The Green Revolution A Glorious Success History Essay

The Green Revolution A Glorious Success History Essay The term Green Revolution was first begat by the USAID United States Agency for International Development in 1968. Everything began in Mexico with US help and sponsored by the help of monsters like Ford and Rockfeller Corporation route, harking back to the 1940s. It was the activity of a man named Norman Borlough who built up a strain of rice and wheat which yielded a yield (under ideal conditions) so far just imagined off. These strains of oats were named as HYV (High Yielding Variety). Norman Borlough is viewed as the dad of the Green Revolution. He assumed an instrumental job alongside M.S. Swaminathan who was our priest for Agriculture in carrying Green Revolution to India. The G R was considered as the answer for feed the universes developing populace, it might have been. [J R McNeill] In India alone the surprising agrarian development in Punjab is exemplified by the expansion in Punjabi wheat creation from 1.9 to 5.6 million tons during the years 1965 through 1972. [1] The creation of rice additionally expanded incredibly. India before long embraced IR8 a semi-overshadow rice assortment created by the International Rice Research Institute (IRRI) that could deliver more grains of rice per plant when developed with specific composts and water system. In 1968, Indian agronomist S.K. De Datta distributed his discoveries that IR8 rice yielded around 5 tons for each hectare with no manure, and just about 10 tons for every hectare under ideal conditions. This was multiple times the yield of conventional rice. IR8 was a triumph all through Asia, and named the Miracle Rice. IR8 was additionally formed into Semi-overshadow IR36. [2] India was near the p recarious edge of a starvation in 1961, however with the presentation of G R we turned into an exporter of food grains inside an extremely brief timeframe. G R was an endowment of the created countries to the underdeveloped nations. It was a bundle bargain advanced by the World Bank to assist them with escaping their obligation traps. The G R was acknowledged with great affection with practically zero idea about its suitability or supportability. It was looked on as a one stop shop to their financial and segment issues. The green insurgency the US-supported innovative bundle for farming improvement was acknowledged in India some-what over-excitedly and furthermore un-basically. It was trusted that with improved homestead creation, not just an enduring arrangement would be found for the unending issues of country destitution and appetite yet in addition it would produce another asset base-a take off platform for rustic industrialisation that would make new work openings and would improve the personal satisfaction at the grassroots in a calculable measure. [Dhanagare 1987] As opposed to Why was the Green Revolution such an extraordinary achievement? I might want to contend from the perspective of Was the Green Revolution such an extraordinary achievement? I might want to consider the perspectives of certain researchers which might be very in opposition to what the advocators and advertisers of Green Revolution might want to accept. The G R as of now referenced before was a bundle bargain it joined certain variables like water system, synthetic composts, bug sprays, pesticides and automation and huge size possessions without which the achievement of G R would not be sensational. These are factors that India didn't and couldn't manage the cost of at all levels. Aside from this G R was not all positive it appeared as though it came in with progressively negative as time passed on. Through various contextual analyses I might want to introduce my contention. Endosulfan Poisoning in Kasargoad, Kerala, India This is the account of a little town in the territory of Kerala a town named Swarga truly meaning paradise. A town immaculate by industrialization and individuals relied upon ranch cultivating. A run of the mill Indian town until out of nowhere individuals discovered things turning out badly, Calves passing on bumble bees vanishing, untamed life being influenced and afterward gradually the individuals being influenced by a bizarre disease. The reason, obscure. The Kerala state government chose to shower its cashew ranches with ariel pesticide. It was a sight to see a helicopter drifting over the town and it pulled in a great deal of consideration. Little did the individuals comprehend what the result of this would be. In any event, when an unexpected and weird sort of disease hit little did they partner it with the helicopter, they accepted that it was an a revile. Until one rancher saw a peculiar happenstance in the demise of his three calves and raised up an issue. This intrigued a writer who started to test into this circumstance. A nearby specialist who started to see a peculiar example of new ailments in his patients enhanced crafted by the columnist. It was anything but a simple way to travel and demonstrate their remain as they needed to battle entrepreneur goliaths whos a lot was on the line in the assembling of the lethal synthetic. The assistance of a worldwide association was looked for. A reality discovering group of PAN(Pestic ide Action Network) AP headed by Dr Romeo F Quijango was shaped. The target of the mission was: To discover the veracity of the reports that there have episodes of ailment since the cashew nut ranches began their activities The degree to which these airborne sprayings have influenced the individuals and the earth After point by point assessment of the environmental factors, physical assessment of the influenced individuals and a wide scope of meetings with both the nearby individuals and specialists the reports of harming were affirmed. The discoveries expressed The reason for the sickness was inherent toxicology properties of endosulfan There appears to exist no other likely explanations other than endosulfan for the event of sickness There is an away from and topographical relationship between the event of disease and the elevated showering There is a confirmed impact on both the earth and the creatures which are identified with endosulfan harming. Clinical reports of the casualties as recorded by the nearby doctors affirmed the harming Organic and ecological examples broke down at research centers affirmed the nearness of endosulfan. The discoveries affirmed the harming and a changeless restriction on the shower of endosulfan was set. The degree of harm can't be fixed. A large portion of the instances of harming depicted in the report are of small kids brought into the world with cerebral paralysis because of the harming. In spite of the fact that this report was kept to Kasargod there are wide spread use and impacts felt in the neighboring states too. Here I might want to incorporate an article from the paper that report instances of endosulfan harming from Karnataka Gowda was conceived in 1977. To his shame through RTI he found that 92 towns were splashed with endosulfan in the four taluks of the region. He visited 82 towns and found that shocking instances of inabilities, particularly cerebral paralysis influencing grown-ups and youngsters. I have chosen not to get hitched - right off the bat to convey this battles forward and furthermore to see that my kids dont live like me. I may get hitched on the off chance that I can stand to do a quality test which demonstrates everything approves of me, he includes. Gowda says: In certain spots the circumstance is too appalling to even consider describing. A mother who is an anganwadi educator has two youngsters one of them is influenced with this kind of harming. She gives him food at 9 am locks the entryway and goes for work. At the point when she restores, the kid will be abounding in his own fecal issue. This is a regular story. The administration authorities, on the off chance that they visit every single home, they will comprehend the gravity of the issue. Yet, they dont, thus dont comprehend our situation [3] This has been the impact of the aimless utilization of pesticides and bug sprays on the unconscious and blameless lives. Rachel Carson committed her whole book The Silent Spring to carry attention with the impacts of bug sprays and pesticides on man and his condition. Despite the fact that she succeeded to huge degree on forbidding their aimless utilize still proceeds in the underdeveloped nations. This as per Clevo Wilson Clem Tisdell are because of shifted monetary reasons and furthermore because of absence of information. Ranchers keep on utilizing pesticides if their net limited pace of return is more prominent in the present. This happens significantly more in less created nations than in progressively created nations. To make themselves monetarily practical ranchers are compelled to utilize pesticides since it causes an expansion in the creation in the short run, however the cost will increment over the long haul which they are ignorant of, and furthermore once another procedure is utilized the expense of returning perhaps extremely high. Further it might be because of an absence of information with respect to ranchers. It might likewise be that utilization of pesticides and manures are viewed as an essential piece of popularized farming. To add to this would be the weight the ranchers may look from notices and deals plans of organizations fabricating bug sprays and composts. It has likewise been discovered that however ranchers might know about Integrated Pest Management frameworks they may not be effectively open, as found on account of ranchers in Sri Lanka.â [4]â Our next contextual investigation is situated in Punjab that features the negative impact that G R has had on the work of the young. Punjab farming has been known for the green upset of the late 1960s and the 1970s. Not just has it accomplished a water system inclusion of 95 percent of the net planted region, editing force of 185, and 98 percent HYV inclusion which are altogether the most noteworthy among the Indian states, however even the yields of significant harvests wheat and paddy are of a high request, I e, 3,941 kgs and 3,393 kgs for each hectare individually [CACP 1997] The rural area in Punjab is extremely capital escalated with the most noteworthy number of tubewells and tractors in the nation and the most noteworthy purchaser of power, 21% of wheat, 9% of rice and 21% of cotton delivered in India originated from Punjab. During the 1980s the scene started to change, a similar degree of p

If stem cell research must rely only on derivation of tissue from a Term Paper - 1

In the event that immature microorganism inquire about must depend just on inference of tissue from a lively embryo, is collecting those cells in any capacity shameless, unlawful or exploitative - Term Paper Example It is difficult to accommodate these situations because of particularly contradicting sees inborn in clinical science as opposed to changing perspectives and translations of morals and profound quality. A run of the mill day-5 human incipient organism comprises of 200-250 cells, the vast majority of which include the trophoblast, which is the peripheral layer of the blastocyst. HESCs are gathered from the inward cell mass of the blastocyst, which comprises of 30-34 cells. The determination of HESC societies requires the expulsion of the trophoblast. This procedure of disaggregating the blastocysts cells disposes of its potential for additional turn of events. Rivals of HESC explore contend that the exploration is ethically impermissible in light of the fact that it includes the vile slaughtering of honest individuals. (Siegel standard. 2). Good and moral discussions have seethed since undeveloped cell look into first crossed scientists’ minds. One shortsighted contention against resistance to the examination habitats upon premature birth babies from which a considerable lot of the cells are assembled. The ethical normal is that in case of a fetus removal probably some useful for the entire of humankind can happen to it. Adding something extra to this position, one can put forth a defense that the defender oneself is conceding fetus removal is unscrupulous, featuring the multifaceted nature of the contention. In addition, they may state, examine is impossible on grown-up immature microorganisms since they don’t share indistinguishable viewpoints from those from an undeveloped organism. The benefit of the exploration exceeds the awful of the strategies. The end legitimizes the methods, since early stage immature microorganism research can help discover remedies for, or forestall ailments including Cancer an d Parkinson’s yet in addition Alzheimer’s, Heart infection, Stroke, Diabetes, birth abandons, spinal string wounds, organ harm and transplant dismissal. Clinical specialists demand undeveloped immature microorganisms are required on the grounds that only they can duplicate some other

Birthday Boy Ben

Birthday Boy Ben As you may already be aware, today is Bens birthday! I wont embarrass him by telling you all how old he is =), but I will tell you the story of how my friends and I unleashed a birthday explosion in his office. So in case you didnt know, I should probably tell you that Ben is pretty much one of the most popular guys on campus. (Not that we dont love Matt and Nance and all the other admissions officers, of course.) Not only does he admit us to MIT, he actually really cares about us after were admitted, as well. His office is almost always open to us (assuming hes around! Hes a busy guy, after all), whether its to chat, to get advice or an ego-boost, or even to crash on his couch. And so a few of my friends and I decided to repay Ben for all his awesomeness by throwing a mini-birthday party in his office. The preparations began last Wednesday night. My friends Tina, Teresa, and Caroline (all freshmen, like me) baked Ben several trays of cupcakes at their dorm, Senior Haus. I was invited to the baking party, but ultimately it was decided all of us would be better off if I didnt come. ;-) Thursday morning (which was, incidentally, the birthday of Sam, Laura, AND Ben Jones Mom), we set out on our missions. Conveniently enough, my UROP is in Building E25, almost right next to Senior Haus (check for yourself here); so instead of taking a lunch break, I just hopped over to Senior Haus and helped Caroline and Tina carry the cupcakes and several LaVerdes bags full of decorations to Bens office, Room 3-107. Unfortunately, we realized that Ben was probably in his office, so we decided that I would be the distraction and get Ben to leave 3-107, while Caroline and Tina snuck in and decorated. Basically, I knocked on the door (you remember how Matt talked about the admissions officers being locked in the dungeon? Well, 3-107 isnt actually a dungeon, but the room really is locked), was let in by one of the Friendly Admissions Officers, and barged into Bens office interrupting the very important letter he was writing. The conversation went something like this: Me: Hey Ben! Want to have coffee? Ben: Hey! Well, I have three letters to finish for Stu Me: Aw, Ben Ben: and a meeting at eleven Me: Ben, come on Ben: Do you want to set a date? Me: Okay, Ben, you want to come get coffee with me. Ben: *getting up to leave* Aw, Tina put you up to this, didnt she? Me: *awkward* Tina? Whos Tina? So we took off down the Infinite Corridor towards the Lobby 7 coffeeshop. Unfortunately, Ben proved to be far more crafty than I had expected and actually glanced back down the Infinite towards his officeso he caught sight of Caroline and Tina as they stealthily knocked on 3-107 with their bags of decorations (and were also let in by another Friendly Admissions Officer). That unfortunate sighting notwithstanding, I managed to delay Ben for about five more minutes (he bought me a cookie from Bosworths, which was delicious, although I felt bad because he bought it for me and I really didnt plan on that happening just goes to show you how nice Ben is) before he headed back towards 3-107. Because hes Ben, I couldnt really stop him, so instead I just dashed into Bens office to help Caroline and Tina with the decorating. The resulting hilarity is best described with picture evidence, so pardon me while I switch into photoblog-mode. (*bzzzzz* *crash* *bang*) Okay, were good to go. Transform and roll out! Friendly Admissions Officer John helps Tina set up the paper chain. Caroline made the snowflakes.The stainless steel contraption you see is actually part of the steam tunnel that runs beneath Bens office, which explains why Bens office is 80 degrees Fahrenheit even with the AC turned all the way up. Actually, the steam tunnel in question gets so hot that the hacking community has dubbed it Hell. Since Bens office is above the steam tunnel, and we all know Ben is God, I personally believe that this makes perfect sense. (Even though Ben, humble as always, is quick to say that God is far cooler than he could ever be. Aw.) Ben spies on us through the window. Fortunately, he seems amused. Tina likes sitting behind Bens desk. It makes her feel powerful. Right, Tina? Bens shelves are one of the more interesting parts of his office. My favorite parts are the Varsity Blogging poster, his turtle collection, and the picture of one of Bens sons in the pumpkin costume. =) We hang a warning sign on Bens door. Bens desk is ready for the birthday boy to be let back in. The cupcakes are actually made with authentic cream cheese frosting, which is apprently Bens favorite. As Tina said, What Ben wants, Ben gets! Tina: You realize youre locking your boss out of his office, dont you? Me: Im gonna get fired for this He likes it! (My job is saved!) Ben and Tina share a post-celebration hug. Teresa arrives and gets a hug too! I was also hugged, but no one though to take a picture of that. Instead, we have a quote: Ben: Can I hug you? Me: Of course you can! *hug* Tina: Paul likes hugs. Me: *grin and nod* Snazzily-dressed Matt sings Happy Birthday to Ben. Also, a funny story: at one point, Ben accidentally knocked one of the cupcakes to the floor. Tina suggested, Give it to someone you dont like! Upon which Ben instantly called out, Matt! Ah, Ben, youre such a kidder Obligatory group shot. From left to right, Tina, Ben, Me, and Caroline. Another group shot.To be honest, this was pretty much the highlight of my week. Sure, IAP and UROP and everything are awesome but its not everyday you get to surprise one of the greatest admissions officers in the world. =) So happy birthday, Ben! You guys should all take a minute and wish him happy birthday too. As if he werent popular enough already. ;-)

A Short Story - 1418 Words

Karjon moved on from the Birthing Centre out to the perimeter of the Hive. He could see the great barren land ahead of him and the lowly looking buildings behind him. This reminded him of his own Hive’s layout. The more important, elaborate and ornate structures were at the centre of the Hive. The edge was reserved for the slum areas. However all of this was above ground. It intrigued him somewhat that the Religious Hive had a slum area at all. Everyone in this Hive were well off, praying to God, weren’t they? Well no time to ponder social castes. He was on a mission. He firstly looked around to see if anyone was noticing him. Moving out to the extremities of the Hive was not only risky but could draw undue attention. He would have a†¦show more content†¦Meanwhile Murfon and Tamblin had returned to the Trainee Centre. They were greeted warmly and gave apologies for Karjon’s absence. It did not take too long for a small band of them to form an audience waiting for another probing debate. Their new friend Quagon seemed to be organising everyone. Murfon nodded to Tamblin to indicate that now may be the time to reveal the information about the sky beyond God’s World. The two had discussed earlier if they should really do it and what consequence might ensue. Telling them about it without proof yet is one thing, suggesting something that would be construed as blasphemy is quite another. But they were resolute to discover if the Trainees knew anything about it or knew someone who knew something about it. If neither, it might prove helpful to have a theoretical discussion about it anyway. From the last meeting they learnt that these Trainees were very intelligent and quite open to different ideas. For the Trainees, they had a secret outlet from their strict doctrine. So they sat eagerly awaiting what the two had in store for them. â€Å"Have you ever wondered what lies beyond God’s World?† Murfon started quite bluntly. â€Å"Obviously there is nothing beyond God’s World. It is the only thing above us. We’ve known that all our lives.† Came one reply with several grunts of agreement. Murfon hesitated before hisShow MoreRelatedshort story1018 Words   |  5 Pagesï » ¿Short Stories:  Ã‚  Characteristics †¢Short  - Can usually be read in one sitting. †¢Concise:  Ã‚  Information offered in the story is relevant to the tale being told.  Ã‚  This is unlike a novel, where the story can diverge from the main plot †¢Usually tries to leave behind a  single impression  or effect.  Ã‚  Usually, though not always built around one character, place, idea, or act. †¢Because they are concise, writers depend on the reader bringing  personal experiences  and  prior knowledge  to the story. Four MajorRead MoreThe Short Stories Ideas For Writing A Short Story Essay1097 Words   |  5 Pageswriting a short story. Many a time, writers run out of these short story ideas upon exhausting their sources of short story ideas. If you are one of these writers, who have run out of short story ideas, and the deadline you have for coming up with a short story is running out, the short story writing prompts below will surely help you. Additionally, if you are being tormented by the blank Microsoft Word document staring at you because you are not able to come up with the best short story idea, youRead MoreShort Story1804 Words   |  8 PagesShort story: Definition and History. A  short story  like any other term does not have only one definition, it has many definitions, but all of them are similar in a general idea. According to The World Book Encyclopedia (1994, Vol. 12, L-354), â€Å"the short story is a short work of fiction that usually centers around a single incident. 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In the short stories â€Å"Miss Brill† and â€Å"Frau Brechenmacher attends a wedding† written by Katherine Mansfield, the themes which are relevant to real life in Miss Brill are isolation and appearance versus reality. Likewise Frau Brechenmacher suffers through isolation throughout the story and also male dominance is one of the major themes that are highlighted in the story. These themes areRead MoreShort Story and People1473 Words   |  6 Pagesï » ¿Title: Story Of An Hour Author: Kate Chopin I. On The Elements / Literary Concepts The short story Story Of An Hour is all about the series of emotions that the protagonist, Mrs. Mallard showed to the readers. With the kind of plot of this short story, it actually refers to the moments that Mrs. Mallard knew that all this time, her husband was alive. For the symbol, I like the title of this short story because it actually symbolizes the time where Mrs. Mallard died with joy. And with thatRead MoreShort Story Essay1294 Words   |  6 PagesA short story concentrates on creating a single dynamic effect and is limited in character and situation. It is a language of maximum yet economical effect. Every word must do a job, sometimes several jobs. Short stories are filled with numerous language and sound devices. These language and sound devices create a stronger image of the scenario or the characters within the text, which contribute to the overall pre-designed effect.As it is shown in the metaphor lipstick bleeding gently in CinnamonRead MoreRacism in the Short Stor ies1837 Words   |  7 PagesOften we read stories that tell stories of mixing the grouping may not always be what is legal or what people consider moral at the time. The things that you can learn from someone who is not like you is amazing if people took the time to consider this before judging someone the world as we know it would be a completely different place. 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Suspense Is Crucial in Horror and Thriller Films Essay

Suspense is a crucial ingredient in the making of horror and thriller films. The significance of suspense in horror films is to bring out the â€Å"twist or unexpected moment of realization that makes someone scream and ones heart race. In the film industry, there are various types of genre, but as different as films may seem, they all have one element that links them all together. That element is known as Mise-en-scene. Mise-en-scene is a French phrase that means â€Å"putting into the scene.† Mise-en-scene includes elements such as setting, lighting, costume, and figure movement and expression (acting). Through the masking of narrative, secret window exposes order and chaos. The use of mise en scene throughout the first scene†¦show more content†¦This is a representation of the coldness of the character that is behind the window, and is blurred within the fog. The use of mise-en-scene is also used in the background that you can see behind the window which is of a forest. This is determined by the clustered trees that are crowded behind the character at the front. This is a cliche in horror films as it is a setting that a lot of horror films use, as a forest is a place that has a creepy atmosphere when dark and is a vulnerable place to be, as it is unrecognizable to you. The use of lighting is used to silhouette the character, this makes her the main focus of attraction. It also blocks out any view of anything else behind them and therefore forcing the viewer to look at the character. This is effective in asserting the audience that this is a horror film.The last use of mise-en-scene that is used in order to make it more bright and to make it stand out is the use of costume. The use of costume isnt fully focused on this poster but it is helpful in finishing off the full image of the atmosphere that it is trying to create. The T-shirt is dirty and torn, which can represent a struggle that it took for the character to come this way. The use of mise en scene within the opening of ‘Hide and Seek’ is very significant as it reveals the victims throughout the film. This is done through the use of the colour red presented through a coat and lipstick that two femaleShow MoreRelatedThe Creation of Suspense in Different Film Genres Essay1876 Words   |  8 PagesCreation of Suspense in Different Film Genres We humans demand a lot nowadays where a film is concerned. No longer do we want simple, traditional storylines (well at least I don’t!), but instead we expect big explosions, top-notch special effects and quality acting. Film directors have a tough task keeping its audience happy; however the more suspense they create in their films, the more appreciative we will be of it. A classic horror or an intense thriller tends toRead MoreRobberies, murder, revenge†¦ some of the most renowned films are centred on some of the vilest human1100 Words   |  5 PagesRobberies, murder, revenge†¦ some of the most renowned films are centred on some of the vilest human acts. Our instinctive nature to crave unpredictability is often satisfied through crime films whether it is through fear, thrill, perplexity, mystification, disgust, horror, amazement, shock, or even offence. So what is it exactly that constitutes the quintessential crime film? People find themselves being transfixed by this popular medium, forming an addiction to the unfolding and prodigious plotsRead MoreEssay Horror Films: The Haunted Castle by George Melies1616 Words   |  7 Pages Since the release of George Melies’s The Haunted Castle in 1896, over 90,000 horror films have been made. 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Chest Pain Free Essays

string(99) " findings have changed our thinking on HRT; long-term HRT is no longer recommended for most women\." CHEST PAIN Chest Pain Overview If you are having severe pain, crushing, squeezing, or pressure in your chest that lasts more than a few minutes, or if the pain moves into your neck, left shoulder, arm, or jaw, go immediately to a hospital emergency department. Chest pain is one of the most frightening symptoms a person can have. It is sometimes difficult even for a doctor or other medical professional to tell what is causing chest pain and whether it is life-threatening. We will write a custom essay sample on Chest Pain or any similar topic only for you Order Now * Any part of the chest can be the cause of the pain including the heart, lungs, esophagus, muscle, bone, and skin. Because of the complex nerve distribution in the body, chest pain may actually originate from another part of the body. * The stomach or other organs in the belly (abdomen), for example, can cause chest pain. Potentially life-threatening causes of chest pain are as follows: Causes of Chest Pain 1. Heart attack (acute myocardial infarction): A heart attack occurs when blood flow to the arteries that supply the heart (coronary arteries) becomes blocked. With decreased blood flow, the muscle of the heart does not receive enough oxygen. This can cause damage, deterioration, and death of the heart muscle. . Angina: Angina is chest pain related to an imbalance between the oxygen demand of the heart and the amount of oxygen delivered via the blood. It is caused by blockage or narrowing of the blood vessels that supply blood to the heart. Angina is different from a heart attac k in that the arteries are not completely blocked, and it causes little or no permanent damage to the heart. â€Å"Stable† angina occurs repetitively and predictably while exercising and goes away with rest. â€Å"Unstable† angina results in unusual and unpredictable pain not relieved totally by rest, or pain that actually occurs at rest. . Aortic dissection: The aorta is the main artery that supplies blood to the vital organs of the body, such as the brain, heart, kidneys, lungs, and intestines. Dissection means a tear in the inner lining of the aorta. This can cause massive internal bleeding and interrupt blood flow to the vital organs. 4. Pulmonary embolism: A pulmonary embolus is a blood clot in one of the major blood vessels that supplies the lungs. It is a potentially life-threatening cause of chest pain but is not associated with the heart. 5. Spontaneous pneumothorax: Often called a collapsed lung, this condition occurs when air enters the saclike space between the chest wall and the lung tissue. Normally, negative pressure in the chest cavity allows the lungs to expand. When a spontaneous pneumothorax occurs, air enters the chest cavity. When the pressure balance is lost, the lung is unable to re-expand. This cuts off the normal oxygen supply in the body. 6. Perforated viscus: A perforated viscus is a hole or tear in the wall of any area of the gastrointestinal tract. This allows air to enter the abdominal cavity, which irritates the diaphragm, and can cause chest pain. . Cocaine-induced chest pain: Cocaine causes the blood vessels in the body to constrict. This can decrease blood flow to the heart, causing chest pain. Cocaine also accelerates the progression of atherosclerosis, a risk factor for a heart attack. Causes of chest pain that are not immediately life-threatening include the following: 8. Acute pericarditis: T his is an inflammation of the pericardium, which is the sac that covers the heart. 9. Mitral valve prolapse: Mitral valve prolapse is an abnormality of one of the heart valves in which the â€Å"leaves† of the valve bulge into the upper heart chamber during contraction. When this occurs, a small amount of blood flows backward in the heart. This is believed by some to be a cause of chest pain in certain people, although this has not been proven with certainty. 10. Pneumonia: Pneumonia is an infection of the lung tissue. Chest pain occurs because of inflammation to the lining of the lungs. 11. Disorders of the esophagus: Chest pain from esophageal disorders can be an alarming symptom because it often mimics chest pain from a heart attack. (a)Acid reflux disease (gastroesophageal reflux disease, GERD, heartburn) occurs when acidic digestive juices flow backward from the stomach into the esophagus. The resulting heartburn is sometimes experienced as chest pain. (b)Esophagitis is an inflammation of the esophagus. (c)Esophageal spasm is defined as excessive, intensified, or uncoordinated contractions of the smooth muscle of the esophagus. 12. Costochondritis: This is an inflammation of the cartilage between the ribs. Pain is typically located in the mid-chest, with intermittently dull and sharp pain that may be increased with deep breaths, movement, and deep touch. 13. Herpes zoster: Also known as shingles, this is a reactivation of the viral infection that causes chickenpox. With shingles, a rash occurs, usually only on one small part of the body. The pain, often very severe, is usually confined to the area of the rash. The pain may precede the rash by 4-7 days. Risk factors include any condition in which the immune system is compromised, such as advanced age, HIV, or cancer. Herpes zoster is highly contagious to people who have not had chickenpox or have not been vaccinated against chickenpox for the five days before and the five days after the appearance of the rash. HEART ATTACK A heart attack is caused by coronary heart disease, or coronary artery disease. Heart disease may be caused by cholesterol build-up in the coronary arteries (atherosclerosis), blood clots, or spasm of the vessels that supply blood to the heart. Risk factors for a heart attack are:- (a) High blood pressure (b) Diabetes (c) Smoking (d) High cholesterol (e) Family history of heart attacks at ages younger than 60 years, one or more previous heart attacks, male gender (f) Obesity (g) Postmenopausal women are at higher risk than premenopausal women. This is thought to be due to loss of the protective effects of the hormone estrogen at menopause. It was previously treated by hormone supplements (hormone replacement therapy, or HRT). However, research findings have changed our thinking on HRT; long-term HRT is no longer recommended for most women. You read "Chest Pain" in category "Papers" (h) Use of cocaine and similar stimulants. Angina Causes 1. Angina may be caused by spasm, narrowing, or partial blockage of an artery that supplies blood to the heart. 2. The most common cause is coronary heart disease, in which a blood clot or buildup of fatty material inside the blood vessel (atherosclerosis) reduces blood flow but does not completely block the blood vessel. 3. Angina can be triggered by exercise or physical exertion, by emotional stress, or by certain heart rhythm disorders (arrhythmias) that cause the heart to beat very fast. Aortic Dissection Causes Aortic dissection may be caused by conditions that damage the innermost lining of the aorta. (a)These include uncontrolled high blood pressure, connective-tissue diseases, cocaine use, advanced age, pregnancy, congenital heart disease, and cardiac catheterization (a medical procedure). (b) Men are at higher risk than women. (c) A similar condition is aortic aneurysm. This is an enlargement of the aorta that can rupture, causing pain and bleeding. Aneurysms can occur in the aorta in the chest or the abdomen. Pulmonary Embolism Causes Pulmonary embolism risk factors include: (a)Sedentary lifestyle, (b)Obesity, (c)Prolonged immobility, (d) Fracture of a long bone of the legs, (e) Pregnancy, (f)Cancer, (g) History or family history of blood clots, (j)Irregular heartbeat (arrhythmias), (k) Heart attack, (l)Congestive heart failure. Spontaneous Pneumothorax Causes 1. Spontaneous pneumothorax (collapsed lung) occurs when the pressure balance between the sac that contains the lung and the outside atmosphere is disrupted. 2. Injury to the chest that pierces through to the lung sac is the most common cause of this condition. This can be caused by trauma, as in a car wreck, bad fall, gunshot wound or stabbing, or in surgery. 3. Some very thin and tall people may suffer a spontaneous pneumothorax due to stretched lung tissues and abnormal air sacs in the upper portions of their lungs. It is possible for these abnormal air sacs to rupture with even a sneeze or excessive coughing. 4. Other risk factors for pneumothorax include AIDS-related pneumonia, emphysema, severe asthma, cystic fibrosis, cancer, and marijuana and crack cocaine use Perforated Viscus Causes Perforated viscus may be caused by direct or indirect injury. Irritation to the diaphragm in this case comes from below the chest. The diaphragm is the muscle that allows us to breathe. It is located up under the ribs and separates the chest and abdominal cavity. Any irritation to the diaphragm, even from below it, can cause pain to be felt in the chest. Risk factors not related to trauma are: (a)Untreated ulcers, * (b)Prolonged or forceful vomiting, * (c)Swallowing a foreign body, * (d)Cancer, * (e)Appendicitis, * (f)Long-term steroid use, (g)Infection of the gallbladder, * (h)Gallstones, and * (j)AIDS. * * * Pericarditis Causes Pericarditis can be caused by viral infection, bacterial infection, cancer, connective-tissue diseases, certain medications, radiation treatment, and chronic renal failure. (a) One life-threatening complication of pericarditis is cardiac tamponade. Cardiac tamponade is an accumulation of fluid around the heart. This prevents the hear t from effectively pumping blood to the body. Symptoms of cardiac tamponade include sudden onset of shortness of breath, fainting, and chest pain. Pneumonia Causes Pneumonia may be caused by viral, bacterial, or fungal infections of the lungs. Esophagus Related Causes Chest pain originating from the esophagus may have several causes. Acid reflux (GERD) may be caused by any factors that decrease the pressure on the lower part of the esophagus, decreased movement of the esophagus, or prolonged emptying of the stomach. This condition may be brought on by: (a)Consumption of high-fat foods, (b)Nicotine use, (c)Alcohol use, (d)Caffeine, pregnancy, (d) Certain medications (for example, nitrates, calcium channel blockers, anticholinergics, estrogen, progesterone), (f)diabetes, g)scleroderma. (h) Esophagitis may be caused by yeast, fungi, viruses, bacteria, or irritation from medications. (j) Esophageal spasm is caused by excessive, intensified, or uncoordinated contractions of the smooth muscle of the esophagus. Spasm may be triggered by emotional upset or swallowing very hot or cold liquids. Heart Attack Symptoms Typical heart attack pain occurs in th e mid to left side of the chest and may also extend to the left shoulder, the left arm, the jaw, the stomach, or the back. Other associated symptoms are shortness of breath, increased sweating, nausea, and vomiting. Women may experience symptoms of heart attack similar to men (chest pain), but they also may be more atypical. Atypical symptoms include: (a) Neck pain (b) Jaw pain (c) Shoulder pain (d) Upper back (e) Abdominal discomfort, (f) Shortness of breath, (g) Nausea or vomiting, (h) Abdominal pain, (j)Heartburn, (k) Sweatiness, (l) Light-headedness, (m) Dizziness, or (n) Unexplained fatigue. * Angina Symptoms Angina is similar to heart attack pain but occurs with physical exertion or exercise and is relieved by rest or nitroglycerin. Angina becomes life threatening when pain occurs at rest, has increased in frequency or intensity, or is not relieved with at least three nitroglycerin tablets taken five minutes apart. This is considered to be unstable angina, which may be a warning sign of an impending heart attack. Aortic Dissection Symptoms The chest pain associated with aortic dissection occurs suddenly and is described as â€Å"ripping† or â€Å"tearing. † The pain may radiate to the back or between the shoulder blades. Because the aorta supplies blood to the entire body, symptoms may also include: (a)Angina-type pain, (b)Shortness of breath, (c)Fainting, d)Abdominal pain, or (e)Symptoms of stroke. Pulmonary Embolism Symptoms Symptoms of a pulmonary embolus include: The sudden onset of shortness of breath, rapid breathing, and sharp pain in the mid chest, which increases with deep breaths. Symptoms of pneumothorax include: The sudden onset of shortness of breath,sharp chest pain, rapid heart rate, dizziness, lightheadedness, or faintness. Perforated Viscus Symptoms Perforated viscus comes on suddenly with severe abdominal, chest, and/or back pain. Abdominal pain may increase with movement or when breathing in and may be accompanied by a rigid, boardlike abdominal wall. Pericarditis Symptoms The pain of pericarditis is typically described as a sharp or stabbing pain in the mid-chest, worsened by deep breaths. pain may mimic the pain of a heart attack, because it may radiate to the left side of the back or shoulder. One distinguishing factor is that the pain is worsened by lying flat and improved by leaning forward. When lying flat, the inflamed pericardium is in direct contact with the heart and causes pain. When leaning forward, there is a space between the pericardium and the heart. people report a recent cold, fever, shortness of breath, or pain when swallowing just before developing pericarditis. Mitral Valve Prolapse Symptoms Mitral valve prolapse usually has no symptoms, but some people experience palpitations (sensation of rapid or strong heartbeat) and chest pain. Chest pain associated with mitral valve prolapse differs from that of typical angina in that it is sharp, does not radiate, and is not related to physical exertion. Other symptoms include fatigue, light-headedness, and shortness of breath. Complications include infection of the heart valves, mitral valve regurgitation (an abnormal blood flow within the chambers of the heart), and abnormal heart rhythms, which rarely cause sudden death. Pneumonia Symptoms The chest pain of pneumonia occurs during prolonged or forceful coughing. The pain is usually one-sided an is worsened by coughing. Other associated symptoms include fever, coughing up mucus (sputum), and shortness of breath. Esophagus Related Symptoms With chest pain originating from the esophagus, symptoms depend on the source. * (a)Symptoms of gastroesophageal reflux disease (GERD) include: (b)Heartburn, (c)Painful swallowing, (d)Excessive salivation, (e)Dull chest discomfort, (f)Chest pressure, or (g)Severe squeezing pain across the mid chest. h)You may feel uncomfortable or may experience: (j)Profuse sweating, (k)Pallor, (l)Nausea, and (m)Vomiting. Symptoms of esophagitis include difficulty swallowing, painful swallowing, or symptoms of GERD. The chest pain comes on suddenly and is not relieved by antacids. The pain of esophageal spasm is usually intermittent and dull. It is located in the mid-chest and may radiate to the back, neck, or shoulders. DIAGNOSIS He art Attack In the hospital emergency department, the healthcare providers use three basic procedures to decide if a patient is having a heart attack. (a) The first is the symptoms reported by the patient. * (b) The second is an electrocardiogram (ECG or EKG), an electrical tracing of the heart’s activity. On the ECG, it may be possible to tell which vessels in the heart are blocked or narrowed. * (c) The third is measurement of enzymes produced by the heart muscle cells when they do not receive enough oxygen. These enzymes are detectable with blood tests and are called cardiac enzymes. Angina Angina is diagnosed by the same methods doctors use to diagnose heart attacks. In angina, the test results reveal no permanent damage to the heart. The diagnosis is made only after the possibility of a heart attack has been ruled out, usually by negative results on three sets of cardiac enzyme tests. the ECG may show abnormalities, these changes are often reversible. * Another way to diagnose angina is the stress test: these tests monitor your ECG during exercise or other stress to identify blockages in blood vessels to the heart. * Cardiac catheterization is used to identify blockages. This is a special type of x-ray (angiography or arteriography) that uses a harmless dye to highlight blockages or other abnormalities in blood vessels. Aortic Dissection The diagnosis of aortic dissection is based on the symptoms the patient describes, chest x-ray, and other special imaging tests. On a chest x-ray, the aorta will have an abnormal contour or appear widened. * Transesophageal echocardiography is a specialized ultrasound of the heart in which a probe is inserted into the esophagus. The technique is performed under sedation or general anaesthesia. The dissection may be identified very accurately by a CT scan of the chest or angiography. * * Pulmonary Embolism * * The diagnosis of pulmonary embolism is made from a variety of sources. Description of the patient’s symptoms and results of ECG and chest x-ray all may contribute to the diagnosis, but are not definitive. patient will be asked if they have had any symptoms of a blood clot in the leg. The healthcare provider may draw blood drawn from the patient’s artery to check the levels of oxygen and other gases. Abnormalities in blood gases indicate a problem in the lungs that is preventing the patient from getting enough oxygen. A ventilation-perfusion scan (V/Q scan) compares blood flow to oxygen intake in different segments of the lung. An irregularity in just one segment can indicate an embolism. CT scan of the lungs is another way to determine if a patient has a pulmonary embolus. It may be done instead of the V/Q scan. Spontaneous Pneumothorax Spontaneous pneumothorax is diagnosed by physical exam and chest x-ray. A CT scan may be helpful in locating a small pneumothorax. Perforated viscus usually can be identified by a chest x-ray with the patient standing upright or an abdominal x-ray lying on the left side. -rays in these positions allow air to rise to the diaphragm, where it can be detected. The symptoms and the results of the physical exam and other lab tests also assist in diagnosis. * Pericarditis * * Acute pericarditis is usually diagnosed by the patient’s symptoms, serial ECGs, and echocardiography. Certain lab tests may be helpful in determining the cause. * * Pneumonia Pneumonia is diagnosed by the patient’s symptoms and medical history, physical examination, and chest x-ray. Esophagus Disorders of the esophagus causing chest pain are diagnosed by a process of elimination. The diagnosis is made on the basis of the patient’s symptoms and medical history, after ruling out cardiac causes and observing whether the patient experiences pain relief from antacids. Chest Pain Treatment Self-Care at Home Heart Attack If you suspect that you or someone you are with may be having a heart attack, call for emergency services or go to the nearest hospital emergency department. * While waiting for the ambulance, have the patient chew two baby aspirin or at least half of a regular aspirin – at least 160 mg. There is no evidence that taking more than this helps more, and the patient could have unwanted side effects if they take too much. * It is important to chew the aspirin before swallowing it because chewing decreases the time the medicine takes to have an effect. Chewing an aspirin in the early stages of a heart attack may reduce the risk of death and it may also reduce the severity of the attack. Angina If the patient has had angina and has nitroglycerin tablets available, have the patient place one under the tongue. This may aid in increasing blood flow to blocked or narrowed arteries. If the chest pain continues in the next five minutes, take another tablet under the tongue. If, after three nitroglycerin tablets, the patient does not have relief of the chest pain, go to the nearest emergency department. Esophagus the pain is from acid reflux (GERD), it may be relieved with antacids. Even if the patient’s pain goes away after taking an antacid, do not assume they are not having a heart attack. The patient should still be evaluated in a hospital emergency department. Medical Treatment Heart Attack Treatment 1. Treatment for a heart attack is aimed at increasing blood flow by opening arteries blocked or narrowed by a blood clot. * 2. Medicines used to achieve this include aspirin, heparin, and clot-busting (thrombolytic) drugs. * 3. Other medications can be used to slow the heart rate, which decreases the workload of the heart and reduces pain. * 4. Angioplasty is a way of unblocking an artery. Angiography is done first to locate narrowing or blockages. A very thin plastic tube called a catheter is inserted into the artery. A tiny balloon on the end of the catheter is inflated. This expands the artery, providing a wider passage for blood. The balloon is then deflated and removed. Sometimes a small metal scaffold called a stent is placed in the artery to keep it expanded. * 5. Surgery may be required if medical treatment is unsuccessful. This could include angioplasty or cardiac bypass. * * Angina Treatment * * Treatment of angina is directed at relieving chest pain that occurs as the result of reduced blood flow to the heart. The medication nitroglycerin is the most widely used treatment. Nitroglycerin dilates (widens) the coronary arteries. It is often taken under the tongue (sublingually). People with known angina may be treated with nitroglycerin for three doses, five minutes apart. the pain remains, nitroglycerin is given by IV, and the patient is admitted to the hospital and monitored to rule out a heart attack. Long-term treatment after the first episode of angina focuses on reducing risk factors for atherosclerosis and heart disease. Aortic Dissection Treatment 1. Suspected aortic dissection often is treated with medications that reduce blood pressure. 2. Medications that slow the heart rate and dilate the arteries are the most widely used. * 3. Close monitoring is required to avoid lowering the blood pressure too much, which can be dangerous. * 4. Surgical repair is required for any dissection that involves the ascending (upward) portion of the aorta. * * Pulmonary Embolism Treatment * * 1. Anyone with a presumed or documented pulmonary embolism requires admission to the hospital. * * 2. Treatment usually includes supplemental oxygen and medication to prevent further clotting of blood, typically heparin. * * 3. If the embolism is very large, clot-busting medications are given in some situations to dissolve the clot. * * 4. Some people undergo surgery to place an umbrella-like filter in a blood vessel to prevent blood clots from the lower extremities from moving to the lungs. * * Pneumothorax Treatment 1. A pneumothorax without symptoms involves six hours of hospital observation and repeat chest x-rays. * 2. If the size of the pneumothorax remains unchanged, the patient is usually discharged with a follow-up appointment in 24 hours. * 3. If the patient develop symptoms or the pneumothorax enlarges, they will be admitted to the hospital. The patient will undergo catheter aspiration or have a chest tube inserted to restore negative pressure in the lung sac. Perforated Viscus Treatment Any disruption or perforation of the intestinal tract (viscus) is a potentially life-threatening emergency. Immediate surgery may be required. Pericarditis Treatment Viral pericarditis usually improves with 7-21 days of therapy with nonsteroidal anti-inflammatory agents such as aspirin andibuprofen (for example, Motrin). Pneumonia Treatment Pneumonia is treated with antibiotics, and pain medication is given for chest wall tenderness. Costochondritis Treatment Costochondritis is usually treated with nonsteroidal anti-inflammatory medication such as ibuprofen. Esophageal Conditions Treatment The three major esophageal disorders that cause chest pain; 1) acid reflux (GERD), 2) esophagitis, and 3) esophageal spasm, are treated with antacid therapy; antibiotic, antiviral, or antifungal medication; medication to relax the muscles of the esophagus; or some combination of these. Follow-up No matter what the cause of chest pain, regular follow-up visits with your healthcare provider are important. This will help you remain as healthy as possible and prevent worsening of your condition. Prevention Heart Attack Prevention Prevention of heart attack and angina involves living what the American Heart Association calls a â€Å"heart healthy† lifestyle. Reducing your risk factors has a significant effect on reducing your risk. * (a) Don’t smoke. * (b) Maintain a healthy weight. * (c) Eat nutritious, low-fat foods in moderate quantities. * (d) If you drink alcohol, use alcohol moderately. * (e) Engage in physical activity or exercise for at least 30 minutes every day. (f) Control high blood pressure and high cholesterol. * (g) If you have diabetes, control your blood sugar every day. Aortic Dissection Prevention Aortic dissection may be prevented by controlling high blood pressure and getting proper screening if the patient has a familial disposition to this disorder. Pulmonary Embolism Prevention (a) Prevention of pulmonary embolism includes living a heart healthy life style. (b) No one should smoke, but women older than 35 years who use birth control pills are at especially high risk from smoking. c) When traveling on extended trips that require sitting for long periods of time (plane, car, train, etc. ) or other times of leg immobilization, get up and allow time for stretching and movement of the legs. Isometric contractions of the calves are helpful if getting out of the seat is not possible. * (d) If the patient has leg swelling, particularly if one is disproportionate to the other, see the doctor or healthcare provider. (e) You should always receive preventive anticoagulant medication after surgery, especially after orthopedic surgery. Spontaneous Pneumothorax Prevention Smoking cessation decreases the risk of spontaneous pneumothorax. Perforated Viscus Prevention Treating peptic ulcers appropriately and avoiding swallowing foreign bodies reduces the risk of perforated viscus. Pericarditis Prevention Because many cases of acute pericarditis are caused by viruses, effective handwashing may reduce transmission of infectious viral agents. Pneumonia Prevention Effective handwashing and good hygiene will help reduce the transmission of infectious viruses and bacteria that can cause pneumonia. Esophagus Disease Prevention (a) Acid reflux (GERD) can be prevented to a certain extent in most people. * (b) Avoid foods and other substances that bring on or worsen symptoms, especially fatty foods * (c) Stop smoking * (d) Use alcohol in moderation, if at all * (e) Avoid eating large meals * (f) Avoid eating for three hours before bedtime * (g) Avoid lying down right after eating * (h) Elevate the head of your bed Outlook Early medical intervention improves survival in potentially life-threatening illnesses involving chest pain. Heart attack and unstable angina: Heart disease, which includes heart attacks and angina, is the leading cause of death for American adults . Whether you survive a heart attack depends on the time it takes to get medical treatment, the region and extent of injury within the heart, and the presence of any other risk factors. Aortic dissection: This condition is life-threatening. Quick action in getting medical treatment is essential with aortic dissection. When left untreated, about 33% of patients die within the first 24 hours, and 50% die within 48 hours. The two week mortality rate approaches 75% in patients with undiagnosed ascending aortic dissection. Pulmonary embolism: Even with early treatment, 1 in 10 people with pulmonary embolism die within the first hour. It is treatable if it is not rapidly severe and caught early. Patients are often maintained on blood thinners as treatment. Pneumothorax: Most people with this condition recover fully as long as it is not associated with other life-threatening injuries (like in an auto accident). It occurs mostly tall, thin, young people without lung disease. Patients who have had one spontaneous pneumothorax have about a 50% chance of recurrence. Other illnesses causing pneumothorax and complications from the chest tube placement may prolong or worsen the condition. Perforated viscus: With early detection and intervention, the prognosis for perforated viscus is good in relatively healthy people. If you are in poor health prior to the perforation you will have a worse outcome. Acute pericarditis: Although the course may vary with each person, the outcome is good if the disorder is treated promptly. Most people recover in two weeks to three months. Pneumonia: In young, healthy adults, the prognosis for pneumonia is good with appropriate treatment. Prognosis is generally poorer in the elderly and in people with weakened immune systems such as those with HIV/AIDS. Chest pain originating from the esophagus: Reflux disease (GERD) affects about one-fourth of the adult population and has a very low death rate. Esophagitis may lead to ulcerations, scarring, or narrowing of the esophagus. With the exception of possible perforation, which has a high death rate, the overall prognosis is good. Esophageal spasm has a good outcome. How to cite Chest Pain, Papers

Chest Pain Free Essays

string(99) " findings have changed our thinking on HRT; long-term HRT is no longer recommended for most women\." CHEST PAIN Chest Pain Overview If you are having severe pain, crushing, squeezing, or pressure in your chest that lasts more than a few minutes, or if the pain moves into your neck, left shoulder, arm, or jaw, go immediately to a hospital emergency department. Chest pain is one of the most frightening symptoms a person can have. It is sometimes difficult even for a doctor or other medical professional to tell what is causing chest pain and whether it is life-threatening. We will write a custom essay sample on Chest Pain or any similar topic only for you Order Now * Any part of the chest can be the cause of the pain including the heart, lungs, esophagus, muscle, bone, and skin. Because of the complex nerve distribution in the body, chest pain may actually originate from another part of the body. * The stomach or other organs in the belly (abdomen), for example, can cause chest pain. Potentially life-threatening causes of chest pain are as follows: Causes of Chest Pain 1. Heart attack (acute myocardial infarction): A heart attack occurs when blood flow to the arteries that supply the heart (coronary arteries) becomes blocked. With decreased blood flow, the muscle of the heart does not receive enough oxygen. This can cause damage, deterioration, and death of the heart muscle. . Angina: Angina is chest pain related to an imbalance between the oxygen demand of the heart and the amount of oxygen delivered via the blood. It is caused by blockage or narrowing of the blood vessels that supply blood to the heart. Angina is different from a heart attac k in that the arteries are not completely blocked, and it causes little or no permanent damage to the heart. â€Å"Stable† angina occurs repetitively and predictably while exercising and goes away with rest. â€Å"Unstable† angina results in unusual and unpredictable pain not relieved totally by rest, or pain that actually occurs at rest. . Aortic dissection: The aorta is the main artery that supplies blood to the vital organs of the body, such as the brain, heart, kidneys, lungs, and intestines. Dissection means a tear in the inner lining of the aorta. This can cause massive internal bleeding and interrupt blood flow to the vital organs. 4. Pulmonary embolism: A pulmonary embolus is a blood clot in one of the major blood vessels that supplies the lungs. It is a potentially life-threatening cause of chest pain but is not associated with the heart. 5. Spontaneous pneumothorax: Often called a collapsed lung, this condition occurs when air enters the saclike space between the chest wall and the lung tissue. Normally, negative pressure in the chest cavity allows the lungs to expand. When a spontaneous pneumothorax occurs, air enters the chest cavity. When the pressure balance is lost, the lung is unable to re-expand. This cuts off the normal oxygen supply in the body. 6. Perforated viscus: A perforated viscus is a hole or tear in the wall of any area of the gastrointestinal tract. This allows air to enter the abdominal cavity, which irritates the diaphragm, and can cause chest pain. . Cocaine-induced chest pain: Cocaine causes the blood vessels in the body to constrict. This can decrease blood flow to the heart, causing chest pain. Cocaine also accelerates the progression of atherosclerosis, a risk factor for a heart attack. Causes of chest pain that are not immediately life-threatening include the following: 8. Acute pericarditis: T his is an inflammation of the pericardium, which is the sac that covers the heart. 9. Mitral valve prolapse: Mitral valve prolapse is an abnormality of one of the heart valves in which the â€Å"leaves† of the valve bulge into the upper heart chamber during contraction. When this occurs, a small amount of blood flows backward in the heart. This is believed by some to be a cause of chest pain in certain people, although this has not been proven with certainty. 10. Pneumonia: Pneumonia is an infection of the lung tissue. Chest pain occurs because of inflammation to the lining of the lungs. 11. Disorders of the esophagus: Chest pain from esophageal disorders can be an alarming symptom because it often mimics chest pain from a heart attack. (a)Acid reflux disease (gastroesophageal reflux disease, GERD, heartburn) occurs when acidic digestive juices flow backward from the stomach into the esophagus. The resulting heartburn is sometimes experienced as chest pain. (b)Esophagitis is an inflammation of the esophagus. (c)Esophageal spasm is defined as excessive, intensified, or uncoordinated contractions of the smooth muscle of the esophagus. 12. Costochondritis: This is an inflammation of the cartilage between the ribs. Pain is typically located in the mid-chest, with intermittently dull and sharp pain that may be increased with deep breaths, movement, and deep touch. 13. Herpes zoster: Also known as shingles, this is a reactivation of the viral infection that causes chickenpox. With shingles, a rash occurs, usually only on one small part of the body. The pain, often very severe, is usually confined to the area of the rash. The pain may precede the rash by 4-7 days. Risk factors include any condition in which the immune system is compromised, such as advanced age, HIV, or cancer. Herpes zoster is highly contagious to people who have not had chickenpox or have not been vaccinated against chickenpox for the five days before and the five days after the appearance of the rash. HEART ATTACK A heart attack is caused by coronary heart disease, or coronary artery disease. Heart disease may be caused by cholesterol build-up in the coronary arteries (atherosclerosis), blood clots, or spasm of the vessels that supply blood to the heart. Risk factors for a heart attack are:- (a) High blood pressure (b) Diabetes (c) Smoking (d) High cholesterol (e) Family history of heart attacks at ages younger than 60 years, one or more previous heart attacks, male gender (f) Obesity (g) Postmenopausal women are at higher risk than premenopausal women. This is thought to be due to loss of the protective effects of the hormone estrogen at menopause. It was previously treated by hormone supplements (hormone replacement therapy, or HRT). However, research findings have changed our thinking on HRT; long-term HRT is no longer recommended for most women. You read "Chest Pain" in category "Papers" (h) Use of cocaine and similar stimulants. Angina Causes 1. Angina may be caused by spasm, narrowing, or partial blockage of an artery that supplies blood to the heart. 2. The most common cause is coronary heart disease, in which a blood clot or buildup of fatty material inside the blood vessel (atherosclerosis) reduces blood flow but does not completely block the blood vessel. 3. Angina can be triggered by exercise or physical exertion, by emotional stress, or by certain heart rhythm disorders (arrhythmias) that cause the heart to beat very fast. Aortic Dissection Causes Aortic dissection may be caused by conditions that damage the innermost lining of the aorta. (a)These include uncontrolled high blood pressure, connective-tissue diseases, cocaine use, advanced age, pregnancy, congenital heart disease, and cardiac catheterization (a medical procedure). (b) Men are at higher risk than women. (c) A similar condition is aortic aneurysm. This is an enlargement of the aorta that can rupture, causing pain and bleeding. Aneurysms can occur in the aorta in the chest or the abdomen. Pulmonary Embolism Causes Pulmonary embolism risk factors include: (a)Sedentary lifestyle, (b)Obesity, (c)Prolonged immobility, (d) Fracture of a long bone of the legs, (e) Pregnancy, (f)Cancer, (g) History or family history of blood clots, (j)Irregular heartbeat (arrhythmias), (k) Heart attack, (l)Congestive heart failure. Spontaneous Pneumothorax Causes 1. Spontaneous pneumothorax (collapsed lung) occurs when the pressure balance between the sac that contains the lung and the outside atmosphere is disrupted. 2. Injury to the chest that pierces through to the lung sac is the most common cause of this condition. This can be caused by trauma, as in a car wreck, bad fall, gunshot wound or stabbing, or in surgery. 3. Some very thin and tall people may suffer a spontaneous pneumothorax due to stretched lung tissues and abnormal air sacs in the upper portions of their lungs. It is possible for these abnormal air sacs to rupture with even a sneeze or excessive coughing. 4. Other risk factors for pneumothorax include AIDS-related pneumonia, emphysema, severe asthma, cystic fibrosis, cancer, and marijuana and crack cocaine use Perforated Viscus Causes Perforated viscus may be caused by direct or indirect injury. Irritation to the diaphragm in this case comes from below the chest. The diaphragm is the muscle that allows us to breathe. It is located up under the ribs and separates the chest and abdominal cavity. Any irritation to the diaphragm, even from below it, can cause pain to be felt in the chest. Risk factors not related to trauma are: (a)Untreated ulcers, * (b)Prolonged or forceful vomiting, * (c)Swallowing a foreign body, * (d)Cancer, * (e)Appendicitis, * (f)Long-term steroid use, (g)Infection of the gallbladder, * (h)Gallstones, and * (j)AIDS. * * * Pericarditis Causes Pericarditis can be caused by viral infection, bacterial infection, cancer, connective-tissue diseases, certain medications, radiation treatment, and chronic renal failure. (a) One life-threatening complication of pericarditis is cardiac tamponade. Cardiac tamponade is an accumulation of fluid around the heart. This prevents the hear t from effectively pumping blood to the body. Symptoms of cardiac tamponade include sudden onset of shortness of breath, fainting, and chest pain. Pneumonia Causes Pneumonia may be caused by viral, bacterial, or fungal infections of the lungs. Esophagus Related Causes Chest pain originating from the esophagus may have several causes. Acid reflux (GERD) may be caused by any factors that decrease the pressure on the lower part of the esophagus, decreased movement of the esophagus, or prolonged emptying of the stomach. This condition may be brought on by: (a)Consumption of high-fat foods, (b)Nicotine use, (c)Alcohol use, (d)Caffeine, pregnancy, (d) Certain medications (for example, nitrates, calcium channel blockers, anticholinergics, estrogen, progesterone), (f)diabetes, g)scleroderma. (h) Esophagitis may be caused by yeast, fungi, viruses, bacteria, or irritation from medications. (j) Esophageal spasm is caused by excessive, intensified, or uncoordinated contractions of the smooth muscle of the esophagus. Spasm may be triggered by emotional upset or swallowing very hot or cold liquids. Heart Attack Symptoms Typical heart attack pain occurs in th e mid to left side of the chest and may also extend to the left shoulder, the left arm, the jaw, the stomach, or the back. Other associated symptoms are shortness of breath, increased sweating, nausea, and vomiting. Women may experience symptoms of heart attack similar to men (chest pain), but they also may be more atypical. Atypical symptoms include: (a) Neck pain (b) Jaw pain (c) Shoulder pain (d) Upper back (e) Abdominal discomfort, (f) Shortness of breath, (g) Nausea or vomiting, (h) Abdominal pain, (j)Heartburn, (k) Sweatiness, (l) Light-headedness, (m) Dizziness, or (n) Unexplained fatigue. * Angina Symptoms Angina is similar to heart attack pain but occurs with physical exertion or exercise and is relieved by rest or nitroglycerin. Angina becomes life threatening when pain occurs at rest, has increased in frequency or intensity, or is not relieved with at least three nitroglycerin tablets taken five minutes apart. This is considered to be unstable angina, which may be a warning sign of an impending heart attack. Aortic Dissection Symptoms The chest pain associated with aortic dissection occurs suddenly and is described as â€Å"ripping† or â€Å"tearing. † The pain may radiate to the back or between the shoulder blades. Because the aorta supplies blood to the entire body, symptoms may also include: (a)Angina-type pain, (b)Shortness of breath, (c)Fainting, d)Abdominal pain, or (e)Symptoms of stroke. Pulmonary Embolism Symptoms Symptoms of a pulmonary embolus include: The sudden onset of shortness of breath, rapid breathing, and sharp pain in the mid chest, which increases with deep breaths. Symptoms of pneumothorax include: The sudden onset of shortness of breath,sharp chest pain, rapid heart rate, dizziness, lightheadedness, or faintness. Perforated Viscus Symptoms Perforated viscus comes on suddenly with severe abdominal, chest, and/or back pain. Abdominal pain may increase with movement or when breathing in and may be accompanied by a rigid, boardlike abdominal wall. Pericarditis Symptoms The pain of pericarditis is typically described as a sharp or stabbing pain in the mid-chest, worsened by deep breaths. pain may mimic the pain of a heart attack, because it may radiate to the left side of the back or shoulder. One distinguishing factor is that the pain is worsened by lying flat and improved by leaning forward. When lying flat, the inflamed pericardium is in direct contact with the heart and causes pain. When leaning forward, there is a space between the pericardium and the heart. people report a recent cold, fever, shortness of breath, or pain when swallowing just before developing pericarditis. Mitral Valve Prolapse Symptoms Mitral valve prolapse usually has no symptoms, but some people experience palpitations (sensation of rapid or strong heartbeat) and chest pain. Chest pain associated with mitral valve prolapse differs from that of typical angina in that it is sharp, does not radiate, and is not related to physical exertion. Other symptoms include fatigue, light-headedness, and shortness of breath. Complications include infection of the heart valves, mitral valve regurgitation (an abnormal blood flow within the chambers of the heart), and abnormal heart rhythms, which rarely cause sudden death. Pneumonia Symptoms The chest pain of pneumonia occurs during prolonged or forceful coughing. The pain is usually one-sided an is worsened by coughing. Other associated symptoms include fever, coughing up mucus (sputum), and shortness of breath. Esophagus Related Symptoms With chest pain originating from the esophagus, symptoms depend on the source. * (a)Symptoms of gastroesophageal reflux disease (GERD) include: (b)Heartburn, (c)Painful swallowing, (d)Excessive salivation, (e)Dull chest discomfort, (f)Chest pressure, or (g)Severe squeezing pain across the mid chest. h)You may feel uncomfortable or may experience: (j)Profuse sweating, (k)Pallor, (l)Nausea, and (m)Vomiting. Symptoms of esophagitis include difficulty swallowing, painful swallowing, or symptoms of GERD. The chest pain comes on suddenly and is not relieved by antacids. The pain of esophageal spasm is usually intermittent and dull. It is located in the mid-chest and may radiate to the back, neck, or shoulders. DIAGNOSIS He art Attack In the hospital emergency department, the healthcare providers use three basic procedures to decide if a patient is having a heart attack. (a) The first is the symptoms reported by the patient. * (b) The second is an electrocardiogram (ECG or EKG), an electrical tracing of the heart’s activity. On the ECG, it may be possible to tell which vessels in the heart are blocked or narrowed. * (c) The third is measurement of enzymes produced by the heart muscle cells when they do not receive enough oxygen. These enzymes are detectable with blood tests and are called cardiac enzymes. Angina Angina is diagnosed by the same methods doctors use to diagnose heart attacks. In angina, the test results reveal no permanent damage to the heart. The diagnosis is made only after the possibility of a heart attack has been ruled out, usually by negative results on three sets of cardiac enzyme tests. the ECG may show abnormalities, these changes are often reversible. * Another way to diagnose angina is the stress test: these tests monitor your ECG during exercise or other stress to identify blockages in blood vessels to the heart. * Cardiac catheterization is used to identify blockages. This is a special type of x-ray (angiography or arteriography) that uses a harmless dye to highlight blockages or other abnormalities in blood vessels. Aortic Dissection The diagnosis of aortic dissection is based on the symptoms the patient describes, chest x-ray, and other special imaging tests. On a chest x-ray, the aorta will have an abnormal contour or appear widened. * Transesophageal echocardiography is a specialized ultrasound of the heart in which a probe is inserted into the esophagus. The technique is performed under sedation or general anaesthesia. The dissection may be identified very accurately by a CT scan of the chest or angiography. * * Pulmonary Embolism * * The diagnosis of pulmonary embolism is made from a variety of sources. Description of the patient’s symptoms and results of ECG and chest x-ray all may contribute to the diagnosis, but are not definitive. patient will be asked if they have had any symptoms of a blood clot in the leg. The healthcare provider may draw blood drawn from the patient’s artery to check the levels of oxygen and other gases. Abnormalities in blood gases indicate a problem in the lungs that is preventing the patient from getting enough oxygen. A ventilation-perfusion scan (V/Q scan) compares blood flow to oxygen intake in different segments of the lung. An irregularity in just one segment can indicate an embolism. CT scan of the lungs is another way to determine if a patient has a pulmonary embolus. It may be done instead of the V/Q scan. Spontaneous Pneumothorax Spontaneous pneumothorax is diagnosed by physical exam and chest x-ray. A CT scan may be helpful in locating a small pneumothorax. Perforated viscus usually can be identified by a chest x-ray with the patient standing upright or an abdominal x-ray lying on the left side. -rays in these positions allow air to rise to the diaphragm, where it can be detected. The symptoms and the results of the physical exam and other lab tests also assist in diagnosis. * Pericarditis * * Acute pericarditis is usually diagnosed by the patient’s symptoms, serial ECGs, and echocardiography. Certain lab tests may be helpful in determining the cause. * * Pneumonia Pneumonia is diagnosed by the patient’s symptoms and medical history, physical examination, and chest x-ray. Esophagus Disorders of the esophagus causing chest pain are diagnosed by a process of elimination. The diagnosis is made on the basis of the patient’s symptoms and medical history, after ruling out cardiac causes and observing whether the patient experiences pain relief from antacids. Chest Pain Treatment Self-Care at Home Heart Attack If you suspect that you or someone you are with may be having a heart attack, call for emergency services or go to the nearest hospital emergency department. * While waiting for the ambulance, have the patient chew two baby aspirin or at least half of a regular aspirin – at least 160 mg. There is no evidence that taking more than this helps more, and the patient could have unwanted side effects if they take too much. * It is important to chew the aspirin before swallowing it because chewing decreases the time the medicine takes to have an effect. Chewing an aspirin in the early stages of a heart attack may reduce the risk of death and it may also reduce the severity of the attack. Angina If the patient has had angina and has nitroglycerin tablets available, have the patient place one under the tongue. This may aid in increasing blood flow to blocked or narrowed arteries. If the chest pain continues in the next five minutes, take another tablet under the tongue. If, after three nitroglycerin tablets, the patient does not have relief of the chest pain, go to the nearest emergency department. Esophagus the pain is from acid reflux (GERD), it may be relieved with antacids. Even if the patient’s pain goes away after taking an antacid, do not assume they are not having a heart attack. The patient should still be evaluated in a hospital emergency department. Medical Treatment Heart Attack Treatment 1. Treatment for a heart attack is aimed at increasing blood flow by opening arteries blocked or narrowed by a blood clot. * 2. Medicines used to achieve this include aspirin, heparin, and clot-busting (thrombolytic) drugs. * 3. Other medications can be used to slow the heart rate, which decreases the workload of the heart and reduces pain. * 4. Angioplasty is a way of unblocking an artery. Angiography is done first to locate narrowing or blockages. A very thin plastic tube called a catheter is inserted into the artery. A tiny balloon on the end of the catheter is inflated. This expands the artery, providing a wider passage for blood. The balloon is then deflated and removed. Sometimes a small metal scaffold called a stent is placed in the artery to keep it expanded. * 5. Surgery may be required if medical treatment is unsuccessful. This could include angioplasty or cardiac bypass. * * Angina Treatment * * Treatment of angina is directed at relieving chest pain that occurs as the result of reduced blood flow to the heart. The medication nitroglycerin is the most widely used treatment. Nitroglycerin dilates (widens) the coronary arteries. It is often taken under the tongue (sublingually). People with known angina may be treated with nitroglycerin for three doses, five minutes apart. the pain remains, nitroglycerin is given by IV, and the patient is admitted to the hospital and monitored to rule out a heart attack. Long-term treatment after the first episode of angina focuses on reducing risk factors for atherosclerosis and heart disease. Aortic Dissection Treatment 1. Suspected aortic dissection often is treated with medications that reduce blood pressure. 2. Medications that slow the heart rate and dilate the arteries are the most widely used. * 3. Close monitoring is required to avoid lowering the blood pressure too much, which can be dangerous. * 4. Surgical repair is required for any dissection that involves the ascending (upward) portion of the aorta. * * Pulmonary Embolism Treatment * * 1. Anyone with a presumed or documented pulmonary embolism requires admission to the hospital. * * 2. Treatment usually includes supplemental oxygen and medication to prevent further clotting of blood, typically heparin. * * 3. If the embolism is very large, clot-busting medications are given in some situations to dissolve the clot. * * 4. Some people undergo surgery to place an umbrella-like filter in a blood vessel to prevent blood clots from the lower extremities from moving to the lungs. * * Pneumothorax Treatment 1. A pneumothorax without symptoms involves six hours of hospital observation and repeat chest x-rays. * 2. If the size of the pneumothorax remains unchanged, the patient is usually discharged with a follow-up appointment in 24 hours. * 3. If the patient develop symptoms or the pneumothorax enlarges, they will be admitted to the hospital. The patient will undergo catheter aspiration or have a chest tube inserted to restore negative pressure in the lung sac. Perforated Viscus Treatment Any disruption or perforation of the intestinal tract (viscus) is a potentially life-threatening emergency. Immediate surgery may be required. Pericarditis Treatment Viral pericarditis usually improves with 7-21 days of therapy with nonsteroidal anti-inflammatory agents such as aspirin andibuprofen (for example, Motrin). Pneumonia Treatment Pneumonia is treated with antibiotics, and pain medication is given for chest wall tenderness. Costochondritis Treatment Costochondritis is usually treated with nonsteroidal anti-inflammatory medication such as ibuprofen. Esophageal Conditions Treatment The three major esophageal disorders that cause chest pain; 1) acid reflux (GERD), 2) esophagitis, and 3) esophageal spasm, are treated with antacid therapy; antibiotic, antiviral, or antifungal medication; medication to relax the muscles of the esophagus; or some combination of these. Follow-up No matter what the cause of chest pain, regular follow-up visits with your healthcare provider are important. This will help you remain as healthy as possible and prevent worsening of your condition. Prevention Heart Attack Prevention Prevention of heart attack and angina involves living what the American Heart Association calls a â€Å"heart healthy† lifestyle. Reducing your risk factors has a significant effect on reducing your risk. * (a) Don’t smoke. * (b) Maintain a healthy weight. * (c) Eat nutritious, low-fat foods in moderate quantities. * (d) If you drink alcohol, use alcohol moderately. * (e) Engage in physical activity or exercise for at least 30 minutes every day. (f) Control high blood pressure and high cholesterol. * (g) If you have diabetes, control your blood sugar every day. Aortic Dissection Prevention Aortic dissection may be prevented by controlling high blood pressure and getting proper screening if the patient has a familial disposition to this disorder. Pulmonary Embolism Prevention (a) Prevention of pulmonary embolism includes living a heart healthy life style. (b) No one should smoke, but women older than 35 years who use birth control pills are at especially high risk from smoking. c) When traveling on extended trips that require sitting for long periods of time (plane, car, train, etc. ) or other times of leg immobilization, get up and allow time for stretching and movement of the legs. Isometric contractions of the calves are helpful if getting out of the seat is not possible. * (d) If the patient has leg swelling, particularly if one is disproportionate to the other, see the doctor or healthcare provider. (e) You should always receive preventive anticoagulant medication after surgery, especially after orthopedic surgery. Spontaneous Pneumothorax Prevention Smoking cessation decreases the risk of spontaneous pneumothorax. Perforated Viscus Prevention Treating peptic ulcers appropriately and avoiding swallowing foreign bodies reduces the risk of perforated viscus. Pericarditis Prevention Because many cases of acute pericarditis are caused by viruses, effective handwashing may reduce transmission of infectious viral agents. Pneumonia Prevention Effective handwashing and good hygiene will help reduce the transmission of infectious viruses and bacteria that can cause pneumonia. Esophagus Disease Prevention (a) Acid reflux (GERD) can be prevented to a certain extent in most people. * (b) Avoid foods and other substances that bring on or worsen symptoms, especially fatty foods * (c) Stop smoking * (d) Use alcohol in moderation, if at all * (e) Avoid eating large meals * (f) Avoid eating for three hours before bedtime * (g) Avoid lying down right after eating * (h) Elevate the head of your bed Outlook Early medical intervention improves survival in potentially life-threatening illnesses involving chest pain. Heart attack and unstable angina: Heart disease, which includes heart attacks and angina, is the leading cause of death for American adults . Whether you survive a heart attack depends on the time it takes to get medical treatment, the region and extent of injury within the heart, and the presence of any other risk factors. Aortic dissection: This condition is life-threatening. Quick action in getting medical treatment is essential with aortic dissection. When left untreated, about 33% of patients die within the first 24 hours, and 50% die within 48 hours. The two week mortality rate approaches 75% in patients with undiagnosed ascending aortic dissection. Pulmonary embolism: Even with early treatment, 1 in 10 people with pulmonary embolism die within the first hour. It is treatable if it is not rapidly severe and caught early. Patients are often maintained on blood thinners as treatment. Pneumothorax: Most people with this condition recover fully as long as it is not associated with other life-threatening injuries (like in an auto accident). It occurs mostly tall, thin, young people without lung disease. Patients who have had one spontaneous pneumothorax have about a 50% chance of recurrence. Other illnesses causing pneumothorax and complications from the chest tube placement may prolong or worsen the condition. Perforated viscus: With early detection and intervention, the prognosis for perforated viscus is good in relatively healthy people. If you are in poor health prior to the perforation you will have a worse outcome. Acute pericarditis: Although the course may vary with each person, the outcome is good if the disorder is treated promptly. Most people recover in two weeks to three months. Pneumonia: In young, healthy adults, the prognosis for pneumonia is good with appropriate treatment. Prognosis is generally poorer in the elderly and in people with weakened immune systems such as those with HIV/AIDS. Chest pain originating from the esophagus: Reflux disease (GERD) affects about one-fourth of the adult population and has a very low death rate. Esophagitis may lead to ulcerations, scarring, or narrowing of the esophagus. With the exception of possible perforation, which has a high death rate, the overall prognosis is good. Esophageal spasm has a good outcome. How to cite Chest Pain, Papers