ISSN: 1305-385X
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Neurophysiology Of The Chest Pain
Dr. Sabriye DEMİRCİa
aİç Hastalıkları AD, İstanbul Üniversitesi Cerrahpaşa Tıp Fakültesi, İSTANBUL
Chest pain is probably the most frequent complaint and is very significant because it is mostly complicated by death fear. The differential diagnosis of chest pain is confusing because it may be a sign of many disorders related to several different organ systems concerning the lungs, heart, blood vessels, intestine, muscle and the skeleton. The patients may complain of either a superficial or profound pain. The characteristics of pain are its quality, region, severity and timing. There are also factors that may aggravate or relieve the pain. Some pain are superficial and may be intensified by respiratory motion. Pleural chest pain is a good example of this type of pain. Others are recognized as deep retrosternal chest pain with burning and aching sensation and can not be localized very well. Such pain are attributed to the six-dermatome band. Angina pectoris, acute myocardial infarction, postcardiotomy syndromes, esophageal discomfort, acute pericarditis, pulmonary artery embolism, dissecting aortic aneurysm, mediastinal lesions all present as six-dermatome pain and therefore this type of pain is not specific for cardiac disease. Differentiation of chest pain depends on the neurophysiological mechanisms of pain generation in the chest. There are two different receptors for pain sensation in the chest and this is the main cause of different types of chest pain. Recognizing these different pathways allows us to make the correct diagnosis.Keywords: Chest pain, nociceptives, six-dermatome painTurkiye Klinikleri J Int Med Sci 2007, 3(15):1-4
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