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Heart may not be the culprit.

A crushing, cramping sensation in the chest and upper arm usually is attributed to heart attack or angina. However, that type of feeling also can come from esophageal or gall bladder inflammation, indicating that these organs--as well as the heart--should be examined by a physician when such discomfort occurs.

Pain from internal organs such as the esophagus and gall bladder often excites the same spinal cord cells that receive heart input. "Our research has shown how the nervous system is organized to process pain coming from the heart," notes Robert Foreman, professor of physiology, University of Oklahoma Health Sciences Center. "Such pain is typically displayed in the chest. Instead of saying, |My heart hurts,' a person suffering from a heart attack or angina usually says his or her chest, arm, or even the jaw or neck hurts. Oddly enough, though, this same sensation can result when internal organs such as the esophagus and gall bladder are swollen or damaged."

Pain radiating from the heart, esophagus, and gall bladder travels, in the form of electrical impulses, up a major "pain pathway" called the spinalthalamic tract, located inside the spinal cord. The spinal cord is segmented into 33 vertebra, with seven in the neck, 12 in the upper back, five in the lower back, five in the pelvic area, and four in the tailbone. The vertebra receive and acknowledge pain impulses from various parts of the body.

Each of the seven cervical vertebra in the neck and the 12 thoracic vertebra in the back also receive pain impulses from various organs. The seventh and eighth cervical segments, for example, get pain input only f rom the hands, while the third and fourth thoracic segments receive input from the heart, esophagus, and gall bladder. Pain impulses then are radiated out into what is called the "somatic field"--which, in the case of the heart, esophagus, and gall bladder, is the chest, upper left arm, neck, and jaw.

"The important thing to remember is that persons who believe they are having heart problems actually might have gall bladder or esophageal inflammation. The reverse, however, also holds true. Someone who complains of heartburn, for instance, actually might be suffering from ischemia of the heart. In either case, it's important to be checked by a physician."
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Title Annotation:chest pain
Publication:USA Today (Magazine)
Date:Feb 1, 1993
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