Normal ECG and echocardiogram, why is there chest pain?
Dec 01, 2022
Source: Cainiu Health
Dr. Tian Hongbo
Introduction
Normal ECG and echocardiography results accompanied by chest pain may be caused by trauma, intercostal neuralgia, pleuritis, reflux esophagitis, myocardial ischemia, or other reasons. Treatment can be based on the specific underlying condition. In addition to the above causes, conditions such as pulmonary embolism and angina pectoris may also lead to chest pain. It is recommended to go to the hospital for detailed examinations to confirm the exact cause.
Even when electrocardiogram (ECG) and echocardiography results are normal, chest pain may still arise due to causes such as trauma, intercostal neuralgia, pleuritis, gastroesophageal reflux disease (GERD), or myocardial ischemia. Treatment should be based on the specific underlying cause. Detailed explanations are as follows:
1. Trauma
Chest pain can result from compression or impact causing soft tissue contusions or rib fractures. Symptoms include chest pain and tightness, which may worsen during coughing or deep breathing. Local skin injuries or bruising may be visible. Mild soft tissue contusions can be relieved with appropriate warm compresses, but rib fractures require prompt medical evaluation and possibly surgical intervention at a正规 hospital.
2. Intercostal Neuralgia
This refers to inflammation of the intercostal nerves caused by various factors, leading to band-like pain along the ribs or abdomen. It commonly occurs in individuals aged 20–40. Patients may experience chest pain despite a normal ECG. Under medical guidance, oral neurotrophic medications such as vitamin B1 tablets or vitamin B12 tablets can help alleviate symptoms.
3. Pleuritis
Pleuritis is an inflammatory condition of the pleura caused by pathogenic stimuli. It frequently affects young adults and may result from trauma or pulmonary infections. Patients may present with chest pain and a normal ECG; some may also experience coughing and chest tightness. Under medical supervision, medications such as levofloxacin hydrochloride tablets or moxifloxacin hydrochloride tablets may be prescribed to relieve symptoms.
4. Gastroesophageal Reflux Disease (GERD)
This condition typically involves the backflow of excessive stomach or duodenal contents into the esophagus, causing symptoms such as heartburn, acid regurgitation, and difficulty swallowing. Common manifestations include acid reflux, burning sensation in the chest, chest pain, and dysphagia. Patients can take proton pump inhibitors such as omeprazole enteric-coated capsules or rabeprazole sodium enteric-coated tablets as directed for treatment.
5. Myocardial Ischemia
Damaged blood vessels in the heart due to hypertension, diabetes, smoking, atherosclerosis, or plaque formation can impair blood circulation, leading to insufficient oxygen supply to myocardial cells. This commonly presents as chest tightness and chest pain, often triggered by emotional stress or physical exertion, with symptoms usually resolving after rest.
In addition to the above causes, conditions such as pulmonary embolism or angina pectoris may also lead to chest pain. It is recommended to seek medical evaluation for accurate diagnosis and identification of the underlying cause.
