What is angina (using stable exertional angina as an example)? Its characteristics are sudden, squeezing, distressing, or suffocating pain behind the sternum that may affect the entire left chest and radiate to the left shoulder and upper arm, sometimes in the lower jaw, pharynx, etc., during activity or emotional excitement. Severe pain can cause sweating, and patients often have to stop their activities immediately. Taking deep breaths is not beneficial for improving symptoms, but taking nitroglycerin under the tongue or resting for a few minutes (usually no more than 5 minutes) can relieve symptoms. This is a signal of insufficient coronary artery blood supply, indicating significant stenosis or even obstruction of the coronary artery. Patients need to take it seriously and seek medical attention in a timely manner, otherwise the disease is prone to progression and there is a high risk of fatal diseases such as acute myocardial infarction. The causes of chest pain include chest wall lesions, lung and pleural lesions, cardiovascular system diseases, mediastinal and esophageal lesions, anxiety, etc. 1、 Pain caused by chest wall lesions is quite common in daily life. Local skin, muscle, and bone lesions caused by chest wall trauma, bacterial infections, viral infections, tumors, etc. We commonly have acute dermatitis, herpes zoster, cervical spondylosis, and so on. They all have a common characteristic, that the painful area is usually fixed at the site of the lesion, and there is a noticeable tenderness in the local area. In addition, during movements such as deep breathing, coughing, and bending, chest pain can worsen. For example, the most common chest injury, chest pain will become severe after a few days, and it will gradually ease after 2-3 weeks. 2、 The phenomenon of pulmonary and pleural lesions is not sensitive to the sensation of pain, such as pneumonia, tuberculosis, etc. They only cause pain when they damage the wall layer. Under normal circumstances, spontaneous pneumothorax may suddenly experience severe pain due to adhesions and tears, while dry pleurisy may cause friction and pain due to inflammation and bloating. Their commonality is generally coughing or sputum, which becomes severe due to these symptoms. Other chest wall movements do not cause pain, and there is no local tenderness. 3、 The common symptoms of cardiovascular diseases include angina pectoris, myocardial infarction, and pericarditis. Their common characteristics are that the main pain is located behind the sternum or in the precordial area, with a few located below the xiphoid process and radiating to the left shoulder. 4、 The phenomenon of mediastinal and esophageal lesions is relatively rare, with chest pain caused by acute mediastinal inflammation, mediastinal tumors, and other diseases. Esophageal diseases are caused by the esophageal mucosa, and their common feature is that chest pain is generally located behind the sternum and presents as persistent dull or distended pain, usually radiating to other areas. 5、 Anxiety is a common phenomenon among middle-aged men and menopausal women, which is often caused by family pressure. How can we detect and self rescue the more dangerous chest pain? 1. The location and nature of chest pain in acute myocardial infarction are similar to those of angina, but the duration is long and cannot be relieved by rest or taking nitroglycerin. At this time, the patient should immediately call an ambulance and be transported by professional ambulance personnel to a hospital with qualifications for myocardial infarction treatment for timely coronary intervention treatment, saving lives. 2. Acute aortic dissection is also one of the fatal cardiovascular diseases, characterized by sudden chest and back tearing or knife like pain, which is extremely severe and unbearable, and patients may experience fainting and shock. At this time, the patient should immediately stop all physical activities, call an ambulance, and be transported to the hospital for emergency treatment by professional ambulance personnel. 3. The pain caused by acute pericarditis is mainly located in the center left position of the chest, presenting as a knife like continuous pain, which can also manifest as a sense of compression and dull pain; When inhaling deeply, coughing, or lying down, the pain can worsen; When sitting in a forward leaning position, the pain can be slightly relieved. Patients often have symptoms of fever. Suspected individuals with pericarditis should seek medical attention promptly, identify the cause, and receive targeted treatment. (Lai Xin She)