QS Study

The presenting symptom of chest pain is a common problem in clinical practice. Unfortunately, chest pain is a symptom common to many conditions and may be a disease in the thoracic and abdominal walls or in many different thoracics and abdominal viscera; the severity of the pain is often unrelated to the seriousness of the cause. This pain can cause many different sensations depending on what’s triggering the symptom. Myocardial pain may mimic esophagitis, musculoskeletal chest wall pain, and other non-lift-threatening causes. It is not good enough to have a correct diagnosis only 99% of the time with pain. An understanding of this pain helps the physician in the systematic consideration of the differential diagnosis.

Somatic Chest Pain

Pain arising from the chest or abdominal walls is interne and discretely localized. This pain arises in sensory nerve endings in these structures and is conducted to the central nervous system by segmental spinal nerves. The symptom of chest pain may be a result or manifestation of somatic dysfunction of the musculoskeletal system.

Visceral Chest Pain

Visceral Chest Pain visceral pain is diffuse and poorly localized. It is ducted to the central nervous system along afferent autonomic nerves. Most visceral pain fibers ascend to the spinal cord along sympathetic nerves and enter the cord through the posterior nerve roots of segmental spinal nerves. Some pain from the spinal and upper part of the esophagus and the trachea enter the central nervous system through the parasympathetic nerves via the glossopharyngeal and vagus nerves. The pain you feel from your internal organs, such as your stomach, bladder, uterus, or rectum.

Referred Chest Pain

Referred is the feeling of pain at a location other than the site of origin of the stimulus but in an area supplied by the same or adjacent segments of the spinal cord. Pain in the chest may also be the result of neck or shoulder joint pain that is referred to the chest, called referred pain. Both somatic and visceral structures can produce referred pain.

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