world didn't have Lyme Disease for a long time, but we've seen several cases in the last three years. A Lyme Disease survivor asked last week whether I could find out on the Internet why he's been suffering non-cardiac chest pain. I naturally referred him back to his doctor. I've also taken the question as a writing prompt. This web site usually avoids mentioning body parts so I won't even mention the specifications about the type of pain I looked up, but here are some things that may cause chest pain, other than heart disease:

1. Ulcers: Massive bleeding ulceration can be caused by reaction to medications. Ordinary ulcers are caused by a messy but treatable infectious disease. Ordinary ulcers are likely to cause pain right after eating, and unlikely to cause much loss of blood.

2. Esophagitis: Inflammation of the esophagus can be caused by infections, vomiting, various recreational drugs and prescription medications, and sometimes more serious things.

3. Pneumonia, asthma, and other breathing problems can cause pain throughout the chest area. This would usually be more of a cramp or stitch-like pain than the pain associated with internal bleeding, but few things can be guaranteed from research alone, when it comes to medical concerns.

4. Pancreatitis: Inflammation of the pancreas can be caused by infections, complications from diabetes, reactions to medications, and sometimes cancer. This one is fairly serious; here are some ways patients have described symptoms that turned out to be pancreatitis.

5. Tissue damage: Some older people manage to break ribs and/or the breastbone itself without even realizing it. "I just leaned over the railing, bumped into the steering wheel as I climbed into a small car, was held back by the seat belt in a minor accident, so why does it still hurt after three weeks?" Hiatal hernias can also cause chest pain. A more unusual disease of the esophagus itself can cause chest pain and internal bleeding.

6. Costochondritis: It's possible for the tissues between the ribs to become inflamed, sometimes due to infection, more often due to stress or injuries. The inflammation is not considered serious; if it's caused by an infection, that may be serious.

7. Liver or gallbladder problems: Anything that can go wrong with the liver or gallbladder may cause pain in the lower chest and upper waist area.

8. Complications from diabetes: This web site lists some complications from diabetes that may cause chest pain.

9. Bowel and kidney diseases: These usually cause pain lower in the body, but can sometimes cause chest pain.

10. B-vitamin deficiency: The authors at this web site seem to have found this problem mostly in young women--as a minor occasional ache-or-pain, not a cause of internal bleeding.

11. Embolism (blood clot): If one gets into the lungs, it may cause chest pain.

What's the prognosis? Can you take care of it all by yourself, without paying for meds? Will you have to go to the hospital? Could you die from non-cardiac chest pain? Is it related to Lyme Disease? Research supports the first answer I gave off the top of my head. Chest pain may be nothing, it may be fatal...who knows? And a vast amount still remains to be learned about Lyme Disease....but there is, in fact, a condition called Lyme Carditis that seems definitely to be a complication from Lyme Disease.

If you're having chest pain with bleeding or fever or other symptoms, it probably is something that needs treatment. Definitely see a doctor.

If you're having minor chest pain without other symptoms, it's likely to be a trivial early warning of something that might be serious a few years later. The sensible thing to do would be to talk to a doctor.