Left sided chest pain

Left sided chest pain

Is left sided chest pain always due to heart disease?

Heart disease is only one cause of chest pain. Diseases of other organs of the chest can also cause chest pain. Pain can originate from the skin, muscles, bone, lung, covering of the lung (pleura) and food pipe (esophagus). Inflammation of the pleura is known as pleurisy. Nature of the pain and associations often help in differentiating the origin. For example, pain arising from the skin will often be associated with redness and local tenderness. Pain arising from the lung or pleura can increase on deep breathing and coughing. Muscle pain is aggravated by movement of the involved muscle. Bone pain also can be increased by local movement and associated with local tenderness (pain on local pressure with the hand).

Pain may arise in the nerves (nerve root pain) of the chest wall. For example, in a condition called Herpes Zoster, chicken pox virus involves the sensory nerve roots, producing severe pain localised to the region of the skin supplied by the concerned nerve. Pain starts a few days prior to the eruptions in skin so that it may be mistaken for other causes of chest pain in the initial days. Diagnosis is clear when the vesicles appear on the skin in the distribution of the nerve supply, strictly to one side of the mid line of the body. In this condition the pain may sometimes persist long after the healing of the vesicles (post herpetic neuralgia). Pain can also be due to damage or compression of the nerve root by bony structures or masses within the spine from where the nerves arise.

Thus a lot more illnesses than heart disease can cause chest pain, either on the left or right side and it needs careful evaluation and work up to identify the exact cause.


Symptoms of heart disease


What are the important symptoms of heart disease?

Symptoms depend on the type of heart disease. Sometimes there could even be silent heart disease without any symptoms. Many of the birth defects of the heart remain asymptomatic for long periods. Some become symptomatic during another illness or a major stressful event. Occasionally the very first manifestation of a silent underlying heart disease is sudden death. Apart from these two extremes, most significant heart diseases have some symptom or other though there may be a lot of variation between individuals. The severity of symptoms may not correlate with the severity of heart disease in some cases.

Important symptom of heart disease which every one is familiar with is the severe chest pain of a heart attack. As the name implies, it often occurs out of the blue and is quite disabling. A crushing feeling may be felt instead of chest pain, and it may spread to the arms or jaw. It may be associated with profuse sweating or sometimes breathlessness and dizziness. Some even feel an impending doom.

Classical symptom of reduced blood supply to the heart is chest pain brought on by exertion and relieved by rest (effort angina). This indicates gradually increasing blockage of coronary arteries which supply oxygenated blood to the heart. This pain may also spread to the jaw, neck or the arms. Occasionally pain may be felt in the upper part of the stomach. Rarely jaw pain or pain in the wrist occurs without chest pain.

Breathlessness brought on by exertion and relieved by rest is another important symptom of heart disease, though it can be due to lung disease or even reduced amount of hemoglobin in the blood (anemia). Sudden breathlessness during sleep and breathlessness which gets worse on lying down are also important symptoms of some forms of heart disease.

Palpitation or undue awareness of one’s heart beats is another important symptom of heart disease, though it may occur with anxiety and undue exertion as well. Palpitation can be fast, slow, regular or irregular, depending on the abnormality in the heart rhythm.

Some forms of heart disease, especially birth defects of the heart, produce a bluish discoloration of the skin and lips (cyanosis). This is due to reduced content of oxygen in circulating blood. Spitting out blood can also be a symptom of heart disease, though it is more often a symptom of lung disease.

Prolonged fever can occur with infections of the heart valve. Joint pain and swelling can occur in infections of the heart valves as well as in rheumatic fever, which can affect the heart valves.

Stroke or sudden weakness of one part of the body can be an indirect symptom of heart disease. Atrial fibrillation, an abnormal rhythm of the upper chambers of the heart, can cause clots to form in the heart. These clots can move out of the heart and block a blood vessel in the brain causing stroke. Similar clots can form in diseases of heart valves, where there is obstruction to blood flow.