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Chest Pain (cont.)

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Shingles

The rash of shingles is caused by the varicella zoster virus, the same one that causes chickenpox. Once the virus enters the body, it hibernates in the nerve roots of the spinal column, only to emerge sometime in the future. The rash is diagnostic as it follows the nerve root as it leaves the back, and circles to the front of the chest, but not crossing the midline.

Once the rash appears, the diagnosis is relatively easy for the health care professional. Unfortunately, the pain of shingles may begin a few days before the rash emerges and can be confusing to both patient and health care professional, since the pain and burning may seem out of proportion to the findings on physical examination.

The treatment for shingles includes antiviral medications like acyclovir (Zovirax) along with pain control medication. Since it is the nerve that has become inflamed, the pain can be quite severe. Some patients may develop postherpetic neuralgia, or chronic pain from the inflamed nerve, which may persist long after the infection has cleared. A variety of pain control strategies are available from medication to pain stimulators to surgery. For more, please read the Shingles article.

The lungs

Pneumonia

An infection of the lung is called pneumonia, in which inflammation can cause fluid buildup within a segment of the lung tissue, decreasing its ability to transfer oxygen from air to the bloodstream.

Pneumonia presents with the typical symptoms of an infection:

  • fever,
  • chills, and
  • malaise.

There may also be:

  • cough,
  • shortness of breath, and
  • sputum production (coughing up mucus).

The chest pain is pleuritic, hurting when taking a deep breath.

The classic presentation of a lung infection caused by the bacteria Streptococcal pneumoniae or pneumococcus, one of the most common causes of pneumonia, is acute onset of shaking chills, fever, and a cough that produces rusty brown sputum.

Physical examination may find the patient to have abnormal vital signs consistent with an infection. The pulse rate and respiratory rate may be elevated. A fever may be present. Listening to the chest may reveal decreased air entry in the area of the infection associated with crackles and occasionally wheezing because of inflammation and narrowing of the bronchial tubes.

A chest X-ray helps make the diagnosis, though the X-ray image sometimes lags behind the clinical findings by a day or two. Blood tests may be used to assess the severity of illness and may include a white blood cell count (markedly elevated or abnormally low counts may indicate more severe illness). Oxygen saturation measured with a probe attached to the finger is a way of assessing oxygenation of the blood and is routinely performed on patients with chest pain or shortness of breath. An arterial blood gas can exactly measure the amount of oxygen and carbon dioxide in the bloodstream to help determine the level of lung function.

Pneumonia may be caused by viruses or bacteria. The latter are treated with antibiotics, either by mouth or in the hospital by intravenous infusion. The general health and past medical history of the patient may guide the decision as to whether inpatient or outpatient therapy is most appropriate. For more, please read the Pneumonia article.

Medically Reviewed by a Doctor on 7/9/2014

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Chest Pain - Cause Question: What was the cause of your chest pain?
Chest Pain - Treatment Question: What was the treatment for your chest pain?
Chest Pain - Broken or Bruised Ribs Question: Was the cause of your chest pain broken or bruised ribs? Please share your story.
Chest Pain - Diagnosis Question: What were the tests and exams you received for your chest pain? What was the diagnosis?
Chest Pain - Pneumothorax Question: If the cause of your chest pain was pneumothorax, please discuss the tests, diagnosis and treatment.
Chest Pain - Angina and Heart Attack Question: Was angina the reason for your chest pain ? Please share your experience.
Source: MedicineNet.com
http://www.medicinenet.com/chest_pain/article.htm

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