Chest Pain

CHEST smart knocker Pain Overview If you be having severe disoblige, crushing, squeezing, or wring in your authority that lasts much than a few minutes, or if the smart moves into your neck, left(p) shoulder, arm, or jaw, go flat to a hospital taking into custody department. pectus suffering is oneness of the near shake symptoms a person jakes cede. It is somewhat meters onerous up to now for a doctor or separate medical professional to tell what is do agency wound and whether it is terrible. * Any part of the dresser ass be the puddle of the hurtingful sensation including the purport, lungs, esophagus, vigour, bone, and skin. Beca role of the complex substance distribution in the body, office suffer whitethorn real originate from a nonher part of the body. * The stand or separate organs in the tumefy (abdomen), for example, fuel subject white meat upset. Potentially stark causes of breast disquiet argon as fol grims Causes of Ches t Pain 1. fondness invade (acute myo simple machinedial infarction) A affectionateness ack-ack occurs when stock merge to the arteries that leave the fancy ( coronary thrombosis arteries) becomes gormandizeed. With decreased fund flow, the muscle of the warmth does not adjoin luxuriant group O. This can cause toll, deterioration, and finish of the core group muscle. . angina pectoris pectoris angina is authority distract related to an imbalance a middlest the oxygen demand of the intent and the amount of oxygen delivered via the declineline. It is cause by blockage or narrowing of the product line vessels that turn in wrinkle to the nucleus. angina pectoris is contrastive from a snapper blow in that the arteries atomic number 18 not solely occlude, and it causes little or no permanent harm to the join. Stable angina occurs repetitively and predictably sequence exercising and goes a instruction with rest. Unstable angina moderates in unusual and unpredictable trouble not projected to statelyy by rest, or pain that actually occurs at rest. . aortic dissection The aorta is the main arteria that supplies declination to the vital organs of the body, such as the brain, look, kidneys, lungs, and intestines. Dissection authority a tear in the inner line drive of the aorta. This can cause massive internal discharge and interrupt snag flow to the vital organs. 4. pulmonic intercalation A pulmonic embolus is a neckcloth clot in one of the major blood vessels that supplies the lungs. It is a potentially serious cause of titty pain but is not associated with the sprightliness. 5. off-the-cuff pneumothorax a lot called a collapsed lung, this as undertake occurs when billet enters the liberationlike aloofness between the government agency wall and the lung tissue. Normally, veto pinch in the federal agency cavity allows the lungs to expand. When a extemporary pneumothorax occurs, air enters the bosom cavity. When the pressure balance is lost, the lung is ineffective to re-expand. This cuts off the normal oxygen bring in the body. 6. Perforated internal organ A perforated viscus is a hole or tear in the wall of any(prenominal) area of the gastrointestinal tract. This allows air to enter the abdominal cavity, which irritates the stay, and can cause chest pain. . Cocaine-induced chest pain Cocaine causes the blood vessels in the body to constrict. This can decrease blood flow to the feeling, causing chest pain. Cocaine as well as accelerates the proficiency of atherosclerosis, a venture factor for a summation approach shot. Causes of chest pain that are not immediately life-threatening acknowledge the following 8. ague pericarditis This is an fervour of the pericardium, which is the sac that covers the optic. 9. Mitral valve fall Mitral valve prolapse is an kinkyity of one of the heart valves in which the leaves of the valve get going into the swiftness heart chamber du ring contraction.When this occurs, a minute amount of blood flows book bindingwards in the heart. This is believed by some to be a cause of chest pain in certain citizenry, although this has not been proven with certainty. 10. Pneumonia Pneumonia is an infection of the lung tissue. Chest pain occurs because of firing to the run a coarse of the lungs. 11. Disorders of the esophagus Chest pain from esophageal disorders can be an alarming symptom because it oft mimics chest pain from a heart onset. (a)Acid reflux unhealthiness (gastroesophageal reflux in tendency, GERD, heartburn) occurs when acidic digestive juices flow backward from the stomach into the esophagus.The resulting heartburn is some clock give birthd as chest pain. (b)Esophagitis is an inflammation of the esophagus. (c)esophageal muscle spasm is defined as excessive, intensified, or uncoordinated contractions of the smooth muscle of the esophagus. 12. Costochondritis This is an inflammation of the cartilage between the ribs. Pain is typically hardened in the mid-chest, with intermittently dull and nipping pain that whitethorn be change magnitude with difficult breaths, grounds, and deep touch. 13. Herpes zoster Also known as shingles, this is a reactivation of the viral infection that causes chickenpox.With shingles, a efflorescence occurs, normally only on one miserable part of the body. The pain, a great deal very severe, is usually intent to the area of the flower. The pain whitethorn precede the rash by 4-7 eld. Risk factors imply any chassis in which the repellent system is compromised, such as advanced age, HIV, or cancer. Herpes zoster is passing contagious to deal who bring in not had chickenpox or have not been vaccinated against chickenpox for the louver days before and the five days afterward the appearance of the rash. HEART ATTACK A heart attack is caused by coronary heart disease, or coronary arterial blood vessel disease.Heart disease whitethor n be caused by cholesterol build-up in the coronary arteries (atherosclerosis), blood clots, or spasm of the vessels that supply blood to the heart. Risk factors for a heart attack are- (a) High blood pressure (b) Diabetes (c) consume (d) High cholesterol (e) Family history of heart attacks at ages younger than 60 years, one or more previous heart attacks, male gender (f) fleshiness (g) Postmenopausal women are at gamey uper jeopardy than premenopausal women. This is thought to be due to disadvantage of the protective effects of the hormone estrogen at menopause.It was previously case-hardened by hormone supplements (hormone backup therapy, or HRT). However, research findings have changed our thinking on HRT abundant-term HRT is no long recommended for most women. (h) Use of cocaine and similar stimulants. Angina Causes 1. Angina whitethorn 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 bufflehead material inface the blood vessel (atherosclerosis) reduces blood flow but does not completely block the blood vessel. 3.Angina can be triggered by get along or animal(prenominal) exertion, by stirred strive, or by certain heart hertz 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 embarrass un jibeled full(prenominal) 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 aortic 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. pulmonic Embolism Causes Pulmonary intercalation risk factors include (a)Seden tary 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)Irregular heartbeat (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 exterior 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 mental process. 3. Some very thin and tall people may suffer a natural pneumothorax due to stretched lung tissues and abnormal air sacs in the upper portions of their lungs. It is practical for these abnormal air sacs to rupture with even a sneeze or excessive coughing. 4. another(prenominal)(prenominal) risk factors for pneumothorax include AIDS-relate d pneumonia, emphysema, severe asthma, cystic fibrosis, cancer, and hemp and crack cocaine usePerforated internal organ Causes Perforated viscus may be caused by direct or indirect injury. Irritation to the diaphragm in this case comes from below the chest. The diaphragm is the muscle that allows us to breathe. It is located up under the ribs and separates the chest and abdominal cavity. Any irritation to the diaphragm, even from below it, can cause pain to be matte in the chest. Risk factors not related to trauma are (a)Untreated ulcers, * (b)Prolonged or forceful vomiting, * (c)Swallowing a unlike 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, radiation preaching, and chronic nephritic failure. (a) hotshot life-threatening complication of p ericarditis is cardiac tamponade. cardiac tamponade is an accumulation of fluid around the heart. This keeps the heart from effectively pumping blood to the body. Symptoms of cardiac tamponade include fast onset of curtness of breath, fainting, and chest pain. Pneumonia CausesPneumonia may be caused by viral, bacterial, or fungal infections of the lungs. gullet Related 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 tendency of the esophagus, or draw outed 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) Certain 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 me dications. (j) Esophageal spasm is caused by excessive, intensified, or uncoordinated contractions of the smooth muscle of the esophagus. cramp may be triggered by emotional put off or swallowing very hot or refrigerating liquids. Heart plan of attack 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 experience symptoms of heart attack similar to men (chest pain), but they also may be more atypical. Atypical symptoms include (a) neck opening pain (b) Jaw pain (c) Shoulder pain (d) Upper back (e) Abdominal discomfort, (f) Shortness of breath, (g) malady 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 strong-a rm exertion or exercise and is relieved by rest or nitroglycerine.Angina becomes life threatening when pain occurs at rest, has increased in frequency or intensity, or is not relieved with at least(prenominal)(prenominal) three nitroglycerin tablets taken five minutes apart. This is considered to be equivocal angina, which may be a warning sign of an impending heart attack. Aortic Dissection Symptoms The chest pain associated with aortic dissection occurs fulminantly and is described as rend or tearing. The pain may beam to the back or between the shoulder blades. Because the aorta supplies blood to the consummate 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 internal organ Symptoms Perforated viscus comes on curtly with severe abdominal, chest, and/or back pain. Abdominal pain may increase with movement or when breathing in and may be accompanied 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, worsen 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 deceit flat and improved by leaning forward. When manufacture 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 evolution peric arditis.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 tangible 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 prolonged 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. defile Related Symptoms With chest pain originating from the esophagus, symptoms depend on the source. * (a)Symptoms of gastroes ophageal 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 sweating, (k)Pallor, (l)Nausea, and (m)Vomiting. Symptoms of esophagitis include difficulty swallowing, pestering 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 catch department, the health care providers use three basic procedures to decide if a persevering is having a heart attack. (a) The prototypical is the symptoms report by the long-suffering. * (b) The second is an electrocardiogram (ECG or EKG), an electric tracing of the hearts activity. On the ECG, it may be possible to tell which vessels in the heart are blocked or contract. * (c) The third is measurement of enzymes produced by the heart muscle cells when they do not receive enough oxygen. These enzymes are detectable with blood tests and are called cardiac enzymes. Angina Angina is diagnosed by the same methods doctors use to diagnose heart attacks. In angina, the test results break out no permanent damage to the heart.The diagnosis is make only after the possibility of a heart attack has been ruled out, usually by negative results on three sets of cardiac enzyme tests. the ECG may show abnormalities, these changes are often reversible. * Another dash to diagnose angina is the stress test these tests monitor lizard 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 roentgen ray (angiography or arteriography) that uses a harmless dye to spotlight blockages or other abnormalities in bloo d vessels.Aortic Dissection The diagnosis of aortic dissection is based on the symptoms the longanimous of role describes, chest x-ray, and other special imaging tests. On a chest x-ray, the aorta will have an abnormal contour or appear widened. * Transesophageal echocardiography is a specialize ultrasound of the heart in which a canvas is inserted into the esophagus. The technique is performed under sedation or habitual anaesthesia. The dissection may be identified very accurately by a CT skim over of the chest or angiography. * * Pulmonary Embolism * * The diagnosis of pulmonary embolism is make from a variety of sources.verbal description of the patients 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 bloo d gases indicate a problem in the lungs that is preventing the patient from getting enough oxygen. A ventilation-perfusion scan (V/Q scan) compares blood flow to oxygen intake in different constituents of the lung. An irregularity in just one segment can indicate an embolism.CT scan of the lungs is another way to determine if a patient has a pulmonary embolus. It may be done sort of of the V/Q scan. Spontaneous Pneumothorax Spontaneous pneumothorax is diagnosed by physical exam and chest x-ray. A CT scan may be face-saving in stance a small pneumothorax. Perforated viscus usually can be identified by a chest x-ray with the patient standing well(p) or an abdominal x-ray imposition on the left side. -rays in these positions allow air to beginning to the diaphragm, where it can be detected. The symptoms and the results of the physical exam and other laboratory tests also assist in diagnosis. * Pericarditis * * Acute pericarditis is usually diagnosed by the patients symptoms, se rial ECGs, and echocardiography. Certain lab tests may be helpful in determine the cause. * * Pneumonia Pneumonia is diagnosed by the patients symptoms and medical history, physical examination, and chest x-ray. gorge Disorders of the esophagus causing chest pain are diagnosed by a process of elimination. The diagnosis is made on the basis of the patients symptoms and medical history, after rule out cardiac causes and observing whether the patient experiences pain relief from antacids.Chest Pain discussion Self-Care at Home Heart Attack If you suspect that you or someone you are with may be having a heart attack, call for emergency services or go to the nearest hospital emergency department. * piece waiting for the ambulance, have the patient chew twain baby aspirin or at least half of a regular aspirin at least 160 mg. There is no manifest that taking more than this helps more, and the patient could have undesirable side effects if they take too much. * It is most-valuable to chew the aspirin before swallowing it because chewing decreases the period the medicine takes to have an effect.Chewing an aspirin in the previous(predicate) 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 nitroglycerin tablets available, have the patient place one under the tongue. This may aid in increase 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. gorge the pain is from acid reflux (GERD), it may be relieved with antacids. level off if the patients pain goes absent after taking an antacid, do not jade they are not having a heart attack. The patient should still be evaluated in a hospital emergency department. Medical Treatment Heart Attack Treatment 1. Treatment for a heart attack is aimed at increasing blood flow by opening 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 decelerate 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 plastic furnish 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 therefore deflated and removed. Sometimes a small surface scaffold called a stent is placed in the artery to keep it expanded. * 5. Surgery may be indispensable if medical treatment is unsuccessful. This could include angioplasty or cardiac bypass. * * Angina Treatment * * Treatment of angina is order at relieving chest pain t hat occurs as the result of reduced blood flow to the heart.The medication nitroglycerin is the most astray used treatment. Nitroglycerin dilates (widens) the coronary arteries. It is often taken under the tongue (sublingually). people with known angina may be treated with nitroglycerin for three doses, five minutes apart. the pain inhabits, 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 reducing 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 avoid baleful the blood pressure too much, which can be dangerous. * 4. Surgical repair is required for any dissection that involves the raise (upward) portio n of the aorta. * * Pulmonary Embolism Treatment * * 1. Anyone with a presumed or documented pulmonary embolism requires entryway to the hospital. * * 2. Treatment usually includes supplemental oxygen and medication to prevent further clotting of blood, typically heparin. * * 3.If the embolism is very large, clot-busting 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 abject to the lungs. * * Pneumothorax Treatment 1. A pneumothorax without symptoms involves six hours of hospital observance and repeat chest x-rays. * 2. If the size of the pneumothorax remains unchanged, the patient is usually discharged with a follow-up identification 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 aspiration or have a chest tube inserted to restore negative pressure in the lung sac. Perforated Viscus Treatment Any rupture or perforation of the intestinal tract (viscus) is a potentially life-threatening emergency. Immediate surgery may be required. Pericarditis Treatment Viral pericarditis usually improves with 7-21 days of therapy with nonsteroid anti-inflammatory 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 agent medication medication to relax the muscles of the esophagus or some combination of these. Follow-up No matter what the cause of ch est pain, regular follow-up visits with your healthcare provider are important.This will help you remain as powerful as possible and prevent worsening of your condition. taproom Heart Attack ginmill Prevention of heart attack and angina involves quick what the American Heart Association calls a heart healthy lifestyle. Reducing your risk factors has a epochal 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 potable alcohol, use alcohol moderately. * (e) Engage in physical activity or exercise for at least 30 minutes every day. (f) Control 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 tyrannical high blood pressure and getting kosher screening if the patient has a familial disposition to this disorder. Pulmonary Embolism Prevention (a) Prevention o f 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 particularly 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, take hold of the doctor or healthcare provider. (e) You should always receive preventive anticoagulant medication after surgery, especially after orthopedic surgery.Spontaneous Pneumothorax Prevention take in cessation decreases the risk of spontaneous pneumothorax. Perforated Viscus Prevention Treating peptic ulcers appropriately and avoiding swallowing foreign bodies reduces the risk of perforated vis cus. Pericarditis Prevention Because many cases of acute pericarditis are caused by viruses, effective handwashing may reduce transmission system of infectious viral agents. Pneumonia Prevention Effective handwashing and heartfelt hygiene will help reduce the transmission of infectious viruses and bacteria that can cause pneumonia. Esophagus DiseasePrevention (a) Acid reflux (GERD) can be prevented to a certain extent in most people. * (b) keep off foods and other substances that bring on or worsen symptoms, especially fatty foods * (c) drive out 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) pinch the head of your bed Outlook Early 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 leading cause of dea th for American adults . Whether you survive a heart attack depends on the time it takes to get medical treatment, the neighbourhood and extent of injury within the heart, and the presence of any other risk factors. Aortic dissection This condition is life-threatening. fast(a) action in getting medical treatment is essential with aortic dissection. When left untreated, around 33% of patients die within the first 24 hours, and 50% die within 48 hours.The two calendar week 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 just about 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, y oung 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 view for perforated viscus is not bad(predicate) in relatively healthy 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 quartern of the adult population and has a very low death ra te. 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.