Having a pain in your chest can be scary. It does not always mean that you are having a heart attack. There can be many other causes, including

• Other heart problems, such as angina
• Panic attacks
• Digestive problems, such as heartburn or esophagus disorders
• Sore muscles
• Lung diseases, such as pneumonia, pleurisy, or pulmonary embolism
• Costochondritis - an inflammation of joints in your chest

Some of these problems can be serious. Get immediate medical care if you have chest pain that does not go away, crushing pain or pressure in the chest, or chest pain along with nausea, sweating, dizziness or shortness of breath. Treatment depends on the cause of the pain.

Angina is chest pain or discomfort you feel when there is not enough blood flow to your heart muscle. Your heart muscle needs the oxygen that the blood carries. Angina may feel like pressure or a squeezing pain in your chest. It may feel like indigestion. You may also feel pain in your shoulders, arms, neck, jaw, or back.

Angina is a symptom of coronary artery disease (CAD), the most common heart disease. CAD happens when a sticky substance called plaque builds up in the arteries that supply blood to the heart, reducing blood flow.

There are three types of angina:

• Stable angina is the most common type. It happens when the heart is working harder than usual. Stable angina has a regular pattern. Rest and medicines usually help.
• Unstable angina is the most dangerous. It does not follow a pattern and can happen without physical exertion. It does not go away with rest or medicine. It is a sign that you could have a heart attack soon.
• Variant angina is rare. It happens when you are resting. Medicines can help.

Not all chest pain or discomfort is angina. If you have chest pain, you should see your health care provider.

Angina can be a warning sign that you are at increased risk of a heart attack. If you have chest pain that does not go away, call 9-1-1 immediately.

Angina is chest pain or discomfort that occurs if an area of your heart muscle does not get enough oxygen-rich blood. It is a common symptom of coronary heart disease, which limits or cuts off blood flow to the heart.

There are several types of angina, and the symptomsdepend on which type you have. Angina chest pain, called an angina event, can happen when your heart is working hard. It can go away when you stop to rest again, or it can happen at rest. This pain can feel like pressure or squeezing in your chest. It also can spread to your shoulders, arms, neck, jaw, or back, just like a heart attack. Angina pain can even feel like an upset stomach. Symptoms can be different for women and men.

To diagnose angina, your doctor will ask you about your signs and symptoms and may run blood tests, take an X-ray, or order tests, such as an electrocardiogram (EKG), an exercise stress test, or cardiac catheterization, to determine how well your heart is working. With some types of angina, you may need emergency medical treatment to try to prevent a heart attack. To control your condition, your doctor may recommend heart-healthy lifestyle changes, medicines, medical procedures, and cardiac rehabilitation.

Each year almost 800,000 Americans have a heart attack. A heart attack happens when blood flow to the heart suddenly becomes blocked. Without the blood coming in, the heart can't get oxygen. If not treated quickly, the heart muscle begins to die. But if you do get quick treatment, you may be able to prevent or limit damage to the heart muscle. That's why it's important to know the symptoms of a heart attack and call 9-1-1 if you or someone else is having them. You should call, even if you are not sure that it is a heart attack.

The most common symptoms in men and women are

• Chest discomfort. It is often in center or left side of the chest. It usually lasts more than a few minutes. It may go away and come back. It can feel like pressure, squeezing, fullness, or pain. It also can feel like heartburn or indigestion.
• Shortness of breath. Sometimes this is your only symptom. You may get it before or during the chest discomfort. It can happen when you are resting or doing a little bit of physical activity.
• Discomfort in the upper body. You may feel pain or discomfort in one or both arms, the back, shoulders, neck, jaw, or upper part of the stomach.

You may also have other symptoms, such as nausea, vomiting, dizziness, and lightheadedness. You may break out in a cold sweat. Sometimes women will have different symptoms then men. For example, they are more likely to feel tired for no reason.

The most common cause of heart attacks is coronary artery disease (CAD). With CAD, there is a buildup of cholesterol and other material, called plaque, on their inner walls or the arteries. This is atherosclerosis. It can build up for years. Eventually an area of plaque can rupture (break open). A blood clot can form around the plaque and block the artery.

A less common cause of heart attack is a severe spasm (tightening) of a coronary artery. The spasm cuts off blood flow through the artery.

At the hospital, health care providers make a diagnosis based on your symptoms, blood tests, and different heart health tests. Treatments may include medicines and medical procedures such as coronary angioplasty. After a heart attack, cardiac rehabilitation and lifestyle changes can help you recover.

A heart attack happens when blood flow to your heart muscle is blocked and the cells in your heart muscle begin to die. Many different health problems can cause a heart attack, but coronary artery disease is the most common.

A heart attack is not the same as cardiac arrest. In a heart attack, the heart keeps beating. The person has a pulse and usually stays conscious (awake). During cardiac arrest, the heart stops beating. The person has no pulse and is unconscious (not awake).

A defibrillator (dee-FIB-ruh-lay-tur) is a machine that sends an electrical shock to the heart to restore normal rhythm. This treatment must be given as soon as possible. For cardiac arrest, call 911 and begin CPR (cardiopulmonary resuscitation) right away. The American Heart Association says that with "hands only" CPR, anyone can give lifesaving treatment to someone having cardiac arrest. Push hard and fast in the center of the chest and keep going until emergency personnel arrive. Do not give CPR for a heart attack.

Heartburn is a painful burning feeling in your chest or throat. It happens when stomach acid backs up into your esophagus, the tube that carries food from your mouth to your stomach.

If you have heartburn more than twice a week, you may have GERD. But you can have GERD without having heartburn.

Pregnancy, certain foods, alcohol, and some medications can bring on heartburn. Treating heartburn is important because over time reflux can damage the esophagus.

Over-the-counter medicines may help. If the heartburn continues, you may need prescription medicines or surgery.

If you have other symptoms such as crushing chest pain, it could be a heart attack. Get help immediately.

Nearly everyone has had indigestion at one time. It's a feeling of discomfort or a burning feeling in your upper abdomen. You may have heartburn or belch and feel bloated. You may also feel nauseated, or even throw up.

You might get indigestion from eating too much or too fast, eating high-fat foods, or eating when you're stressed. Smoking, drinking too much alcohol, using some medicines, being tired, and having ongoing stress can also cause indigestion or make it worse. Sometimes the cause is a problem with the digestive tract, like an ulcer or GERD.

Avoiding foods and situations that seem to cause it may help. Because indigestion can be a sign of a more serious problem, see your health care provider if it lasts for more than two weeks or if you have severe pain or other symptoms. Your health care provider may use x-rays, lab tests, and an upper endoscopy to diagnose the cause. You may need medicines to treat the symptoms.

What is indigestion?

Indigestion, also called dyspepsia or upset stomach, is a general term that describes a group of gastrointestinal symptoms that occur together. These symptoms most often include

• pain, a burning feeling, or discomfort in your upper abdomen
• feeling full too soon while eating a meal
• feeling uncomfortably full after eating a meal

Indigestion may be

• occasional—happening once in a while
• chronic—happening regularly for a few weeks or months
• functional—having chronic symptoms without a specific cause

Indigestion is not a disease. However, indigestion may be a sign of certain digestive tract diseases or conditions. Indigestion is not always related to eating.

Sometimes digestive tract diseases such as peptic ulcer disease, gastritis, and stomach cancer cause chronic indigestion. However, most often doctors do not know what causes chronic indigestion. Chronic indigestion without a health problem or digestive tract disease that could explain symptoms is called functional dyspepsia.

How common is indigestion?

Indigestion is a common condition, affecting about 1 in 4 people in the United States each year.

Of those people with indigestion who see a doctor, almost 3 in 4 are diagnosed with functional dyspepsia.

Who is more likely to get indigestion?

You are more likely to get indigestion if you

• drink
  • too many alcoholic beverages
  • too much coffee or too many drinks containing caffeine
• eat
  • too fast or too much during a meal
  • spicy, fatty, or greasy foods
  • foods that contain a lot of acid, such as tomatoes, tomato products, and oranges
• feel stressed
• have certain health problems or digestive tract diseases
• smoke
• take certain medicines

What are the complications of indigestion?

In most cases, indigestion does not have complications, although it may affect your quality of life.

Costochondritis is a chest wall pain caused by inflammation of the costal cartilages or the area where the ribs meet the sternum, known as sternal articulations. It is a benign cause of chest pain. Patients often present with the chief complaint of chest pain; therefore, other causes of chest pain must be excluded with history, physical exam, and/or diagnostic testing prior to a diagnosis of costochondritis.

Panic disorder is a type of anxiety disorder. It causes panic attacks, which are sudden feelings of terror when there is no real danger. You may feel as if you are losing control. You may also have physical symptoms, such as

• Fast heartbeat
• Chest or stomach pain
• Breathing difficulty
• Weakness or dizziness
• Sweating
• Feeling hot or a cold chill
• Tingly or numb hands

Panic attacks can happen anytime, anywhere, and without warning. You may live in fear of another attack and may avoid places where you have had an attack. For some people, fear takes over their lives and they cannot leave their homes.

Panic disorder is more common in women than men. It usually starts when people are young adults. Sometimes it starts when a person is under a lot of stress. Most people get better with treatment. Therapy can show you how to recognize and change your thinking patterns before they lead to panic. Medicines can also help.

People with panic disorder have frequent and unexpected panic attacks. These attacks are characterized by a sudden wave of fear or discomfort or a sense of losing control even when there is no clear danger or trigger. Not everyone who experiences a panic attack will develop panic disorder.

Panic attacks often include physical symptoms that might feel like a heart attack, such as trembling, tingling, or rapid heart rate. Panic attacks can occur at any time. Many people with panic disorder worry about the possibility of having another attack and may significantly change their life to avoid having another attack. Panic attacks can occur as frequently as several times a day or as rarely as a few times a year.

Panic disorder often begins in the late teens or early adulthood. Women are more likely than men to develop panic disorder.

Imagine that you are at the mall one day with your friends and—suddenly and inexplicably—you begin sweating and trembling, your heart starts pounding, you have trouble breathing, and you start to feel dizzy and nauseous. This episode lasts for 10 minutes and is terrifying because you start to think that you are going to die. When you visit your doctor the following morning and describe what happened, she tells you that you have experienced a panic attack. If you experience another one of these episodes two weeks later and worry for a month or more that similar episodes will occur in the future, it is likely that you have developed panic disorder.

People with panic disorder experience recurrent (more than one) and unexpected panic attacks, along with at least one month of persistent concern about additional panic attacks, worry over the consequences of the attacks, or self-defeating changes in behavior related to the attacks (e.g., avoidance of exercise or unfamiliar situations) (APA, 2013). As is the case with other anxiety disorders, the panic attacks cannot result from the physiological effects of drugs and other substances, a medical condition, or another mental disorder. A panic attack is defined as a period of extreme fear or discomfort that develops abruptly and reaches a peak within 10 minutes. Its symptoms include accelerated heart rate, sweating, trembling, choking sensations, hot flashes or chills, dizziness or lightheadedness, fears of losing control or going crazy, and fears of dying (APA, 2013). Sometimes panic attacks are expected, occurring in response to specific environmental triggers (such as being in a tunnel); other times, these episodes are unexpected and emerge randomly (such as when relaxing). According to the DSM-5, the person must experience unexpected panic attacks to qualify for a diagnosis of panic disorder.

Experiencing a panic attack is often terrifying. Rather than recognizing the symptoms of a panic attack merely as signs of intense anxiety, individuals with panic disorder often misinterpret them as a sign that something is intensely wrong internally (thinking, for example, that the pounding heart represents an impending heart attack). Panic attacks can occasionally precipitate trips to the emergency room because several symptoms of panic attacks are, in fact, similar to those associated with heart problems (e.g., palpitations, racing pulse, and a pounding sensation in the chest) (Root, 2000). Unsurprisingly, those with panic disorder fear future attacks and may become preoccupied with modifying their behavior in an effort to avoid future panic attacks. For this reason, panic disorder is often characterized as fear of fear (Goldstein & Chambless, 1978).

Panic attacks themselves are not mental disorders. Indeed, around 23% of Americans experience isolated panic attacks in their lives without meeting the criteria for panic disorder (Kessler et al., 2006), indicating that panic attacks are fairly common. Panic disorder is, of course, much less common, afflicting 4.7% of Americans during their lifetime (Kessler et al., 2005). Many people with panic disorder develop agoraphobia, which is marked by fear and avoidance of situations in which escape might be difficult or help might not be available if one were to develop symptoms of a panic attack. People with panic disorder often experience a comorbid disorder, such as other anxiety disorders or major depressive disorder (APA, 2013).

Researchers are not entirely sure what causes panic disorder. Children are at a higher risk of developing panic disorder if their parents have the disorder (Biederman et al., 2001), and family and twins studies indicate that the heritability of panic disorder is around 43% (Hettema, Neale, & Kendler, 2001). The exact genes and gene functions involved in this disorder, however, are not well-understood (APA, 2013). Neurobiological theories of panic disorder suggest that a region of the brain called the locus coeruleus may play a role in this disorder. Located in the brainstem, the locus coeruleus is the brain’s major source of norepinephrine, a neurotransmitter that triggers the body’s fight-or-flight response. Activation of the locus coeruleus is associated with anxiety and fear, and research with nonhuman primates has shown that stimulating the locus coeruleus either electrically or through drugs produces panic-like symptoms (Charney et al., 1990). Such findings have led to the theory that panic disorder may be caused by abnormal norepinephrine activity in the locus coeruleus (Bremner, Krystal, Southwick, & Charney, 1996).

Conditioning theories of panic disorder propose that panic attacks are classical conditioning responses to subtle bodily sensations resembling those normally occurring when one is anxious or frightened (Bouton, Mineka, & Barlow, 2001). For example, consider a child who has asthma. An acute asthma attack produces sensations, such as shortness of breath, coughing, and chest tightness, that typically elicit fear and anxiety. Later, when the child experiences subtle symptoms that resemble the frightening symptoms of earlier asthma attacks (such as shortness of breath after climbing stairs), he may become anxious, fearful, and then experience a panic attack. In this situation, the subtle symptoms would represent a conditioned stimulus, and the panic attack would be a conditioned response. The finding that panic disorder is nearly three times as frequent among people with asthma as it is among people without asthma (Weiser, 2007) supports the possibility that panic disorder has the potential to develop through classical conditioning.

Cognitive factors may play an integral part in panic disorder. Generally, cognitive theories (Clark, 1996) argue that those with panic disorder are prone to interpret ordinary bodily sensations catastrophically, and these fearful interpretations set the stage for panic attacks. For example, a person might detect bodily changes that are routinely triggered by innocuous events such getting up from a seated position (dizziness), exercising (increased heart rate, shortness of breath), or drinking a large cup of coffee (increased heart rate, trembling). The individual interprets these subtle bodily changes catastrophically (“Maybe I’m having a heart attack!”). Such interpretations create fear and anxiety, which trigger additional physical symptoms; subsequently, the person experiences a panic attack. Support of this contention rests with findings that people with more severe catastrophic thoughts about sensations have more frequent and severe panic attacks, and among those with panic disorder, reducing catastrophic cognitions about their sensations is as effective as medication in reducing panic attacks (Good & Hinton, 2009).

Pulmonary embolism is a type of venous thromboembolism (VTE) that occurs when a blood clot breaks loose and travels through the bloodstream to the lungs. Usually, pulmonary embolisms come from blood clots in the deep vein of the leg (deep vein thrombosis (DVT)).

Deep Vein Thrombosis and Pulmonary Embolism (DVT/PE) are often underdiagnosed and serious, but preventable medical conditions.

Deep vein thrombosis (DVT) is a medical condition that occurs when a blood clot forms in a deep vein. These clots usually develop in the lower leg, thigh, or pelvis, but they can also occur in the arm.

It is important to know about DVT because it can happen to anybody and can cause serious illness, disability, and in some cases, death. The good news is that DVT is preventable and treatable if discovered early.

Complications of DVT

The most serious complication of DVT happens when a part of the clot breaks off and travels through the bloodstream to the lungs, causing a blockage called pulmonary embolism (PE). If the clot is small, and with appropriate treatment, people can recover from PE. However, there could be some damage to the lungs. If the clot is large, it can stop blood from reaching the lungs and is fatal.

In addition, one-third to one-half of people who have a DVT will have long-term complications caused by the damage the clot does to the valves in the vein called post-thrombotic syndrome (PTS). People with PTS have symptoms such as swelling, pain, discoloration, and in severe cases, scaling or ulcers in the affected part of the body. In some cases, the symptoms can be so severe that a person becomes disabled.

For some people, DVT and PE can become a chronic illness; about 30% of people who have had a DVT or PE are at risk for another episode.

Risk Factors for DVT

Almost anyone can have a DVT. However, certain factors can increase the chance of having this condition. The chance increases even more for someone who has more than one of these factors at the same time.

Following is a list of factors that increase the risk of developing DVT:

• Injury to a vein, often caused by:
  • Fractures,
  • Severe muscle injury, or
  • Major surgery (particularly involving the abdomen, pelvis, hip, or legs).

• Slow blood flow, often caused by:
  • Confinement to bed
    (e.g., due to a medical condition or after surgery);
  • Limited movement (e.g., a cast on a leg to help heal an injured bone);
  • Sitting for a long time, especially with crossed legs; or
  • Paralysis.

• Increased estrogen, often caused by:
  • • Birth control pills
    • Hormone replacement therapy, sometimes used after menopause
    • Pregnancy, for up to 3 months after giving birth

• Certain chronic medical illnesses, such as:
  • Heart disease
  • Lung disease
  • Cancer and its treatment
  • Inflammatory bowel disease (Crohn’s disease or ulcerative colitis)

• Other factors that increase the risk of DVT include:
  • Previous DVT or PE
  • Family history of DVT or PE
  • Age (risk increases as age increases)
  • Obesity
  • A catheter located in a central vein
  • Inherited clotting disorders

Preventing DVT

The following tips can help prevent DVT:

• Move around as soon as possible after having been confined to bed, such as after surgery, illness, or injury.

• If you’re at risk for DVT, talk to your doctor about:
  • Graduated compression stockings (sometimes called “medical compression stockings”)
  • Medication (anticoagulants) to prevent DVT.

• When sitting for long periods of time, such as when traveling for more than four hours:
  • Get up and walk around every 1 to 2 hours.
  • Exercise your legs while you’re sitting by:
    • Raising and lowering your heels while keeping your toes on the floor
    • Raising and lowering your toes while keeping your heels on the floor
    • Tightening and releasing your leg muscles
  • Wear loose-fitting clothes.

• You can reduce your risk by maintaining a healthy weight, avoiding a sedentary lifestyle, and following your doctor’s recommendations based on your individual risk factors.

Symptoms

Know the Signs. Know your Risk. Seek Care.

Everybody should know the signs and symptoms of DVT/PE, their risk for DVT/PE, to talk to their health care provider about their risk, and to seek care immediately if they have any sign or symptom of DVT/PE.

DVT

About half of people with DVT have no symptoms at all. The following are the most common symptoms of DVT that occur in the affected part of the body:

• Swelling
• Pain
• Tenderness
• Redness of the skin

If you have any of these symptoms, you should see your doctor as soon as possible.

PE

You can have a PE without any symptoms of a DVT.

Signs and symptoms of PE can include:

• Difficulty breathing

• Faster than normal or irregular heart beat
• Chest pain or discomfort, which usually worsens with a deep breath or coughing
• Coughing up blood
• Very low blood pressure, lightheadedness, or fainting

If you have any of these symptoms, you should seek medical help immediately.

Diagnosis of DVT and PE

The diagnosis of DVT or PE requires special tests that can only be performed by a doctor. That is why it is important for you to seek medical care if you experience any of the symptoms of DVT or PE.

Treatments for DVT and PE

DVT

Medication is used to prevent and treat DVT. Compression stockings (also called graduated compression stockings) are sometimes recommended to prevent DVT and relieve pain and swelling. These might need to be worn for 2 years or more after having DVT. In severe cases, the clot might need to be removed surgically.

PE

Immediate medical attention is necessary to treat PE. In cases of severe, life-threatening PE, there are medicines called thrombolytics that can dissolve the clot.  Other medicines, called anticoagulants, may be prescribed to prevent more clots from forming. Some people may need to be on medication long-term to prevent future blood clots.

Did you know?

DVT does not cause heart attack or stroke. There are two main types of blood clots.
How a clot affects the body depends on the type and location of the clot:

• A blood clot in a deep vein of the leg, pelvis, and sometimes arm, is called deep vein thrombosis (DVT). This type of blood clot does not cause heart attack or stroke.
• A blood clot in an artery, usually in the heart or brain, is called arterial thrombosis. This type of blood clot can cause heart attack or stroke.

Both types of clots can cause serious health problems, but the causes and steps you can take to protect yourself are different.

Your blood is an amazing, multi-purpose substance. It flows continuously through the body, carrying oxygen and nutrients to your cells. But if you get a scrape or cut, some of this flowing liquid quickly turns to a protective clot.

Clots are tangles of molecules and blood cells that clump together. They help prevent blood loss when the skin breaks open. They also help stop infections from getting inside the body. But when clotting happens inside a blood vessel, it can be dangerous.

Clots can form on the blood vessel walls to help them heal if they get damaged. Afterward, the clots usually dissolve. But sometimes a clot doesn’t get broken down as it’s supposed to. Clots may also form when they’re not needed.

Sometimes, clots break off a vessel wall and travel through the blood to other parts of the body. They may cause a lot of damage, depending on where they block blood flow. Blood clots can potentially harm the brain, heart, lungs, or other organs.

But researchers have made great progress over the last few decades in managing blood clots. They continue to develop new ways to treat and prevent such blockages.

Clogs in the System

Three main things can lead to dangerous blood clots, explains Dr. Mitchell Elkind, an expert on stroke at Columbia University. “One is an abnormality in the blood that makes it more likely to clot. For example, genetic causes, cancer, or damage from smoking,” he says. “The second is when blood doesn’t flow properly.” This can be a side effect of diseases and disorders of the heart or blood vessels.

The third is damage to the lining of blood vessels. One cause of such damage is cholesterol buildup in the blood. Cholesterol is a waxy, fat-like substance that can clump together to form plaques. If a plaque breaks apart, it can damage the blood vessel.

Blood clots can happen to anyone, at any age. But some people are at increased risk. These include older adults and those with certain heart conditions.

Major surgery or a serious injury also add risk. Obesity, being physically inactive, and some medications can boost the chance of a dangerous clot, too.

“And once you’ve had one blood clot, you’re at high risk of another one,” notes Dr. Nigel Key, an expert on blood disorders at the University of North Carolina.

Some infections may also increase the risk of blood clotting. Recent studies have shown that the virus that causes COVID-19, SARS-CoV-2, can cause blood clots in some people.

Symptoms of a Clot

Blood clots can occur anywhere in the body. That makes it difficult to find them before they cause a problem, Elkind explains. The symptoms of a blood clot depend on where they are.

A clot blocking blood flow to the brain can lead to a stroke. Strokes can cause sudden difficulty seeing, speaking, or walking. They can also make you feel weak, numb, dizzy, or confused.

A clot that blocks blood flow to the heart can cause a heart attack. The most common signs are crushing chest pain and difficulty breathing. Others range from cold sweats to arm or shoulder pain.

A clot in the lungs can cause shortness of breath, pain when breathing deeply, or even coughing up blood. A clot in a vein deep within the body is called a deep vein thrombosis, or DVT. Symptoms include swelling, pain, warmth, or red or discolored skin. These usually happen in your legs. Long periods of inactivity can increase your risk.

“Compared with a heart attack or stroke, there’s low awareness of the symptoms of deep vein thrombosis,” Key says. Many symptoms overlap with less dangerous conditions, such as a muscle sprain.

If you have symptoms of a blood clot, call your health care provider or 911 immediately. You may need to go to the hospital to have blood or imaging tests.

Busting Blockages

Treatment depends on where a clot is and how long you’ve had symptoms. Certain drugs can break up and dissolve some types of clots. But they have to be given within a few hours of when symptoms start.

A type of surgery called a thrombectomy can be used to remove clots in large blood vessels. It can be used even if people don’t get to the hospital in time to receive clot-busting drugs. “That’s been a huge benefit for patients,” says Dr. Waleed Brinjikji, an expert on stroke at the Mayo Clinic.

This technique has also let researchers study what clots are made of after they’re removed. “We’re starting to realize how different clots can be,” says Brinjikji.

Different types of clots might benefit from different removal techniques or drugs. So Brinjikji’s team is now testing ways to identify the type of clot before it’s removed. That way they can start to test which treatments work best.

Stopping a Clot

If you have a clot that’s forming, certain medications may help shrink it or stop it from growing. These drugs are called anticoagulants. They’re more commonly known as blood thinners.

Sometimes, people with certain heart conditions are given blood thinners to prevent blood clots from forming. But blood thinners can have side effects, including an increased risk of bleeding. So doctors don’t give them to everyone.

Elkind’s team has been researching which heart conditions may benefit from this type of preventive treatment.

Recent research has shown that blood thinners may help in COVID-19. They might reduce the risk of blood clots and organ damage in people hospitalized with COVID-19. More work is underway to figure out how best to prevent and treat blood clots for those with the disease.

This work will also help researchers better understand how other viruses can affect the blood, Elkind explains. “I think we’re going to learn a lot about how other infections also trigger clotting from studying COVID-19,” he says.

There are many things you can do to decrease your risk of harmful blood clots. See the Wise Choices box for tips.

Reduce Your Risk of Blood Clots

• Eat a heart-healthy diet. Eat more fruits, vegetables, and whole grains. Limit salt and red meat.
• Be physically active. Experts recommend adults get at least 150 minutes of moderate-intensity activity per week.
• Aim for a healthy weight. Excess weight can increase your chances of developing health conditions linked with blood clots. Healthy eating and physical activity can help prevent excess weight.
• Manage stress. Stress can contribute to high blood pressure and other heart disease risk factors.
• Quit smoking. Get free help to quit smoking at smokefree.gov, 1-800-QUIT-NOW (1-800-784-8669), or by texting QUIT to 47848.
• Control high blood pressure, high cholesterol, and diabetes. Talk with your doctor about how to manage these conditions.

Your pleura is a large, thin sheet of tissue that wraps around the outside of your lungs and lines the inside of your chest cavity. Between the layers of the pleura is a very thin space. Normally it's filled with a small amount of fluid. The fluid helps the two layers of the pleura glide smoothly past each other as your lungs breathe air in and out.

Disorders of the pleura include

• Pleurisy - inflammation of the pleura that causes sharp pain with breathing
• Pleural effusion - excess fluid in the pleural space
• Pneumothorax - buildup of air or gas in the pleural space
• Hemothorax - buildup of blood in the pleural space

Many different conditions can cause pleural problems. Viral infection is the most common cause of pleurisy. The most common cause of pleural effusion is congestive heart failure. Lung diseases, like COPD, tuberculosis, and acute lung injury, cause pneumothorax. Injury to the chest is the most common cause of hemothorax. Treatment focuses on removing fluid, air, or blood from the pleural space, relieving symptoms, and treating the underlying condition.

What is pneumonia?

Pneumonia is an infection in one or both of the lungs. It causes the air sacs of the lungs to fill up with fluid or pus. It can range from mild to severe, depending on the type of germ causing the infection, your age, and your overall health.

What causes pneumonia?

Bacterial, viral, and fungal infections can cause pneumonia.

Bacteria are the most common cause. Bacterial pneumonia can occur on its own. It can also develop after you've had certain viral infections such as a cold or the flu. Several different types of bacteria can cause pneumonia, including:

• Streptococcus pneumoniae
• Legionella pneumophila; this pneumonia is often called Legionnaires' disease
• Mycoplasma pneumoniae
• Chlamydia pneumoniae
• Haemophilus influenzae

Viruses that infect the respiratory tract may cause pneumonia. Viral pneumonia is often mild and goes away on its own within a few weeks. But sometimes it is serious enough that you need to get treatment in a hospital. If you have viral pneumonia, you are at risk of also getting bacterial pneumonia. The different viruses that can cause pneumonia include:

• Respiratory syncytial virus (RSV)
• Some common cold and flu viruses
• SARS-CoV-2, the virus that causes COVID-19

Fungal pneumonia is more common in people who have chronic health problems or weakened immune systems. Some of the types include:

• Pneumocystis pneumonia (PCP)
• Coccidioidomycosis, which causes valley fever
• Histoplasmosis
• Cryptococcus

Who is at risk for pneumonia?

Anyone can get pneumonia, but certain factors can increase your risk:

• Age; the risk is higher for children who are age 2 and under and adults age 65 and older
• Exposure to certain chemicals, pollutants, or toxic fumes
• Lifestyle habits, such as smoking, heavy alcohol use, and malnourishment
• Being in a hospital, especially if you are in the ICU. Being sedated and/or on a ventilator raises the risk even more.
• Having a lung disease
• Having a weakened immune system
• Have trouble coughing or swallowing, from a stroke or other condition
• Recently being sick with a cold or the flu

What are the symptoms of pneumonia?

The symptoms of pneumonia can range from mild to severe and include:

• Fever
• Chills
• Cough, usually with phlegm (a slimy substance from deep in your lungs)
• Shortness of breath
• Chest pain when you breathe or cough
• Nausea and/or vomiting
• Diarrhea

The symptoms can vary for different groups. Newborns and infants may not show any signs of the infection. Others may vomit and have a fever and cough. They might seem sick, with no energy, or be restless.

Older adults and people who have serious illnesses or weak immune systems may have fewer and milder symptoms. They may even have a lower than normal temperature. Older adults who have pneumonia sometimes have sudden changes in mental awareness.

What other problems can pneumonia cause?

Sometimes pneumonia can cause serious complications such as:

• Bacteremia, which happens when the bacteria move into the bloodstream. It is serious and can lead to septic shock.
• Lung abscesses, which are collections of pus in cavities of the lungs
• Pleural disorders, which are conditions that affect the pleura. The pleura is the tissue that covers the outside of the lungs and lines the inside of your chest cavity.
• Kidney failure
• Respiratory failure

How is pneumonia diagnosed?

Sometimes pneumonia can be hard to diagnose. This is because it can cause some of the same symptoms as a cold or the flu. It may take time for you to realize that you have a more serious condition.

Your health care provider may use many tools to make a diagnosis:

• A medical history, which includes asking about your symptoms
• A physical exam, including listening to your lungs with a stethoscope
• Various tests, such as
  • A chest x-ray
  • Blood tests such as a complete blood count (CBC) to see if your immune system is actively fighting an infection
  • A Blood culture to find out whether you have a bacterial infection that has spread to your bloodstream

If you are in the hospital, have serious symptoms, are older, or have other health problems, you may also have more tests, such as:

• Sputum test, which checks for bacteria in a sample of your sputum (spit) or phlegm (slimy substance from deep in your lungs).
• Chest CT scan to see how much of your lungs is affected. It may also show if you have complications such as lung abscesses or pleural effusions.
• Pleural fluid culture, which checks for bacteria in a fluid sample that was taken from the pleural space
• Pulse oximetry or blood oxygen level test, to check how much oxygen is in your blood
• Bronchoscopy, a procedure used to look inside your lungs' airways

What are the treatments for pneumonia?

Treatment for pneumonia depends on the type of pneumonia, which germ is causing it, and how severe it is:

• Antibiotics treat bacterial pneumonia and some types of fungal pneumonia. They do not work for viral pneumonia.
• In some cases, your provider may prescribe antiviral medicines for viral pneumonia
• Antifungal medicines treat other types of fungal pneumonia

You may need to be treated in a hospital if your symptoms are severe or if you are at risk for complications. While there, you may get additional treatments. For example, if your blood oxygen level is low, you may receive oxygen therapy.

It may take time to recover from pneumonia. Some people feel better within a week. For other people, it can take a month or more.

Can pneumonia be prevented?

Vaccines can help prevent pneumonia caused by pneumococcal bacteria or the flu virus. Having good hygiene, not smoking, and having a healthy lifestyle may also help prevent pneumonia.

Inflammation is your body’s response to infection or injury. It can affect many areas of the body and is a cause of many major diseases, including cancer, ischemic heart disease, and autoimmune diseases. Inflammation in the heart causes damage and can lead to serious health problems.

There are three main types of heart inflammation: endocarditis, myocarditis, and pericarditis. Endocarditis is inflammation of the inner lining of the heart’s chambers and valves. Myocarditis is inflammation of the heart muscle. Pericarditis is inflammation of the tissue that forms a sac around the heart. Many things cause heart inflammation. Common causes include viral or bacterial infections and medical conditions that damage the heart and cause inflammation.

You may have different signs and symptoms depending on the type and severity of the heart inflammation that you have. The treatment your doctor recommends may depend on whether you are diagnosed with inflammation of the lining of your heart or valves, the heart muscle, or the tissue surrounding the heart. You may be treated with medicine, procedures, or possibly surgery to treat your condition and its complications. Complications may include an arrhythmia, or irregular heartbeat, and heart failure.