Everything You Need To Know About Chest Pain And Why You May Need A CT Cardiac Scan

Chest pain can happen for a number of reasons that could be associated with your heart, lungs, or the digestive system. Some of the causes of chest pain can be life-threatening, whereas others can point towards a non-life-threatening condition. In the event when the cause of the chest pain is a heart issue, it can become fatal if no action is taken immediately. Therefore, whenever you feel sharp chest pain, you should consult a medical professional to rule out any life-threatening conditions. A specialist doctor may carry out investigations which may include a cardiac CT scan to diagnose the condition correctly and start the appropriate treatment.

man experiencing chest pain

What Causes Chest Pain?

Sudden onset of chest pain when breathing that goes away quickly can be caused by a number of factors. Chest pain can be described as either a stabbing pain like an electric shock, burning sensation, dull, squeezing, and pressurising. In any case, it may be caused by any of the following reasons:

Gastroesophageal Reflux Disease (GERD) or Heartburn

Heartburn is a very common cause of chest pain. When the acid in the stomach splashes up into the oesophagus, it can cause chest pain or a burning sensation in the chest.

Muscle Strain

If the bones or muscles in your ribcage get injured or strained during any high impact activity like working out, injury, or a fall, it can cause sudden pain in the chest. If the muscle or bone irritates an adjoining nerve, it can cause chest pain.

Precordial Catch Syndrome

Precordial Catch Syndrome refers to a condition where a nerve in the chest gets pinched or a chest muscle spasms, resulting in sudden sharp pain in the chest. This is a harmless condition that is usually common among children and young adults, however any person can experience it.

Anxiety

Anxiety and panic attacks can cause sharp pain in the chest and tightness that may also be mistaken for a heart attack. Individuals suffering from anxiety may experience such sudden pain or discomfort after a stressful event.

Lung Problems

Chest pain is also often caused by lung problems. Some of these conditions may be serious whereas others are not that serious but can contribute towards chest pains. These conditions include:

  • Asthma
  • Pneumonia
  • Pleuritis or pleural effusion
  • Collapsed lung
  • Pulmonary embolism
  • Pulmonary hypertension
  • Chest infection

Heart Problems

Chest pain caused by a heart attack is typically described as a dull, crushing pain or a feeling of tightness in the chest. The pain may continue and worsen with time or it may last for a few minutes and then go away, only to return again later. There are 2 distinct types of chest pain in patient with coronary artery disease. The stable type is when the chest pain symptom is mainly related to exertion/emotional stress and can be relieved with rest. The unstable type is when the symptoms can happen at any time where the pain usually lasts more than 30 minutes and associated with other symptoms like shortness of breath, sweating and nausea. Moreover, chest pain caused by a heart attack cannot be pinpointed to a specific location; patients often feel diffused and widespread pain all over their chest which may or may not travel towards their neck, jaw, and arms. Apart from a heart attack, other heart problems like angina and myocarditis can cause a sudden pain in the chest.

Digestive System Disorders

Some digestive system disorders can also cause chest pain such as gallstones, pancreas inflammation, muscle spasms in the chest wall, and swallowing disorders.

a man having chest pain in the midst of work

When To Seek Medical Attention For Chest Pain

If you feel chest pain symptoms that resemble those of a heart attack, it is essential to immediately seek medical attention. Race towards the nearest hospital if you feel:

  • Dull, squeezing, and crushing pressure in the chest.
  • Spread out pain in the chest
  • That the pain lasts for more than a few minutes and gets worse with activity.
  • Chest pain that worsens when you take a deep breath.
  • Chest pain that worsens when you cough.

CT Scan Room from Radlink

What is Cardiac CT Scan?

If you experience chest pain symptoms, your doctor may order a cardiac computerised tomography (CT) scan to diagnose its underlying cause. Let’s go into detail about a cardiac CT scan in Singapore.

Find out about the difference between MRI and CT Scans in this article.

How does a CT cardiac scan work?

A cardiac CT scan is a non-invasive imaging test that is performed to evaluate the heart and its surrounding muscles to check for any blockages or narrowing of the arteries. A cardiac CT scan machine works by using x-rays generated from multiple angles to acquire high-quality 3D images of the heart muscle and surrounding areas.

Sometimes, plaque and buildup of calcium and other substances can narrow or block the coronary arteries that can hinder the blood flow to the heart resulting in chest pain and heart attack. A cardiac CT scan can allow doctors to identify the location and extent of buildup in the arteries that can help them recommend a treatment plan for the patient.

A cardiac CT scan can be done with or without a dye contrast to better visualise the heart, vessels, and other structures. A cardiac CT is able to show the following structures in the form of high-resolution, 3D images:

  • Coronary arteries
  • Pulmonary veins
  • Chambers, muscles, and valves of the heart
  • Thoracic aorta
  • Pericardium which is the sac around the heart

Advantages of CT Cardiac Scans

There are several benefits of a cardiac CT scan including the following:

  • A cardiac CT scan procedure is non-invasive and painless.
  • It can detect blockages or narrowing of the arteries in some cases even before any symptoms occur. This can help diagnose cardiovascular diseases early and start treatment accordingly.
  • It can detect any abnormalities in the surrounding blood vessels of the heart including aneurysms and tumours.
  • It also helps in monitoring existing cardiovascular diseases to check for their progression or any changes over time.

When is CT Cardiac Scan performed?

A cardiac specialist may order a cardiac CT scan in Singapore for the following reasons:

  • To identify the cause of dull pain in the chest
  • To identify the cause of shortness of breath.
  • To check the heart arteries and veins for calcium and fats build up
  • To assess the heart valves.
  • To check if any bypass grafts or stents are blocked.
  • To check for any congenital heart problems.
  • To check the pericardium for any fluid around the heart.
  • To check for any tumour or mass in or around the heart.
  • To plan and carry out pre-surgical assessment for various heart procedures including heart surgery, valve procedures, and arrhythmia ablation.

doctor explaining an angiogram

What is an Angiogram?

Another diagnostic tool that is used to identify the cause of pain in chest or other heart issues is an angiogram. An angiogram is a minimally invasive procedure that is used to visualise the heart muscle and view the blood vessels to check for any blockage. During an angiogram, a long hollow tube called a catheter is inserted into a large artery, usually in the groin or wrist. A contrast dye is then inserted through the catheter that can highlight the targeted areas. Fluoroscopy x-rays are used to assess the blood flow through the coronary arteries by taking images through several angles.

Advantages of Angiogram

Although a minimally invasive procedure, there are several advantages of a conventional angiogram.

  • It is used by doctors to detect blood vessel abnormalities of the heart including plaque buildup , blood clots, and weakened blood vessels.
  • It is an effective procedure to diagnose aneurysms in medium and large arteries in patients with vasculitis.
  • It can measure intra arterial blood pressure directly.
  • It can assist in catheter-based procedures like angioplasty and stent placement.

When Angiogram is performed?

An angiogram is usually performed when there are symptoms such as chest pain that is highly suspicious of coronary heart disease. If your cardiac doctor suspects blockage or narrowing of the blood vessels of the heart, he may order a conventional angiogram for a more detailed diagnosis. An angiogram is also more effective in assessing the extent of narrowing in coronary artery blockage.

CT Cardiac Scan VS Angiogram

In case of CT Cardiac Scan versus Angiogram, both are diagnostic imaging tests to view the heart muscles, valves, blood vessels, and surrounding structures. However, there are a few differences between the two procedures and one might be more effective in some situations than the other. This comparison is discussed in the following points:

  • A CT cardiac scan is fast, convenient, less invasive, and painless than an angiogram.
  • In a CT scan, contrast may be injected through a vein in the arm or hand whereas in case of an angiogram, a catheter is inserted into a large artery in the groin or wrist from where the contrast dye is injected.
  • A heart CT scan may not be able to accurately detect when there is calcification. In such cases, a traditional angiogram is ordered as a follow up.
  • A traditional angiogram is more beneficial in certain cases where the doctor detects severe blockage and can insert a stent or carry out angioplasty right away.
  • Doctors typically recommend cardiac CT for patients with a pretest probability for coronary heart disease of 50% or lower. For higher probabilities, the doctor may order angiography so that angioplasty or stent insertion may be carried out during the same procedure if required.

Treating Chest Pains

Depending on the underlying cause of chest pain, the doctor may recommend the following treatment options.

Medication

The following medications may be prescribed depending on the underlying cause:

  • Artery relaxers such as Nitroglycerin and some blood pressure medicines to relax arteries to allow blood to flow more easily.
  • Aspirin to thin the blood.
  • Clot dissolving medicines called thrombolytics that can dissolve already formed clots in patients with heart attack.
  • Blood thinners other than Aspirin to prevent clots from forming in patients with heart attack.
  • Acid reducing medicines to reduce the amount of stomach acid.
  • Antidepressants in case of anxiety and panic attacks.

Lifestyle Changes

Switching to a healthier lifestyle is essential to reduce the risk of coronary heart disease. Exercising regularly, eating a well-balanced diet, avoiding fats and sugars, stopping smoking, and maintaining good mental health are some lifestyle changes that can help prevent heart and other problems that may contribute towards chest pain.

Surgery

In severe and life threatening causes of chest pain, a specialist doctor can recommend any of the following surgical procedures:

  • Angioplasty and stent insertion in case of blockage in the arteries.
  • Coronary artery bypass surgery
  • Emergency repair surgery to repair a ruptured aorta
  • Lung re-inflation in case of a collapsed lung.

man having chest pain at the park

Conclusion

Chest pain can be caused by several factors, some of which may be life threatening. In case of any kind of chest pain, it is advised to visit your nearest medical service provider and get evaluated for the underlying cause. Most of the life-threatening causes of chest pain can be confirmed or excluded through a cardiac CT scan. For CT cardiac scan in Singapore and other diagnostic imaging tests, contact RadLink today and get specialised innovative care and assessment.

Frequently Asked Questions

Can chest pain be a sign of a heart problem?

Usually a heart problem manifests itself in the form of chest discomfort, pressure, tightness, fullness, crushing pain, and burning in the chest that may spread towards the back, neck, jaw, and arms. Nevertheless, no type of chest pain should be ignored and medical advice should be sought immediately.

What to do if I experience chest pain?

In case of any type of chest pain, visit a healthcare professional at the earliest.

Are there any risks associated with CT cardiac scans?

The risks associated with CT cardiac scans are very less with a rare occurrence. These risks can include radiation exposure, allergic reaction to the contrast dye, and the dye leaking into the skin.

How do I prepare for a CT cardiac scan?

Consider the following suggestions for a cardiac CT scan preparation :

  • Stop eating anything 4 hours before the scan.
  • Avoid drinking caffeine as it can make the heart beat faster which can make it difficult to get clear pictures of the heart.
  • Remove all jewellery, glasses, and any hair accessories.
  • You will be required to undress from the waist up and change into a hospital gown.
  • Inform your doctor about any medication that you are taking for you may be asked to stop taking the medicine for some time for the scan.
  • You may be given a beta blocker to slow your heart rate during the scan.
  • You may be given nitroglycerin to relax and dilate the blood vessels before the scan.
  • An IV may be inserted into your arm or hand to inject the contrast dye.

How quickly can I get results from a CT cardiac scan, and how are they interpreted?

The images from the CT scan are ready soon after the scan. The technician will prepare the report and send it to your healthcare provider. If your arteries and heart look normal in the cardiac CT scan results and your calcium score is zero, these are considered normal results indicating that you do not have heart disease. Abnormal results may be indicated by a large calcium score, narrowing of the arteries, malfunctioning of the valves, inflammation or fluid in the heart, and tumours. Your healthcare provider will discuss the CT scan results with you and recommend treatment options accordingly.

Are CT cardiac scans recommended for people without symptoms but with risk factors for heart disease?

Yes, a CT cardiac scan may be recommended for people with a high risk for heart disease since a CT scan is able to detect damage or blockage in the arteries in some cases even before there are any visible symptoms.