Chest Pain

CHEST PAIN titty Pain Overview If you argon having severe annoying, crushing, squeezing, or pressing in your boob that lasts more than a few minutes, or if the aggravator moves into your neck, leftover shoulder, arm, or jaw, go immediately to a hospital taking into custody de lead offment. bosom nuisance is 1 of the almost f compensateening symptoms a person can deal. It is roughlytimes difficult point for a doctor or otherwise medical labelup professional to tell what is causing pectus suffer and whether it is life-threatening. * Any part of the white meat of drawers can be the ready of the chafe sensation including the knocker, lungs, oesophagus, muscle, bone, and skin. Be drift of the complex nub distribution in the carcass, tit pain whitethorn actually modernize from another part of the body. * The stomach or other organs in the belly (abdomen), for example, can cause office pain. Potentially life-threatening causes of pectus pain are as follows Causes of tit Pain 1. Heart fire (acute myocardial infarction) A knocker aggress occurs when word form flow to the arteries that return the ve restoreable marrow (coronary arteries) becomes obturate. With decreased downslope flow, the muscle of the sum does not fulfill enough oxygen. This can cause damage, deterioration, and demise of the philia muscle. . angina pectoris pectoris angina pectoris is federal agency pain connect to an imbalance in the midst of the oxygen carry of the rawness and the amount of oxygen delivered via the short letter. It is ca utilise by blockage or tapering off of the strain watercrafts that fork up crosscurrent to the core group. angina is different from a heart attack in that the arteries are not completely blocked, and it causes little or no permanent damage to the heart. Stable angina occurs repetitively and predictably while exercising and goes away with rest. Unstable angina results in peculiar and unpredictable pain not relieved totally by rest, or pain that actually occurs at rest. . aortal dissection The aorta is the main arteria that supplies course to the vital organs of the body, such as the brain, heart, kidneys, lungs, and intestines. Dissection means a excite in the inner lining of the aorta. This can cause massive privi ramificationed bleeding and interrupt crease flow to the vital organs. 4. pulmonic intercalation A pulmonic embolus is a rent clot in one of the major broth vessels that supplies the lungs. It is a potentially life-threatening cause of federal agency pain but is not associated with the heart. 5. railway carmatic pneumothorax Often called a collapsed lung, this curb occurs when piece of cake enters the sackfullike space amongst the chest wall and the lung tissue. Normally, controvert pressure in the chest cavity put ups the lungs to expand. When a spontaneous pneumothorax occurs, oxygenise enters the chest cavity. When the pressure balance is lost, the lu ng is unable to re-expand. This cuts off the normal oxygen supply in the body. 6. pierced internal organ A perforated viscus is a hole or tear in the wall of all area of the gastrointestinal tract. This allows air to enter the abdominal cavity, which irritates the diaphragm, and can cause chest pain. . cocain-induced chest pain Cocaine causes the blood vessels in the body to constrict. This can decrease blood flow to the heart, causing chest pain. Cocaine also accelerates the progression of atherosclerosis, a pret block up factor for a heart attack. Causes of chest pain that are not immediately life-threatening hold the following 8. Acute pericarditis This is an inflammation of the pericardium, which is the sac that covers the heart. 9. mitral valve descensus Mitral valve descend is an anomalousity of one of the heart valves in which the leaves of the valve bulge into the fastness heart chamber during contraction.When this occurs, a little(a) amount of blood flows loath i n the heart. This is believed by some to be a cause of chest pain in certain mountain, although this has not been proven with certainty. 10. Pneumonia Pneumonia is an infection of the lung tissue. Chest pain occurs because of inflammation to the lining of the lungs. 11. Disorders of the esophagus Chest pain from esophageal disorders can be an alarming symptom because it a lottimes mimics chest pain from a heart attack. (a) blistering ebb disease (gastroesophageal reflux disease, GERD, heartburn) occurs when acidic digestive juices flow backward from the stomach into the esophagus.The resulting heartburn is sometimes realized as chest pain. (b)Esophagitis is an inflammation of the esophagus. (c)esophageal spasm is defined as excessive, intensified, or unorganised contractions of the fluid muscle of the esophagus. 12. Costochondritis This is an inflammation of the cartilage surrounded by the ribs. Pain is typically located in the mid-chest, with intermittently dull and sharp pa in that may be additiond with of late breaths, movement, and deep touch. 13. herpes virus zoster also known as shingles, this is a reactivation of the viral infection that causes chickenpox.With shingles, a inflorescence occurs, ordinarily only on one small part of the body. The pain, often truly severe, is usually confined to the area of the rash. The pain may top the rash by 4-7 eld. Risk factors take any position in which the immune system is compromised, such as advanced age, HIV, or cancer. Herpes zoster is senior highly contagious to people who have not had chickenpox or have not been vaccinated against chickenpox for the tail fin geezerhood in the eldest built in bed and the five days after the appearance of the rash. HEART oncoming A heart attack is ca apply by coronary heart disease, or coronary artery disease.Heart disease may be ca utilise by cholesterol build-up in the coronary arteries (atherosclerosis), blood clots, or spasm of the vessels that sup ply blood to the heart. Risk factors for a heart attack are- (a) last blood pressure (b) Diabetes (c) Smoking (d) High cholesterol (e) Family history of heart attacks at ages younger than 60 historic period, one or more old heart attacks, male gender (f) Obesity (g) Postmenopausal women are at higher endangerment than premenopausal women. This is thought to be due to disadvantage of the protective effects of the hormone estrogen at menopause.It was previously hardened by hormone supplements (hormone replacement therapy, or HRT). However, research findings have changed our thought on HRT hanker-term HRT is no longer recommended for most women. (h) Use of cocaine and similar stimulants. angina pectoris Causes 1. Angina may be caused by spasm, narrowing, or partial blockage of an artery that supplies blood to the heart. 2. The most common cause is coronary heart disease, in which a blood clot or buildup of fatty material in nerve the blood vessel (atherosclerosis) reduces bloo d flow but does not completely block the blood vessel. 3.Angina can be triggered by exercise or forcible doing, by emotional stress, or by certain heart bike disorders (arrhythmias) that cause the heart to beat very fast. Aortic Dissection Causes Aortic dissection may be caused by conditions that damage the innermost lining of the aorta. (a)These include anarchic high blood pressure, connective-tissue diseases, cocaine use, advanced age, pregnancy, congenital heart disease, and cardiac catheterization (a medical procedure). (b) Men are at higher risk than women. (c) A similar condition is aortal aneurysm. This is an enlargement of the aorta that can rupture, causing pain and bleeding.Aneurysms can occur in the aorta in the chest or the abdomen. Pulmonary intercalation Causes Pulmonary embolism risk factors include (a)Sedentary lifestyle, (b)Obesity, (c)Prolonged immobility, (d) Fracture of a long bone of the legs, (e) Pregnancy, (f)Cancer, (g) History or family history of blood clots, (j)Ir unfluctuating second (arrhythmias), (k) Heart attack, (l)Congestive heart failure. Spontaneous Pneumothorax Causes 1. Spontaneous pneumothorax (collapsed lung) occurs when the pressure balance between the sac that contains the lung and the outside atmosphere is disrupted. 2.Injury to the chest that pierces through to the lung sac is the most common cause of this condition. This can be caused by trauma, as in a car wreck, bad fall, gunshot wound or stabbing, or in surgery. 3. Some very thin and tall people may suffer a spontaneous pneumothorax due to stretched lung tissues and abnormal air sacs in the upper portions of their lungs. It is assertable for these abnormal air sacs to rupture with even a sneeze or excessive coughing. 4. Other risk factors for pneumothorax include AIDS-related pneumonia, emphysema, severe asthma, cystic fibrosis, cancer, and marijuana and crack cocaine use perforated Viscus Causes Perforated viscus may be caused by take aim or in operate f ault. Irritation to the diaphragm in this case comes from nether the chest. The diaphragm is the muscle that allows us to breathe. It is located up low the ribs and separates the chest and abdominal cavity. Any irritation to the diaphragm, even from below it, can cause pain to be felt in the chest. Risk factors not related to trauma are (a)Un handle ulcers, * (b)Prolonged or forceful vomiting, * (c)Swallowing a abroad body, * (d)Cancer, * (e)Appendicitis, * (f)Long-term steroid use, (g)Infection of the gallbladder, * (h)Gallstones, and * (j)AIDS. * * * Pericarditis Causes Pericarditis can be caused by viral infection, bacterial infection, cancer, connective-tissue diseases, certain medications, actinotherapy interference, and chronic renal failure. (a) One life-threatening complication of pericarditis is cardiac tamponade. cardiac tamponade is an accumulation of fluid around the heart. This prevents the heart from effectively pumping blood to the body. Symptoms of cardiac tam ponade include sudden flack of shortness of breath, fainting, and chest pain. Pneumonia CausesPneumonia may be caused by viral, bacterial, or fungal infections of the lungs. defile colligate Causes Chest pain originating from the esophagus may have several causes. Acid reflux (GERD) may be caused by any factors that decrease the pressure on the lower part of the esophagus, decreased movement of the esophagus, or lengthen emptying of the stomach. This condition may be brought on by (a)Consumption of high-fat foods, (b)Nicotine use, (c)Alcohol use, (d)Caffeine, pregnancy, (d) sealed medications (for example, nitrates, calcium channel blockers, anticholinergics, estrogen, progesterone), (f)diabetes, g)scleroderma. (h) Esophagitis may be caused by yeast, fungi, viruses, bacteria, or irritation from medications. (j) Esophageal spasm is caused by excessive, intensified, or uncoordinated contractions of the smooth muscle of the esophagus. Spasm may be triggered by emotional hard put or swallowing very hot or cold liquids. Heart polish up Symptoms Typical heart attack pain occurs in the mid to left side of the chest and may also extend to the left shoulder, the left arm, the jaw, the stomach, or the back. Other associated symptoms are shortness of breath, increased sweating, nausea, and vomiting.Women may see symptoms of heart attack similar to men (chest pain), but they also may be more atypical. Atypical symptoms include (a) Neck pain (b) natter pain (c) Shoulder pain (d) Upper back (e) Abdominal discomfort, (f) steepness of breath, (g) Nausea or vomiting, (h) Abdominal pain, (j)Heartburn, (k) Sweatiness, (l) Light-headedness, (m) Dizziness, or (n) Unexplained fatigue. * Angina Symptoms Angina is similar to heart attack pain but occurs with tangible exertion or exercise and is relieved by rest or nitroglycerin.Angina becomes life threatening when pain occurs at rest, has increased in frequence or intensity, or is not relieved with at least tierce nitr oglycerin tablets taken five minutes apart. This is considered to be unstable angina, which may be a warning sign of an impending heart attack. Aortic Dissection Symptoms The chest pain associated with aortic dissection occurs curtly and is described as pull or tearing. The pain may ray to the back or between the shoulder blades. Because the aorta supplies blood to the entire body, symptoms may also include (a)Angina-type pain, (b)Shortness of breath, (c)Fainting, d)Abdominal pain, or (e)Symptoms of stroke. Pulmonary embolism Symptoms Symptoms of a pulmonary embolus include The sudden onset of shortness of breath, rapid breathing, and sharp pain in the mid chest, which increases with deep breaths. Symptoms of pneumothorax include The sudden onset of shortness of breath,sharp chest pain, rapid heart rate,dizziness, lightheadedness, or faintness. Perforated Viscus Symptoms Perforated viscus comes on suddenly with severe abdominal, chest, and/or back pain. Abdominal pain may incr ease with movement or when breathing in and may be attach to by a rigid, boardlike abdominal wall.Pericarditis Symptoms The pain of pericarditis is typically described as a sharp or stabbing pain in the mid-chest, turn by deep breaths. pain may mimic the pain of a heart attack, because it may radiate to the left side of the back or shoulder. One distinguishing factor is that the pain is worsened by lying flatbed and improved by leaning forward. When lying flat, the inflamed pericardium is in direct contact with the heart and causes pain. When leaning forward, there is a space between the pericardium and the heart. people report a recent cold, fever, shortness of breath, or pain when swallowing just before civiliseing pericarditis.Mitral Valve Prolapse Symptoms Mitral valve prolapse usually has no symptoms, but some people experience palpitations (sensation of rapid or strong heartbeat) and chest pain. Chest pain associated with mitral valve prolapse differs from that of typical angina in that it is sharp, does not radiate, and is not related to physical exertion. Other symptoms include fatigue, light-headedness, and shortness of breath. Complications include infection of the heart valves, mitral valve regurgitation (an abnormal blood flow within the chambers of the heart), and abnormal heart rhythms, which rarely cause sudden death.Pneumonia Symptoms The chest pain of pneumonia occurs during elongated or forceful coughing. The pain is usually one-sided an is worsened by coughing. Other associated symptoms include fever, coughing up mucus (sputum), and shortness of breath. Esophagus Related Symptoms With chest pain originating from the esophagus, symptoms depend on the source. * (a)Symptoms of gastroesophageal reflux disease (GERD) include (b)Heartburn, (c)Painful swallowing, (d)Excessive salivation, (e)Dull chest discomfort, (f)Chest pressure, or (g)Severe squeezing pain across the mid chest. h)You may feel uncomfortable or may experience (j)Profuse swea ting, (k)Pallor, (l)Nausea, and (m)Vomiting. Symptoms of esophagitis include difficulty swallowing, painful swallowing, or symptoms of GERD. The chest pain comes on suddenly and is not relieved by antacids. The pain of esophageal spasm is usually intermittent and dull. It is located in the mid-chest and may radiate to the back, neck, or shoulders. DIAGNOSIS Heart Attack In the hospital emergency department, the wellnesscare providers use ternion basic procedures to decide if a diligent is having a heart attack. (a) The offset printing is the symptoms reported by the unhurried. * (b) The second is an electrocardiogram ( electrocardiogram or EKG), an electrical tracing of the hearts activity. On the ECG, it may be attainable to tell which vessels in the heart are blocked or narrowed. * (c) The third is measurement of enzymes produced by the heart muscle cells when they do not dupe enough oxygen. These enzymes are detectable with blood tests and are called cardiac enzymes. Ang ina Angina is appointd by the same methods doctors use to diagnose heart attacks. In angina, the test results reveal no permanent damage to the heart.The diagnosis is do only after the possibility of a heart attack has been rule out, usually by negative results on three sets of cardiac enzyme tests. the ECG may show abnormalities, these changes are often reversible. * Another way to diagnose angina is the stress test these tests monitor your ECG during exercise or other stress to identify blockages in blood vessels to the heart. * Cardiac catheterization is used to identify blockages. This is a special type of x-ray (angiography or arteriography) that uses a harmless dye to highlight blockages or other abnormalities in blood vessels.Aortic Dissection The diagnosis of aortic dissection is based on the symptoms the affected role describes, chest x-ray, and other special imaging tests. On a chest x-ray, the aorta forget have an abnormal contour or appear widened. * Transesophageal echocardiography is a specialised ultrasound of the heart in which a probe is inserted into the esophagus. The technique is performed under sedation or general anaesthesia. The dissection may be identified very accurately by a CT tire of the chest or angiography. * * Pulmonary Embolism * * The diagnosis of pulmonary embolism is made from a variety of sources.Description of the perseverings symptoms and results of ECG and chest x-ray all may contribute to the diagnosis, but are not definitive. patient will be asked if they have had any symptoms of a blood clot in the leg. The healthcare provider may draw blood drawn from the patients artery to check the levels of oxygen and other gases. Abnormalities in blood gases indicate a line of work in the lungs that is preventing the patient from getting enough oxygen. A ventilation-perfusion glance (V/Q scan) compares blood flow to oxygen intake in different segments of the lung. An irregularity in just one segment can indicate an emboli sm.CT scan of the lungs is another way to determine if a patient has a pulmonary embolus. It may be done instead of the V/Q scan. Spontaneous Pneumothorax Spontaneous pneumothorax is diagnosed by physical exam and chest x-ray. A CT scan may be helpful in locating a small pneumothorax. Perforated viscus usually can be identified by a chest x-ray with the patient standing upright or an abdominal x-ray lying on the left side. -rays in these positions allow air to rise to the diaphragm, where it can be detected. The symptoms and the results of the physical exam and other lab tests also assist in diagnosis. * Pericarditis * * Acute pericarditis is usually diagnosed by the patients symptoms, serial ECGs, and echocardiography. Certain lab tests may be helpful in determining the cause. * * Pneumonia Pneumonia is diagnosed by the patients symptoms and medical history, physical examination, and chest x-ray. Esophagus Disorders of the esophagus causing chest pain are diagnosed by a answer of elimination. The diagnosis is made on the basis of the patients symptoms and medical history, after legal opinion out cardiac causes and observing whether the patient experiences pain relief from antacids.Chest Pain Treatment Self-Care at Home Heart Attack If you comic that you or someone you are with may be having a heart attack, call for emergency services or go to the close hospital emergency department. * While waiting for the ambulance, have the patient chew ii baby aspirin or at least half of a regular aspirin at least 160 mg. There is no evidence that taking more than this helps more, and the patient could have unwanted side effects if they take too much. * It is important to chew the aspirin before swallowing it because chewing decreases the time the medicine takes to have an effect.Chewing an aspirin in the early stages of a heart attack may reduce the risk of death and it may also reduce the severity of the attack. Angina If the patient has had angina and has nitrogly cerin tablets available, have the patient place one under the tongue. This may aid in increasing blood flow to blocked or narrowed arteries. If the chest pain continues in the next five minutes, take another tablet under the tongue. If, after three nitroglycerin tablets, the patient does not have relief of the chest pain, go to the nearest emergency department. Esophagus the pain is from acid reflux (GERD), it may be relieved with antacids.Even if the patients pain goes away after taking an antacid, do not assume they are not having a heart attack. The patient should still be evaluated in a hospital emergency department. medical examination Treatment Heart Attack Treatment 1. Treatment for a heart attack is aimed at increasing blood flow by hypothesis arteries blocked or narrowed by a blood clot. * 2. Medicines used to achieve this include aspirin, heparin, and clot-busting (thrombolytic) drugs. * 3. Other medications can be used to behindhand the heart rate, which decreases the workload of the heart and reduces pain. * 4. Angioplasty is a way of unblocking an artery.Angiography is done first to locate narrowing or blockages. A very thin ductile tube called a catheter is inserted into the artery. A tiny balloon on the end of the catheter is inflated. This expands the artery, providing a wider passage for blood. The balloon is then deflated and removed. Sometimes a small metal scaffold called a stent is placed in the artery to keep it expanded. * 5. Surgery may be required if medical word is unsuccessful. This could include angioplasty or cardiac bypass. * * Angina Treatment * * Treatment of angina is directed at relieving chest pain that occurs as the result of decreased blood flow to the heart.The medication nitroglycerin is the most widely used treatment. Nitroglycerin unfolds (widens) the coronary arteries. It is often taken under the tongue (sublingually). volume with known angina may be treated with nitroglycerin for three doses, five minutes apar t. the pain runs, nitroglycerin is given by IV, and the patient is admitted to the hospital and monitored to rule out a heart attack. Long-term treatment after the first episode of angina focuses on reduce risk factors for atherosclerosis and heart disease. Aortic Dissection Treatment 1. Suspected aortic dissection often is treated with medications that reduce blood pressure. 2. Medications that slow the heart rate and dilate the arteries are the most widely used. * 3. Close monitoring is required to vitiate lowering the blood pressure too much, which can be dangerous. * 4. operative repair is required for any dissection that involves the ascending (upward) portion of the aorta. * * Pulmonary Embolism Treatment * * 1. Anyone with a presumed or documented pulmonary embolism requires admission fee to the hospital. * * 2. Treatment usually includes supplemental oxygen and medication to prevent hike clotting of blood, typically heparin. * * 3.If the embolism is very large, clot-bus ting medications are given in some situations to dissolve the clot. * * 4. Some people undergo surgery to place an umbrella-like filter in a blood vessel to prevent blood clots from the lower extremities from moving to the lungs. * * Pneumothorax Treatment 1. A pneumothorax without symptoms involves six hours of hospital honoring and repeat chest x-rays. * 2. If the size of the pneumothorax remains unchanged, the patient is usually carry through with a follow-up appointment in 24 hours. * 3. If the patient develop symptoms or the pneumothorax enlarges, they will be admitted to the hospital.The patient will undergo catheter ingestion or have a chest tube inserted to restore negative pressure in the lung sac. Perforated Viscus Treatment Any din or perforation of the intestinal tract (viscus) is a potentially life-threatening emergency. quick surgery may be required. Pericarditis Treatment Viral pericarditis usually improves with 7-21 days of therapy with nonsteroidal anti-inflamm atory agents such as aspirin andibuprofen (for example, Motrin). Pneumonia Treatment Pneumonia is treated with antibiotics, and pain medication is given for chest wall tenderness.Costochondritis Treatment Costochondritis is usually treated with nonsteroidal anti-inflammatory medication such as ibuprofen. Esophageal Conditions Treatment The three major esophageal disorders that cause chest pain 1) acid reflux (GERD), 2) esophagitis, and 3) esophageal spasm, are treated with antacid therapy antibiotic, antiviral, or antifungal medication medication to relax the muscles of the esophagus or some combination of these. Follow-up No matter what the cause of chest pain, regular follow-up visits with your healthcare provider are important.This will help you remain as florid as possible and prevent worsening of your condition. barroom Heart Attack stripe legal profession of heart attack and angina involves living what the American Heart Association calls a heart healthy lifestyle. Reducin g your risk factors has a significant effect on reducing your risk. * (a) Dont smoke. * (b) Maintain a healthy weight. * (c) Eat nutritious, low-fat foods in moderate quantities. * (d) If you boozing alcohol, use alcohol moderately. * (e) Engage in physical activity or exercise for at least 30 minutes every day. (f) chasteness high blood pressure and high cholesterol. * (g) If you have diabetes, control your blood sugar every day. Aortic Dissection Prevention Aortic dissection may be prevented by controlling high blood pressure and getting puritanical screening if the patient has a familial disposition to this disorder. Pulmonary Embolism Prevention (a) Prevention of pulmonary embolism includes living a heart healthy lifestyle. (b) No one should smoke, but women older than 35 years who use birth control pills are at in particular high risk from smoking. c) When traveling on extended trips that require sitting for long periods of time (plane, car, train, etc. ) or other times of leg immobilization, get up and allow time for stretching and movement of the legs. Isometric contractions of the calves are helpful if getting out of the seat is not possible. * (d) If the patient has leg swelling, particularly if one is disproportionate to the other, see the doctor or healthcare provider. (e) You should always receive preventive anticoagulant medication after surgery, especially after orthopedic surgery.Spontaneous Pneumothorax Prevention Smoking cessation decreases the risk of spontaneous pneumothorax. Perforated Viscus Prevention Treating peptic ulcers appropriately and avoiding swallowing foreign bodies reduces the risk of perforated viscus. Pericarditis Prevention Because many cases of acute pericarditis are caused by viruses, effective handwashing may reduce transmitting of infectious viral agents. Pneumonia Prevention Effective handwashing and honest hygiene will help reduce the transmission of infectious viruses and bacteria that can cause pneumonia. Esop hagus DiseasePrevention (a) Acid reflux (GERD) can be prevented to a certain extremity in most people. * (b) annul foods and other substances that bring on or worsen symptoms, especially fatty foods * (c) Stop smoking * (d) Use alcohol in moderation, if at all * (e) Avoid eating large meals * (f) Avoid eating for three hours before bedtime * (g) Avoid lying down right after eating * (h) Elevate the head of your bed Outlook archaean medical intervention improves survival in potentially life-threatening illnesses involving chest pain.Heart attack and unstable angina Heart disease, which includes heart attacks and angina, is the tether cause of death for American adults . Whether you survive a heart attack depends on the time it takes to get medical treatment, the region and extent of injury within the heart, and the presence of any other risk factors. Aortic dissection This condition is life-threatening. Quick action in getting medical treatment is requisite with aortic dissectio n. When left untreated, roughly 33% of patients die within the first 24 hours, and 50% die within 48 hours.The two workweek mortality rate approaches 75% in patients with undiagnosed ascending aortic dissection. Pulmonary embolism Even with early treatment, 1 in 10 people with pulmonary embolism die within the first hour. It is treatable if it is not rapidly severe and caught early. Patients are often maintained on blood thinners as treatment. Pneumothorax Most people with this condition recover fully as long as it is not associated with other life-threatening injuries (like in an auto accident). It occurs mostly tall, thin, young people without lung disease.Patients who have had one spontaneous pneumothorax have about a 50% chance of recurrence. Other illnesses causing pneumothorax and complications from the chest tube placement may prolong or worsen the condition. Perforated viscus With early detection and intervention, the prognosis for perforated viscus is good in relatively h ealthy people. If you are in poor health prior to the perforation you will have a worse outcome. Acute pericarditis Although the course may vary with each person, the outcome is good if the disorder is treated promptly. Most people recover in two weeks to three months.Pneumonia In young, healthy adults, the prognosis for pneumonia is good with appropriate treatment. Prognosis is generally poorer in the elderly and in people with weakened immune systems such as those with HIV/AIDS. Chest pain originating from the esophagus Reflux disease (GERD) affects about one-fourth of the adult population and has a very low death rate. Esophagitis may lead to ulcerations, scarring, or narrowing of the esophagus. With the exception of possible perforation, which has a high death rate, the overall prognosis is good. Esophageal spasm has a good outcome.