Chest Pain: How to Distinguish Between Heart- and Lung-Related Causes

Kuo-Pin Wu, a traditional Chinese medicine doctor, outlines common causes and symptoms of types of chest pain and offers recipes and remedies for heart health.
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When we experience chest pain, how do we know if the cause is heart-related or lung-related? Chest pain typically occurs in the area between the neck and the lower part of the sternum—across the front and sides of the chest. Within the chest cavity, the two major organs are the heart and lungs.

Common Causes of Heart-Related Pain

Heart-related pain is most often associated with coronary artery disease, in which angina (chest pain) and myocardial infarction (heart attack) are common and serious clinical symptoms.

How to Differentiate Between Angina and Myocardial Infarction

The main criteria for assessment are duration and symptoms. Angina pain is typically located near the heart, behind the breastbone, or below the xiphoid process (lower part of the sternum) and often radiates to areas like the neck, jaw, shoulders, inner side of the left arm, back, and sometimes even to the fingers. The area of pain is usually about the size of a clenched fist.
The location of pain during a myocardial infarction is similar to that during angina. (The Epoch Times)
The location of pain during a myocardial infarction is similar to that during angina. The Epoch Times
The location of pain during a myocardial infarction is similar to that of angina but tends to last longer and is more intense. The radiating pain pattern is also comparable, and some myocardial infarction patients also report tooth pain as an initial symptom. Research has identified periodontal disease as a risk factor for acute myocardial infarction.

Typical symptoms of angina and myocardial infarction include squeezing pain, burning pain, a heavy or pressing sensation, and a feeling of suffocation. Notably, some myocardial infarction patients may also experience intense fear or a sense of impending doom.

Pain from angina typically lasts only a few minutes and rarely exceeds 15 minutes. It can be triggered by exertion, stress, or intense physical activity, which can lead to myocardial ischemia (reduced blood flow to the heart) and subsequent pain. Rest or sublingual nitroglycerin can usually relieve angina symptoms.

The triggers for myocardial infarction are similar to those of angina. However, myocardial infarction pain usually persists for more than 30 minutes, and the methods that relieve angina symptoms are ineffective for myocardial infarction (MI).

For example, nitroglycerin is commonly used for relieving angina by dilating blood vessels and reducing the heart’s workload. However, it is not sufficient in treating an MI, where the heart muscle is already suffering from severe oxygen deprivation due to blocked arteries. Rest can help alleviate angina by reducing the heart’s demand for oxygen. However, in the case of an MI, immediate medical intervention (such as thrombolytic therapy or angioplasty) is necessary to restore blood flow to the heart muscle.

In short, angina results from narrowed heart vessels that reduce oxygen supply to the heart muscle, while myocardial infarction occurs when blocked vessels cause parts of the heart muscle to die. The symptoms of myocardial infarction are more severe than those of angina.

Common Causes of Lung-Related Pain

Lung-related chest pain is often seen in conditions such as pneumothorax, pleurisy, and pulmonary embolism. In these cases, the pain is typically located near the anterior (front) and mid-axillary (vertical, separating the front and back sides of the body) lines on the affected side. However, if the diaphragm (the muscle beneath the lungs) is involved, the pain may radiate to the shoulder and back on the same side. The area of pain is generally about the size of a palm.
Patients with lung cancer often experience dull, persistent chest pain, whereas pain from a pulmonary embolism is typically intense, sharp, or squeezing and frequently accompanied by shortness of breath. Lung-related pain may worsen with coughing or breathing and tends to ease or disappear when chest movement is minimized.

Key Comparisons Between Heart- and Lung-Related Pain

Heart-related pain can extend to the neck, jaw, and particularly the inner side of the left arm—the pathway of the “heart meridian”—and typically covers an area about the size of a clenched fist. In traditional Chinese medicine (TCM), the heart meridian is the pathway of the heart’s energy flow, located along the inner side of the left arm. By contrast, lung-related pain generally covers an area about the size of an open palm and is often accompanied by coughing.
Additional note: Acid reflux can cause chest pain and a burning sensation in the center of the chest, behind the breastbone. It typically occurs after eating, especially after having coffee or sweet foods, and is not directly related to angina or myocardial infarction.

Preventing Blood Clots Following a Fracture

In addition to causing chest pain, both myocardial infarction and pulmonary embolism can sometimes arise unexpectedly following certain injuries.

In clinical practice, it is occasionally observed that patients with fractures—particularly femur fractures—can suddenly develop critical conditions such as myocardial infarction, pulmonary embolism, or cerebral infarction within three days of the injury.

This is primarily due to blood clots or fat emboli formed from bleeding or fat released at the fracture site, which can travel through the bloodstream. If a clot lodges in the heart, it can result in myocardial infarction. If it reaches the lungs, it can cause pulmonary embolism, and if it blocks blood flow in the brain, it can lead to cerebral infarction.

Therefore, in the early stages following a severe fracture, TCM recommends taking herbs that help remove blood stasis and prevent blood clots. For younger patients, ground Eupolyphaga (Tu Bie Chong) can be used to disperse stagnant blood. For older patients, salvia (Dan Shen) and raw Panax notoginseng (San Qi) are preferred. To relieve severe initial pain and reduce swelling, frankincense (Ru Xiang) and myrrh (Mo Yao) can be used.

The basic prescription includes herbs that promote circulation and remove blood stasis, with the addition of Eupolyphaga, frankincense, and myrrh. This regimen is typically followed for three to five days.

Everyday Care for Heart and Lung Health

The underlying risk for angina, myocardial infarction, and pulmonary embolism is thrombosis, whereas pneumothorax and pleurisy are acute lung conditions that require urgent medical attention.
Regularly consuming wood ear mushrooms can help promote blood circulation and remove blood stasis, thereby preventing blood clots.

Recipe for Heart Health

Ingredients:
  • 1 ounce (30 grams) dried white-backed wood ear mushrooms (soak in water before cooking)
  • 2 ounces (60 grams) lean pork
  • 5 red dates
  • 2 slices aged ginger
Preparation:

Simmer the ingredients in 50.72 fluid ounces (6 to 7 cups) of water over low heat for at least two hours until the liquid reduces to approximately 16.91 fluid ounces (about 2 cups).

Drink on an empty stomach before meals. Prepare one serving daily and continue for 30 days. For optimal results, drink it in the early morning on an empty stomach.

Research has shown that compounds in wood ear mushrooms possess anticoagulant properties, which may help inhibit blood clot formation.

Herbal Remedies

Another simple herbal remedy for health maintenance includes salvia (Dan Shen), Panax notoginseng (San Qi), and American ginseng (Xi Yang Shen). Grind these herbs in equal parts into a fine powder, and take 0.1 ounces (3 grams) after breakfast and dinner. This formula helps replenish qi, improve blood circulation, and remove blood stasis, thereby preventing blood clots.
In TCM, the body’s energy is referred to as qi. When the heart is weakened, qi may become deficient. Taking American ginseng can help replenish qi, as it supports cardiovascular function. Studies have shown that ginsenosides in ginseng provide various benefits for cardiovascular health, including regulating blood pressure and lipids, as well as protecting vascular endothelial cells.
Panax notoginseng (San Qi) has been shown to aid in the treatment of coronary artery disease by reducing heart muscle cell damage associated with myocardial infarction. Salvia (Dan Shen) also provides multiple cardiovascular protective effects, including antioxidant and anti-inflammatory properties, blood viscosity reduction, and microcirculation improvement.

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Views expressed in this article are the opinions of the author and do not necessarily reflect the views of The Epoch Times. Epoch Health welcomes professional discussion and friendly debate. To submit an opinion piece, please follow these guidelines and submit through our form here.
Kuo-Pin Wu
Kuo-Pin Wu
Kuo-Pin Wu is the superintendent of Taiwan XinYiTang TCM Clinic. He began studying traditional Chinese medicine in 2008 and earned a Doctor of Medicine degree from China Medical University in Taiwan.
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