Many people experience epigastric pain, but since it often resolves quickly, many dismiss it. In reality, numerous factors can cause epigastric pain. We need to understand these causes and related treatment methods. Let's explore them below!
What Causes Epigastric Pain?
1. Angina pectoris;
2.Gastric diseases like gastritis or gastric ulcers;
3. Esophageal conditions such as esophagitis, esophageal diverticulum, or reflux esophagitis;
4. Pain from cholecystitis or the liver region can also radiate to the area below the xiphoid process.
5. Angina pectoris is a clinical syndrome caused by insufficient blood supply to the coronary arteries, resulting in sudden, temporary myocardial ischemia and hypoxia.
It is characterized by paroxysmal, crushing pain in the anterior chest, primarily behind the sternum, which may radiate to the precordial area and left upper limb. It often occurs during exertion or emotional agitation, lasts for several minutes, and resolves with rest or nitrates.
This condition predominantly affects males, with most patients being over 40 years old.
Causes of Epigastric Pain
1. Common triggers include exertion, emotional stress, overeating, exposure to cold, overcast/rainy weather, and acute circulatory failure.
2. Underlying conditions include coronary atherosclerosis, aortic valve stenosis or regurgitation, syphilitic aortitis, hypertrophic cardiomyopathy, congenital coronary artery anomalies, and rheumatic coronary arteritis.
3. Inflammation of the cartilage connecting ribs (costochondritis) is one of the more common causes of chest wall pain.
4. Inflammation caused by viruses such as influenza, known as Tietze's syndrome. (Influenza itself can also cause widespread bone pain.)
5. Rib fractures are less common but cause the most severe pain.
Symptoms of Epigastric Pain
Angina typically presents as sudden, crushing pain in the upper-middle sternum accompanied by tightness, suffocation, burning sensations, or a feeling of heavy pressure on the chest. The pain intensifies over minutes, reaching its peak, and may radiate to the inner left shoulder, neck, jaw, upper-middle abdomen, or both shoulders.
It is accompanied by cold sweats, gradually subsiding after a few minutes, and can be relieved by rest or nitroglycerin. In atypical cases, pain may occur in the lower sternum, upper abdomen, or precordial tenderness.
Some patients only experience pain in the radiating areas, such as throat tightness, jaw pain, or cervical tenderness. Others may only feel chest tightness, shortness of breath, or fatigue.Elderly diabetic patients may even experience only chest tightness without chest pain. 1. Exercise-Induced Angina Exercise-induced angina is characterized by transient chest pain triggered by physical exertion or other conditions increasing myocardial oxygen demand. The pain typically resolves rapidly with rest or sublingual nitroglycerin.
Exertional angina can be classified into three types:
① New-onset exertional angina: Duration of exertional angina symptoms is less than 1 month;
② Stable exertional angina: Duration of exertional angina symptoms has been stable for over 1 month;
③ Worsening exertional angina: Sudden increase in the frequency, severity, and duration of chest pain episodes triggered by the same level of exertion, requiring active treatment.
2. Spontaneous angina
Spontaneous angina is characterized by chest pain episodes that show no clear relationship with increased myocardial oxygen demand.Compared to exertional angina, this pain typically lasts longer, is more severe, is less responsive to nitroglycerin, and shows no enzyme changes.
ECGs often reveal transient ST-segment depression or T-wave changes. Spontaneous angina may occur alone or coexist with exertional angina.
Patients with unstable angina may present with varying clinical manifestations based on the frequency, duration, and intensity of pain episodes. Occasionally, patients may experience prolonged chest pain episodes resembling myocardial infarction, yet without characteristic ECG or enzyme changes.
Some patients with unstable angina exhibit transient ST-segment elevation during episodes, often termed variant angina.However, this term should not be applied when this ECG pattern is recorded in the early stages of myocardial infarction.
New-onset exertional angina, worsening angina, and spontaneous angina are collectively termed "unstable angina."
Conclusion: The above covers some key knowledge about epigastric pain. By now, you should have a basic understanding. If you notice any unusual symptoms, seek prompt medical attention for appropriate treatment. Take it seriously to avoid delaying diagnosis. We hope this information proves helpful.