Patient's question:
Poor condition discovered four months after birth: noticed a lump on the child's chest. Previous treatment and effectiveness: no treatment given. What kind of assistance is desired: want to ask how the treatment should be done, what precautions should be taken...Doctor's answer:
Common symptoms in the emergency department are generally caused by chest diseases. The severity of chest pain does not necessarily correlate with the cause of the pain. For example, herpes zoster in the chest can cause severe chest pain, while the chest pain from an acute myocardial infarction may sometimes be mild. Therefore, patients with chest pain should undergo a thorough examination to identify the underlying cause as much as possible.(1) Nature and Characteristics of Chest Pain
1. Characteristics of Chest Pain
Chest pain caused by chest wall diseases is well-localized, accompanied by local redness, swelling, tenderness, rashes, or deformities.
2. Nature of Chest Pain
- Pain caused by intercostal neuralgia is paroxysmal and needle-like.
- Pain caused by esophagitis is burning in nature.
- Slicing-like pain is often seen in aortic dissection.
3. Location of Chest Pain
- Post-sternal pain is common in angina.
- Anterior left chest pain can also be due to angina, myocardial infarction, or left-sided pneumonia.
- Chest pain radiating to the left shoulder is often indicative of angina.
(2) Common Causes of Chest Pain
1. Pleural Diseases
- Conditions such as pleurisy and spontaneous pneumothorax cause chest pain that is related to respiration and coughing.
- Chest pain intensifies during deep breathing or coughing and is often accompanied by shortness of breath.
- The pain is localized to the affected side due to inflammation.
2. Cardiovascular Diseases
- Angina and myocardial infarction are representative conditions, followed by pericarditis.
- This type of chest pain is often described as pressure-like or constrictive, sometimes even slicing-like, and may radiate to the left shoulder, neck, and inner left arm.
- Severe cases may be accompanied by shock symptoms.
3. Intercostal Neuralgia, Herpes Zoster, and Esophagitis
- All three can cause chest pain.
- During herpes zoster, severe chest pain follows a dermatome along the ribs, accompanied by the appearance of clustered small blisters on the skin 1–2 days later.