Angina is simply the medical word for pain. Angina pectoris means pain in the chest, and the two words have slipped into common usage as meaning heart pain.
However, many pains in the chest are not connected to the heart. They may arise from cramping or bruising in the muscles of the chest wall, or from inflammation of the surface of the lung, or from spasm or acid in the esophagus. A common chest pain arises from the ribs, which can be inflamed at the junction between their bony back two-thirds and their cartilaginous front third. Coughing can bruise the muscles between the ribs, causing pain upon deep breathing. Pain in the chest can even come from the stomach, as in indigestion—though it should never be diagnosed as such until heart pain has been ruled out. The precise site of the pain is very relevant. The heart is just left of center in the chest, but heart pain is not confined to this area. It mainly occurs behind the breastbone (in the center of the chest) and around and above the left nipple, but it can spread up to the left shoulder, into the left half of the jaw, down into the left arm, into the back, and even into the upper abdomen. It is less likely to cross over into the right-hand side of the chest, and it is very rare for it to be entirely right-sided. (However, I did once meet a patient with entirely right-sided angina pectoris. He was a “mirror-image” twin, whose organs were on the opposite side of the body as normal, so that his heart was right-sided, and his liver and appendix were on his left side. His twin had his organs on the normal side of the body—they had developed from a single egg that had split early on in the pregnancy.)
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