A report on Chest pain and Pericarditis

Potential location of pain from a heart attack
An ECG showing pericarditis. Note the ST elevation in multiple leads with slight reciprocal ST depression in aVR.
A blockage of coronary arteries can lead to a heart attack
Figure A shows the location of the heart and a normal heart and pericardium (the sac surrounding the heart). The inset image is an enlarged cross-section of the pericardium that shows its two layers of tissue and the fluid between the layers. Figure B shows the heart with pericarditis. The inset image is an enlarged cross-section that shows the inflamed and thickened layers of the pericardium.
Gastroesophageal reflux disease is a common cause of chest pain in adults
Diffuse ST elevation in a young male due to myocarditis / pericarditis
An ECG showing pericarditis. Note the ST elevation in multiple leads with slight reciprocal ST depression in aVR.
Ultrasounds showing a pericardial effusion in someone with pericarditis
A pericardial effusion as seen on CXR in someone with pericarditis

Symptoms typically include sudden onset of sharp chest pain, which may also be felt in the shoulders, neck, or back.

- Pericarditis

Serious and relatively common causes include acute coronary syndrome such as a heart attack (31%), pulmonary embolism (2%), pneumothorax, pericarditis (4%), aortic dissection (1%) and esophageal rupture.

- Chest pain
Potential location of pain from a heart attack

6 related topics with Alpha

Overall

A myocardial infarction occurs when an atherosclerotic plaque slowly builds up in the inner lining of a coronary artery and then suddenly ruptures, causing catastrophic thrombus formation, totally occluding the artery and preventing blood flow downstream.

Myocardial infarction

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A myocardial infarction (MI), commonly known as a heart attack, occurs when blood flow decreases or stops to the coronary artery of the heart, causing damage to the heart muscle.

A myocardial infarction (MI), commonly known as a heart attack, occurs when blood flow decreases or stops to the coronary artery of the heart, causing damage to the heart muscle.

A myocardial infarction occurs when an atherosclerotic plaque slowly builds up in the inner lining of a coronary artery and then suddenly ruptures, causing catastrophic thrombus formation, totally occluding the artery and preventing blood flow downstream.
Cross section showing anterior left ventricle wall infarction
Diagram showing the blood supply to the heart by the two major blood vessels, the left and right coronary arteries (labelled LCA and RCA). A myocardial infarction (2) has occurred with blockage of a branch of the left coronary artery (1).
A 12-lead ECG showing an inferior STEMI due to reduced perfusion through the right coronary artery. Elevation of the ST segment can be seen in leads II, III and aVF.
ECG : AMI with ST elevation in V2-4
Inserting a stent to widen the artery.

The most common symptom is chest pain or discomfort which may travel into the shoulder, arm, back, neck or jaw.

Dressler's syndrome, a reaction following larger infarcts and a cause of pericarditis is also possible.

Heart

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Muscular organ in most animals.

Muscular organ in most animals.

Human heart during an autopsy
Computer-generated animation of a beating human heart
The human heart is in the middle of the thorax, with its apex pointing to the left.
Heart being dissected showing right and left ventricles, from above
Frontal section showing papillary muscles attached to the tricuspid valve on the right and to the mitral valve on the left via chordae tendineae.
Layers of the heart wall, including visceral and parietal pericardium
The swirling pattern of myocardium helps the heart pump effectively
Arterial supply to the heart (red), with other areas labelled (blue).
Autonomic innervation of the heart
Development of the human heart during the first eight weeks (top) and the formation of the heart chambers (bottom). In this figure, the blue and red colors represent blood inflow and outflow (not venous and arterial blood). Initially, all venous blood flows from the tail/atria to the ventricles/head, a very different pattern from that of an adult.
Blood flow through the valves
The cardiac cycle as correlated to the ECG
The x-axis reflects time with a recording of the heart sounds. The y-axis represents pressure.
Transmission of a cardiac action potential through the heart's conduction system
Conduction system of the heart
The prepotential is due to a slow influx of sodium ions until the threshold is reached followed by a rapid depolarization and repolarization. The prepotential accounts for the membrane reaching threshold and initiates the spontaneous depolarization and contraction of the cell; there is no resting potential.
3D echocardiogram showing the mitral valve (right), tricuspid and mitral valves (top left) and aortic valve (top right).
The closure of the heart valves causes the heart sounds.
Cardiac cycle shown against ECG
Heart and its blood vessels, by Leonardo da Vinci, 15th century
Animated heart
Elize Ryd making a heart sign at a concert in 2018
The tube-like heart (green) of the mosquito Anopheles gambiae extends horizontally across the body, interlinked with the diamond-shaped wing muscles (also green) and surrounded by pericardial cells (red). Blue depicts cell nuclei.
Basic arthropod body structure – heart shown in red
The human heart viewed from the front
The human heart viewed from behind
The coronary circulation
The human heart viewed from the front and from behind
Frontal section of the human heart
An anatomical specimen of the heart
Heart illustration with circulatory system
Animated Heart 3d Model Rendered in Computer

Cardiovascular diseases frequently do not have symptoms or may cause chest pain or shortness of breath.

The sac which surrounds the heart, called the pericardium, can become inflamed in a condition known as pericarditis.

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Troponin

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Complex of three regulatory proteins that are integral to muscle contraction in skeletal muscle and cardiac muscle, but not smooth muscle.

Complex of three regulatory proteins that are integral to muscle contraction in skeletal muscle and cardiac muscle, but not smooth muscle.

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Troponin activation. Troponin C (red) binds Ca2+, which stabilizes the activated state, where troponin I (yellow) is no longer bound to actin. Troponin T (blue) anchors the complex on tropomyosin.

They are measured in the blood to differentiate between unstable angina and myocardial infarction (heart attack) in people with chest pain or acute coronary syndrome.

They can rise in inflammatory conditions such as myocarditis and pericarditis with heart muscle involvement (which is then termed myopericarditis).

A microscope image of myocarditis at autopsy in a person with acute onset of heart failure

Myocarditis

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Acquired cardiomyopathy due to inflammation of the heart muscle.

Acquired cardiomyopathy due to inflammation of the heart muscle.

A microscope image of myocarditis at autopsy in a person with acute onset of heart failure
Diffuse ST elevation in a young male due to myocarditis and pericarditis
Lymphocytic myocarditis (white arrow points to a lymphocyte), commonly showing myocyte necrosis (black arrow), seen as hypereosinophilic cytoplasm with loss of striations.
Endomyocardial biopsy specimen with extensive eosinophilic infiltrate involving the endocardium and myocardium (hematoxylin and eosin stain)

Symptoms can include shortness of breath, chest pain, decreased ability to exercise, and an irregular heartbeat.

Additionally, myocarditis is often associated with pericarditis, and many people with myocarditis present with signs and symptoms that suggest myocarditis and pericarditis at the same time.

Dressler syndrome

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Dressler syndrome is a secondary form of pericarditis that occurs in the setting of injury to the heart or the pericardium (the outer lining of the heart).

The disease consists of a persistent low-grade fever, chest pain (usually pleuritic), pericarditis (usually evidenced by a pericardial friction rub, chest pain worsening when recumbent, and diffuse ST elevation with PR segment depression), and/or a pericardial effusion.

Figure A shows normal anatomy. Figure B shows lungs with pleurisy in the right lung, and a pneumothorax of the left lung.

Pleurisy

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Inflammation of the membranes that surround the lungs and line the chest cavity .

Inflammation of the membranes that surround the lungs and line the chest cavity .

Figure A shows normal anatomy. Figure B shows lungs with pleurisy in the right lung, and a pneumothorax of the left lung.
Pleurisy
Pleural linings and space (marked in blue)
The illustration shows a person undergoing thoracentesis. The person sits upright and leans on a table. Excess fluid from the pleural space is drained into a bag.

This can result in a sharp chest pain while breathing.

Other conditions that can produce similar symptoms include pericarditis, heart attack, cholecystitis, pulmonary embolism, and pneumothorax.