Chest pain or discomfort is always a cause for concern, as it could indicate lung or heart disease. However, in most cases, the pain in the upper torso is due to less serious problems, such as indigestion, acid reflux, or muscle strain. It is not at all difficult to distinguish pain caused by a lung disease from that triggered by a muscle disorder, if you know the symptoms that indicate each pathology. If you have any concerns about your health condition and chest pain (especially if it gets worse), see your doctor as soon as possible or even go to the emergency room for a physical exam.
Steps
Part 1 of 2: Understanding the Different Symptoms
Step 1. Assess the duration and type of pain
Muscle pain develops very differently than lung pain. A moderate or severe strain generates immediate physical pain, while a mild strain takes about a day to become sore. Muscle pain is almost always associated with excessive fatigue or some type of trauma, so the cause-and-effect relationships are generally well understood. Conversely, the pain caused by lung disease gradually becomes more intense and is preceded by other symptoms, such as shortness of breath, wheezing, fever, or general malaise. Furthermore, lung pain cannot be attributed to a particular event or time.
- Car accidents, falls from a slip, injuries sustained during sports (football, rugby, basketball), and while constantly lifting weights in the gym all tend to cause sudden pain.
- Lung cancer, infections and inflammation tend to gradually worsen (over days or months) and are associated with many other symptoms.
Step 2. Monitor your cough carefully
Many lung diseases and diseases cause chest pain, including: cancer, infections (bacterial and viral pneumonia and bronchitis), pulmonary embolism (thrombi in the lungs), pleurisy (inflammation of the lung membranes), perforation of the lung and pulmonary hypertension (high blood pressure blood in the lungs). Almost all of these disorders result in coughing and / or shortness of breath. Conversely, a muscle strain in the chest or torso does not cause a cough, although it is possible to feel discomfort while breathing if the muscle is connected to a rib.
- Bloody sputum is common in lung cancer, late-stage pneumonia, and traumatic pneumothorax. Go to the emergency room immediately if you notice blood in the mucus.
- The muscles connected to the ribs are the intercostal ones, the obliques, the abdominals and the scalene ones. These are involved in breathing movements, so a tearing or stretching of them can cause pain when breathing deeply, but coughing should not be present.
Step 3. Try to identify the source of the pain
Tearing a chest muscle is quite common among those who train in the gym or play sports. Typically, associated pain is described as achiness, stiffness, or contracture, often one-sided and easy to spot by feeling around the source of the pain. For this reason, try palpating your chest to find the area that hurts. When they are traumatized, the muscles contract in spasms and you can feel them as fibrous bands. If you can find the source of the pain, then it means that you have suffered a muscle tear and do not suffer from lung disease. Most respiratory organ-related diseases lead to widespread (often referred to as acute) pain that cannot be localized to the outside of the chest.
- Feel the area around the ribs gently, as the muscles in this area often tear as the torso rotates or bends sideways beyond its means. If you experience intense pain near the breastbone, it is possible that it is more likely to be a lesion of the rib cartilages than a simple muscle strain.
- Muscle tears usually only cause pain when you move your body or breathe deeply, while the aches and pains associated with lung disease (especially cancer and infections) are constant.
- The muscles that lie directly above the lungs are the pectorals (large and small). These can tear during push-ups, pull-ups, or when using the chest machine at the gym.
Step 4. Look closely at each bruise
Take off your shirt, underwear and check your chest / torso carefully for redness or bruising. A moderate or mild stretch involves partial rupture of muscle fibers that can bleed. Blood collects in the surrounding tissues. The result of all this is the presence of a dark, purple-reddish bruise that fades and becomes yellowish over time. Reddened areas on the chest may indicate trauma suffered during sports or from a fall. Pulmonary diseases, on the other hand, do not generally involve bruising, unless it is a pneumothorax caused by a severe rupture in the ribs.
- Mild strains rarely leave a bruise or redness, they are more likely to be accompanied by localized swelling of varying intensity.
- In addition to bruising, muscle trauma causes contractions or spasms for a few hours (sometimes even days) during the recovery phase. These "fasciculations" are further proof that it is a muscle problem and not a lung problem.
Step 5. Measure your body temperature
Many diseases that lead to lung pain are caused by pathogenic microorganisms (bacteria, viruses, fungi and parasites) or by environmental irritants (asbestos fibers, dust, allergens). For this reason, in addition to cough and pain, fever (high body temperature) is very common when suffering from some respiratory disease. Muscle injuries, on the other hand, never have any effect on body temperature, unless they are severe enough to trigger hyperventilation. For this reason, measure the fever with a digital thermometer that is placed under the tongue. The average temperature measured with this method should be around 36.8 ° C.
- A mild fever often proves useful because it is a reaction of the body to defend itself against infections.
- However, when it is very high (over 39.4 ° C in an adult) it is also potentially dangerous and must be monitored constantly.
- Chronic and long-term lung diseases (cancer, tuberculosis, chronic obstructive pulmonary disease) often raise body temperature by only a few tenths of a degree.
Part 2 of 2: Obtaining a Formal Diagnosis
Step 1. Make an appointment with your family doctor
Muscle strains always resolve on their own within a few days (or weeks in severe cases), so if you experience chest or chest pain for longer or the situation gets worse, you should call your doctor for an appointment. He will take the medical history, give you a physical exam, and auscultate your lungs and breathing. If your breathing causes abnormal noises (crackling or whistling), there is likely an obstructed airway (fluid or debris) or the passages are too narrow due to inflammation or swelling.
- The signs of lung cancer, in addition to sputum with blood and chest pain with deep breathing, are: hoarseness, loss of appetite, rapid weight loss and lethargy.
- The doctor may collect a sample of spit (saliva / mucus / blood) to prepare a culture and thus detect a bacterial infection (pneumonia, bronchitis).
Step 2. Get a chest x-ray
Once your doctor has ruled out the possibility of a muscle strain and suspects a lung infection, they may order chest x-rays. In this way, it is possible to visualize broken ribs, fluid accumulated in the lungs (pulmonary edema), tumors and any tissue damage caused by smoking, environmental irritants, emphysema, cystic fibrosis or previous outbreaks of tuberculosis. X-rays are also able to rule out other important causes of chest pain: heart disease.
- Advanced lung cancer can almost always be located with this imaging test; however, in the initial stages it may escape the attention of the radiologist.
- An X-ray could help detect signs of certain cardiovascular disorders.
- Chest x-rays cannot detect a muscle strain or tear in the upper torso or chest. If your doctor suspects this type of trauma or a tendon injury, you will need to have a computed tomography or MRI scan.
- Cross-sectional images of the chest are recreated during computed tomography to help the doctor diagnose the problem when the physical exam and x-rays have not led to a definitive conclusion.
Step 3. Get a blood test
In addition to the culture of the spit, the blood test is very useful in distinguishing which type of lung disease has affected you. For example, an acute infection (pneumonia or bronchitis) results in an increase in the white blood cell count because the immune system is activated to kill pathogens such as bacteria and viruses. Blood tests also indicate how much oxygen is being carried, an indirect measure of lung function.
- However, the blood test cannot confirm or rule out muscle trauma, even if it is very serious.
- Blood tests do not indicate the level of oxygenation.
- A test, called erythrocyte sedimentation rate (ESR), can indicate whether the body is under stress and whether a chronic inflammatory disease is present.
- Blood tests are not useful in diagnosing lung cancer, x-rays and biopsy remain the most reliable tests.
Advice
- Pain accompanied by persistent cough (indicating chest congestion) or cough that produces blood, phlegm, or dark mucus, is most likely due to a lung problem.
- Lung irritation can be caused by inhaling irritants, such as smoke, or by other conditions that inflame surrounding tissues, such as pleurisy.
- Respiratory diseases that cause pain are asthma, hyperventilation and smoking.
- Hyperventilation often occurs during an anxiety attack, panic attack, or as a response to an emergency situation.
