Chest pain in women

Published on 10/03/2015 by admin

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Last modified 10/03/2015

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Chapter 9 CHEST PAIN IN WOMEN

Chest pain is a very common complaint of patients presenting to the emergency room, as well as those presenting to outpatient clinics. More than 50% of patients presenting to the emergency department with chest pain have acute coronary syndrome, pulmonary embolism, or heart failure. However, most patients presenting to outpatient departments have diseases such as stable angina, musculoskeletal disorders, gastrointestinal disease, pulmonary disease, or psychiatric disorders.

Of patients who present with acute coronary syndrome, women are more likely than men to experience atypical chest pain and complain of associated symptoms such as nausea, vomiting, fatigue, dyspnea, or neck and shoulder pain. In addition, the diagnosis of acute coronary syndrome is more likely to be delayed in women. It is important that when a woman presents with chest pain, the history is carefully documented and a careful physical examination is performed to evaluate for more serious causes of chest pain. A complete work-up should be performed if it is indicated.

Causes of Chest Pain in Women

Breast Pain

Cyclic breast pain

Cardiac Causes

Acute coronary syndrome (myocardial infarction, unstable angina)

Aortic stenosis

Coronary artery dissection

Coronary artery spasm

Thoracic aortic dissection (TAD)

Gastrointestinal Causes

Biliary disease

Esophageal cancer

Esophageal spasm

Gastroesophageal reflux disease

Pancreatic cancer

Peptic ulcer disease

Musculoskeletal Causes

Costochondritis

Disk disease (cervical or thoracic)

Thoracic outlet syndrome

Tietze syndrome

Psychiatric Causes

Factitious disorder

Pulmonary Causes

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