Chest pain that is not a heart attack

Angina pectoris or chest pain is an ominous symptom which is caused by heart muscles not receiving enough oxygen for its work of "perpetual" pumping. This great mass of muscle actually gets its oxygen from blood brought by arteries that crisscross it. Yes, though the heart contains and pumps blood, it has its special delivery system of  oxygen-laden blood from small arteries springing right at the base of the aorta, that big artery that receives blood as it is pumped out of the heart to supply the rest of the body.

But what about chest pain that is not at all related to an oxygen-starved heart?

There are other causes of chest pain and among the most common is arthritis of the breast bone to rib joint or the costochondral joint. Costochondritis can be mistaken for a heart attack in many occasions and can cause unnecessary laboratory examinations intended to check the heart to be ordered.  ECGs are routine and can be superfluous in this condition. How then can costochondritis be discerned?

from: Google images, mayoclinic.com

There are ways to differentiate costochondritis from a heart attack. First is to suspect it when the pain is movement-related (twisting the torso, for instance) and happens to occur in a young individual, especially females. A specific kind of costochondritis,  Tietze's syndrome, affects females in their 20's and involves the 2nd left rib to breastbone joint, so that the pain it produces is right smack where pain of heart attacks is felt - mid chest. Second, the pain is lancinating and quite severe, but is usually not associated with cold sweats and the "sense of impending doom", which occurs with the chest pain of heart attacks. More so, save for the pain and the rapid heart rate it can produce, costochondritis is not related with serious breathing difficulty and blood pressure problems, as seen quite commonly during heart attacks.  Costochondritis cause pain in the affected chest on pressure over the area, while this does not occur in heart attacks, where the pain is deep and persistent.

It is however, prudent to relate matters like these to family histories of heart attacks or ailments, as well as, lifestyle risk factors like smoking, sleep deprivation, dietary excesses and diabetes. Despite age, a person with chest pain will warrant a thorough check when the above conditions are present.

from Goodle images

The other common cause of chest pain that happens not to be a heart attack is the viral infection Herpes zoster, when it erupts along the spinal nerve of the nipple line. Chest pain is usually more superficial than deep, also severe, and then in about 2 weeks, chicken pox-like eruptions appear over the affected part of the chest. That would clinch the diagnosis, but in the early phase, the pain can be so distressing and cause the patient to be worked up for a heart problem. It is advised that superficial gnawing pain with unusually sensitive skin in localized areas of the chest warrants observation and monitoring for the appearance of skin lesions. Early treatment is necessary to shorten the course of the rash and the disease in general.

Do you have chest pain? In addition to heart attacks, think joints and skin conditions!

Aurora's Fingers

If you are one who awakens at dawn to feel around for your first 3 fingers, you could well have carpal tunnel syndrome or CTS, a malady I have had for the past 3 years and which I fondly call aurora's fingers (did Aurora, goddess of dawn, have it?). 

photo from Google images

Carpal tunnel syndrome is a disturbing hand disease that causes sensation of pins and needles, and numbness of the first 3 fingers (start with the thumb) and half of the ring finger, especially at dawn (aurora). During the first months, the symtoms can be fleeting, a few dawn awakenings due to numbness, and relieved by shaking the hands. Later, these symptoms become more intense, prolonged and associated with weakness of the thumb and index finger grip, or the pincer grip. Each dawn becomes a misery as sleep and the pins and needles vie for the few more minutes of slumber till morning sun.

There are many possible causes including inheritance, age, work-related causes,  as those seen in jack-hammer operators and long distance drivers and other events that cause pressure inside the carpal tunnel, (where the nerve that gives sensation and strength to the 3 1/2 fingers is lodged), to rise and create the nerve pinch. Perhaps for me, it's stick driving, and the vibration of  the wheel during the frequent long drives I do daily.

Rest from repetitive or wrist-intensive hand activities is paramount for relief during the early days of the disease and  a CTS splint can be helpful, but only for a time. Nerve-pain relieving drugs, and injections into the carpal tunnel are also known to relieve the pain. Don't wait though, for the pincer grip to be compromised to the point of being "clumsy", frequently dropping utencils and hand-held stuff.  Decreasing the carpal tunnel pressure by surgery can be a permanent cure.

For those with the inherited trait, prevention may not work, but those who don't have the symptoms yet might have to avoid some activities (operating jack-hammers, vibrating equipment, etc.) 

Common and disturbing as it is, it is far from life threatening and many an elderly chap or lady have lived with the aurora fingers, albeit, with misgivings.