胸痛(chest pain)有哪些原因引起的?

可能引起胸痛的原因 :

缺血性心髒病，心包膜炎，主動脈剝離，肺栓塞，肺部疾病，腸胃道疾病，神經肌肉骨骼病患，恐慌性精神病。

與心髒有關的毛病（Cardiac causes ）:

1.心絞痛(Angina)︰

這種引發胸痛的現象，是由于心髒內血液不足，以致心髒肌肉缺乏氧氣供應所致。心絞痛是一種重要的警號，患者可能已經患上冠狀動脈疾病，甚至或有潛伏發展心髒病的危機。
Restricted blood flow to your heart can cause recurrent episodes of chest pain — angina pectoris, or angina. Angina  is often described as a pressure or tightness in the chest. It's usually brought on by physical or emotional stress. The pain usually goes away within minutes after you stop the stressful activity.

2.心髒病發作(Heart Attack)︰

由心髒病引發的胸痛主要是由于心髒血管的閉塞所致。
A heart attack can cause pressure, fullness or a crushing pain in your chest that lasts more than a few minutes. The pain may radiate to your back, neck, jaw, shoulders and arms, especially your left arm. Other signs and symptoms may include shortness of breath, sweating, dizziness and nausea. All, some or none of these may accompany your chest pain. 

3.心包 ( 圍心膜 ) 發炎(Pericarditis)︰

這種胸痛是由包圍心髒的圍心膜發炎而引起。
Inflammation of the sac surrounding your heart (pericarditis) causes sharp, piercing and centralized chest pain. You may also have a fever and feel sick.

4.心髒大動脈壁破裂(也稱主動脈剝離Aortic dissection)︰

這是一種罕見但致命性高的現象，能引發嚴重的胸痛及背痛。 大動脈是主要的血管，其作用在于傳送血液至身體各部份。老年人出現這種現象除了歸咎于血管硬化的毛病外，也可能是因長期處于高血壓的狀態之故。
 
5.冠狀動脈痙攣(Coronary artery spasm)︰

這種胸痛是由于冠狀動脈一時的痙攣，造成短暫性無血流通過心髒而引起的。
Coronary spasm can cause varying degrees of chest discomfort. In coronary spasm, arteries that supply blood to your heart go into spasm, temporarily closing down blood flow to your heart. It can occur with activity or at rest. A spasm may even wake you from sleep.

與肺部有關的毛病︰

1.良性胸壁疼痛︰

這種胸痛是源于肺膜短暫刺激的反應。這種反應可能引起很大程度的痛楚，但這感覺很快減退。這是一個普遍現象，與任何疾病或異常無關。

2.胸部創傷(Injured ribs or Sore muscles)︰ 

這種胸痛可以由近期發生的胸部創傷如肋骨骨折胸部肌肉受傷或胸部挫傷所致。

3.其他肺部問︰

胸痛可由其他肺部問而引起，包括哮喘支氣管炎(Asthmatic bronchitis )、肺炎(Pneumonia)、胸膜炎(Pleurisy)、肋軟骨炎(Costochondritis)、氣胸 (Pneumothorax) (肺部氣囊穿破)及肺栓塞(Pulmonary embolism )等。

其它毛病︰

1.焦慮或恐懼(Anxiety or Panic attack)︰

這種胸痛會伴隨焦慮或恐懼出現，主要是由于重復有太多有預計的焦慮及恐懼出現令到胸壁的肌肉收縮所致。

2.食道痙攣(Esophageal spasms)和胃酸倒流(GERD=gastroesophageal reflux disease )︰ 

由于胃酸和食物倒流食道而產生炙熱的不適感覺。

3.胃潰瘍(Gastric Ulcer)︰ 

這種痛楚主要出現于腹部，有時甚至蔓延至胸部。

4.神經線受壓(Pinched Nerves):︰

這種胸痛是由脊椎骨刺造成神經線受壓所致，亦會引起上臂和胸部產生麻及弱的感覺。

5.膽囊(如:膽石)或胰腺問題(Gallbladder or Pancreas problems)︰

膽石可引致嚴重的上腹背部和胸部的痛楚。
 
6.帶狀皰疹(Shingles)︰
　
Symptoms of this reactivation of the same virus that causes chickenpox include pain and a band of blisters from your back around to your chest wall. The sharp, burning pain may begin several hours to a day or so before blisters appear.

什麼時候的胸痛是緊急的?

如胸痛的原因不明或對生命構成威協的情下，應立即醫治或到急癥室就醫 。由心絞痛心髒病大動脈破裂肺栓塞和氣胸所引起的胸痛必須作緊急的診斷和治療。



來源︰
http://www.mayoclinic.com/health/chest-pain/DS00016/DSECTION=symptoms

http://healthyageing.sph.cuhk.edu.hk/chest%20pain_ch.htm