From the Research
Introduction to Chest Pain Treatment
Chest pain is a common symptom that requires immediate attention, as it can be a sign of a life-threatening condition such as myocardial infarction or unstable angina 1, 2. The treatment of chest pain depends on the underlying cause, which can be cardiac or noncardiac in origin.
Cardiac Causes of Chest Pain
Cardiac causes of chest pain include myocardial infarction, unstable angina, and stable angina 1. The immediate treatment for cardiac-related chest pain includes:
- Aspirin to prevent blood clotting 3, 4, 5
- Nitroglycerin to treat chest pain and improve oxygen supply to the heart 4, 5
- Oxygen therapy to increase oxygen supply to the heart 5
- Pain management with morphine or meperidine 4
- Beta-blockers, ACE inhibitors, or calcium channel blockers to lower blood pressure and improve oxygen demand of the heart 4
Noncardiac Causes of Chest Pain
Noncardiac causes of chest pain include gastroesophageal reflux disease, pneumonia, and pneumothorax 1, 2. The treatment of noncardiac-related chest pain depends on the underlying cause, but may include:
- Proton-pump inhibitors for gastroesophageal reflux disease 1
- Antibiotics for pneumonia 2
- Chest tube insertion for pneumothorax 2
Prehospital Care for Chest Pain
Prehospital care for chest pain includes the use of supplemental oxygen, aspirin, nitrates, and opiates, as well as the performance of a 12-lead electrocardiogram (ECG) 5. The dosing of these medications may vary, but common dosages include:
- Aspirin 325 mg or 162 mg 5
- Nitroglycerin as needed for chest pain 5
- Morphine as needed for pain management 5
Caveats and Differentials
It is essential to note that the treatment of chest pain should be individualized based on the patient's underlying medical conditions and the severity of their symptoms. Additionally, the diagnosis of chest pain should consider both cardiac and noncardiac causes, as well as psychological and psychiatric factors that may contribute to the patient's symptoms 1, 2. A thorough medical history, physical examination, and diagnostic testing, such as ECG and coronary angiography, are necessary to determine the underlying cause of chest pain and guide treatment 1, 4.