What can we know of chest pains for our own benefit? Let us look at chest pain generally to observe a few fundamental facts about it. First of all, most chest pains are not caused by the heart. Most chest pains have their cause in either:

1. The breathing mechanism.
2. The muscle, ligament and bone of the chest.
3. Inflammation or tumor growth.
4. The swallowing tube (esophagus).
5. Pain originating from the abdomen.
6. Nerves (often called effort syndrome or neurocirculatory asthenia).

Heart pain can best be appreciated if the other chest pain sources are studied first. So let us first examine pain caused by the breathing mechanism. Pleurisy pain is the most common-type pain felt when the lungs or bronchial tubes are diseased. If pain is definitely related to the movement of breathing in and out, and ceases when breathing is stopped, it is nearly always the pain of pleurisy.

What causes pleurisy pain? Ordinarily, the lungs, covered by a smooth, wet envelope called the pleura, slide over a similar surface on the inside of the chest wall with each breath. If either of these smooth surfaces is irritated, inflammed or roughened in any way, the gliding movements of breathing cause enough friction to bring about pain (pleural pain). Pleurisy may be caused by various lung disorders such as pneumonia, tuberculosis, lung abscess, a blood clot in the lungs (infarction), pus in between the lung and chest wall (empyema), fractured ribs, and other difficulties. Pleurisy pain is thoroughly easy to understand and to identify when it occurs. It is not the kind of pain produced by the heart. It is well to know that heart disease is rarely accompanied by any pleural pain.

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