Causes of Chest Pain

Cause of pain:

Aortic dissection is a tearing of the lining of the aorta - the body's main artery that comes directly off the heart. It often leads to heart attack or stroke. When aortic dissection occurs acutely, it is often accompanied by sudden severe pain, sometimes occurring in the chest.

Characteristics of pain:

The pain of aortic dissection is often very sudden and severe in onset. It is often described as a tearing pain, and is usually located beneath the breastbone. When aortic dissection is acute, there is usually no question in the patient's mind that something quite catastrophic has just occurred, and medical help is sought immediately. With subacute aortic dissection the tearing of the aorta occurs more slowly and gradually, and the pain tends to be somewhat less severe.

Evaluation:

The evaluation is begun by taking medical history and doing a physical examination (which often reveals a new heart murmur). When dissection is suspected, the diagnosis is made by echocardiogram, MRI scan, CT scan or cardiac cath. If the dissection is mistaken as a "'routine" heart attack and "clot busting" drugs are given, the dissection can become suddenly worse and death can ensue.

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