Category Archives: Chest Pain Causes
Chest Muscle Pain – What Does It Mean?
Chest muscle pain is rather common for a number of reasons, and although the sensation can be somewhat alarming, more often than not it is due to non-life-threatening issues. Common causes include increased activity with exercise, an injury to the chest, pneumonia or blood clot, or violent coughing.
Minor chest pains brought on by increased activity have a few simple treatments to follow. Simply resting and decreasing major movement in the area as well as applying ice will decrease the pain and swelling. It’s also very important to lay your body correctly when going to sleep or taking a nap so that you do not put more pressure on the injury. Turning, twisting, and other such motions should be avoided as much as possible since they may aggravate the pain.
In more mild cases such as coughs, normally the better your cough gets you’ll feel the same with the chest pain. NSAIDs or acetaminophens are good choices to help subside chest pain.
Another important cause of chest muscle pain includes anxiety attacks. Panic attacks can have a very random but strong occurrence and such events tend to contract the muscles in the chest wall. This sometimes makes it harder to breathe and can result in loss of consciousness in more extreme cases. Panic/anxiety attacks are mainly a psychological phenomenon which can be treated with certain medications and even regular meditation. Activities such as meditation and yoga on a regular basis help relax the mind as well as the body so panic and anxiety disorders occur less often.
In more severe cases, heart attack is a cause for chest pain. Symptoms include irregular heartbeat and strong pain in the chest. It differs completely from chest wall pain. Things like blood clots make it harder for blood to flow through the system causing a number of problems.
Some suggestions for preventing a serious ordeal like heart attack is to change eating habits. Many fattening, greasy and heavy foods eventually lead to a general slowing down of blood flow. High blood pressure is another culprit of this chest pain which can lead to heart attack. Having a balanced diet will make the body feel a lot healthier as well as not work hard when performing it’s duties. Regular exercise also is great for helping the heart rate as well as resting the body when it’s more stationary.
Some common prevention tips for overall muscle pain includes limiting drink intake. Alcohol can often produce burning chest pains, and it’s unsafe to have more than one (for women) and two drinks (for men) daily. Smoking is another cause of chest pain because it can lead to lung cancer which has a tremendous effect on the chest. Tobacco smoke is a huge culprit for this cancer. Sometimes, body temperature plays a part in chest pain, so it’s important to have an environment that caters to more of a room temperature setting.
These are a few tips, treatments, and suggestions that will greatly help in curbing your chest muscle pain, so that you live a much healthier and prosperous lifestyle.
Sharp Chest Pain
What would you think if you were curled up in your favorite chair reading a book and you suddenly experienced a sharp pain in your chest?
If you are like many people, you might fear that your sharp chest pain is caused by a heart attack, especially if the pain comes on suddenly.
However, there are many different causes of sharp chest pain, and cardiac arrest is usually not one of them.
The American Heart Association notes that the chest pain that generally causes heart attacks is a painful pressure or a “squeezing” chest pain, not a sharp chest pain. You can find the warning signs for a heart attack by visiting The American Heart Association’s website at http://www.heart.org/HEARTORG/.
So if you experience sharp chest pain, remember that there are a variety of possible causes for it, and that it probably does not mean you are having a heart attack.
Another fear some people experiencing sharp chest pain have is that it is caused by angina, a condition where the heart muscle spasms due to lack of oxygen. Angina is often connected to physical exertion.
However, Jeffrey Larson writes that the chest pain experienced from angina is an uncomfortable pressure instead of a sharp, stabbing pain.
Some people who experience esophageal spasms, sharp chest pains caused by nerve malfunctions in the esophagus, fear the pain is caused by angina (especially if the pain occurs during a workout or physical activity).
The Irish Times notes that the sharp chest pain of esophageal spasms can be felt under the breastbone and that they can also cause difficulty swallowing. Certain foods and beverages or temperatures of food sometimes trigger esophageal spasms, but they can occur at any time.
Costochondritis, sometimes called slipping rib syndrome, is another cause of sharp chest pain. Judith Sims writes that when the cartilage that attaches the ribs to the breastbone becomes inflamed and tender causing sharp chest pain, that is costochondritis.
However, the causes of costochondritis are not fully understood. Costochondritis could be the result of an injury, a recurrent minor trauma, or unusually excessive physical activities.
Have you been to the doctor for a sharp chest pain and after extensive testing had the doctor say you are experiencing “undiagnosed chest pain?” Undiagnosed chest pain is chest pain the doctors were unable to find a cause for so they say the problem is “undiagnosed chest pain.”
Dr. Gifford Jones writes that Tietze Syndrome may be the cause of undiagnosed chest pain. The sharp chest pain of Tietze Syndrome is similar to that of costochondritis. Judith Sims reports that the main difference between Tietze Syndrome and costochondritis is that Tietze Syndrome is caused by inflamed cartilage, but the area will also swell.
The sharp chest pain from both costochondritis and Teitze Syndrome can increase with bad posture and prolonged sitting.
These are a few possible causes for your sharp chest pain. If you are experiencing chest pain, or if a previously diagnosed condition has become worse, you should seek medical attention to find out the cause and so that you can begin treatment.
Works Cited
Gifford-Jones, W. “The Doctor Game.” The Globe and Mail. 23 Aug 1984. LexisNexis. 20 May 2011.
Larson, Jeffrey. “Angina.” The Gale Encyclopedia of Medicine. 3rd ed. Vol 1. 2006. 206-208. Web. 7 July 2011.
“A Short, Sharp Chest Shock.” The Irish Times. 25 Mar 2008. Health:16. Lexis Nexis. Web 27 June 2011.
Sims, Judith. “Costochondritis.” The Gale Encyclopedia of Medicine. 3rd ed. Vol. 2. 1036-1037. Web. 19 June 2011.
Siwek, Jay. “The Jaw and the Heart.” The Washington Post. 25 Aug 1998 Final Ed. Lexis Nexis. Web 27 June 2011
Warning Signs of a Heart Attack. American Heart Assoc., 13 Jun 2011. Web. 30 June 2011.
Can Anxiety Cause Chest Pain
Many people all over the world suffer from anxiety, and some are not even aware of it. Anxiety can easily degenerate into a psychological disorder if it is causing an individual a great amount of stress, and may result in exaggerated fear and panic.
Anxiety in general can be considered a normal response to life, especially if we are going through a lot of difficulties that we are forced to deal with everyday. These “stressors” can arise from different situations or scenarios that elicit negative emotions like anger and frustration, and our psychological mechanism forces us to cope or bust. If our anxieties cause us to behave in an extreme manner, then it becomes an anxiety disorder. The symptoms vary, depending on our reactions, but the question is, can anxiety cause chest pain?
Different people have different reactions to anxiety. In fact, it is already a part of our everyday lives. We feel anxiety and stress if in front of a crowd or an audience, when worrying about money or even when faced with a hostile, angry dog. We feel it if a loved one is ill. We may also feel it before a presentation, or when we are having an argument with somebody. Anxiety is normal. It is how our bodies react to it that sometimes causes implications to our health. “Can anxiety cause chest pain?”, we ask. By the end of reading this article, we are all going to find out.
There are hundreds of symptoms that anxiety typically comes with. Some are emotional; some are more physical; while some experience both. When feeling emotional, more often than not we have difficulties in concentrating, we become irritable and impatient in dealing with other people, and there’s this feeling of unexplainable restlessness. We tend to have botched predictions resulting from not being able to think properly.
The physical aspect of anxiety that could also result from feeling all these emotions are unexplainable headaches, extreme fatigue and tiredness, or difficulty in sleeping. Some even become nauseous all of a sudden. More often than not, anxiety produces excessive amount of sweating, which could become very embarrassing when in front of other people. Our hearts pound uncontrollably, leading to palpitation. We may also develop a tremendous difficulty in breathing, or hyperventilation. Can anxiety cause chest pain? Yes, it can, and it most definitely will if it reaches to a point that we can no longer regulate the stress or contain our emotions.
You can’t always take anxiety lightly, especially if it becomes more and more difficult for you to live your life normally. If you think that it already poses a risk to your health, or if your panic attacks become too frequent for comfort, it is best to consult or seek professional help from a physician, or a psychiatrist.
The more knowledge that you have about your unaccounted fear the better you can nip the problem in the bud. Anxiety can cause chest pain if not treated properly. It could even become a big obstacle as to how you interact with your family, friends and fellow workers. Sometimes, it even leads to the point of a ruining a relationship.
Nervousness, apprehension, worrying, and fear are but some of the symptoms that a person with anxiety may experience. We hope that we’ve been able to answer some of your questions about anxiety today. Anxiety can indeed cause chest pain, but it takes a licensed physician to make that assessment. For any health concerns, please see your doctor and avoid self-analysis.
Chest Pain When Breathing Deeply
Chest pain, especially chest pain when breathing deeply, is something we react to differently than pain experienced elsewhere in the body. Usually we think about different possible causes for our pain, but chest pain is often accompanied by fear of a heart attack since that is the type of chest pain we hear about the most. Becoming aware of some of the possible causes of chest pain when breathing deeply can help alleviate some of the fears if you experience it in the future.
Panic Attacks and Chest Pain
Panic attacks are all about fear. Consider Basil Ross’s situation. Nine months after quadruple bypass surgery, he was rushed to the hospital in fear for his life. He had shooting chest pain and difficulty breathing. However, his EKG results were normal, so he was sent home. After several more trips to the hospital with the same symptoms and a clean angiogram, he was finally diagnosed with panic disorder (chronic panic attacks).
According to the Mayo Clinic, a panic attack is when, for no known reason, someone experiences intense fear accompanied by physical symptoms. During panic attacks, some people feel like they are experiencing a heart attack. They may experience chest pain when breathing deeply, shortness of breath, an increased heart rate, sweating, chills, or other symptoms. If left untreated, panic disorder can lead to serious problems such as depression, substance abuse, and crippling phobias that can leave someone unable to drive a car or leave their own home.
Lung-related Causes
Pulmonary embolisms, blood clots that block blood vessels leading to the lungs, are serious causes of chest pain that can become worse when breathing deeply. Lori De Milo has written that some of the risk factors for pulmonary embolism include lack of movement for prolonged periods of time, surgery, childbirth, cancer, obesity, oral contraceptives, and heart attack or other heart-related problems.
Serena Williams, the tennis star, experienced a pulmonary embolism in February 2011 that was probably caused by flying after surgery since both increase the risk of blood clots. She survived the experience and was back on the tennis courts within a few months because she immediately sought help when her problem began, and the doctors diagnosed her condition quickly.
Pleurisy can be frightening because, as Ian Peate reported, it usually begins suddenly and the pain can increase when breathing in or taking deep breaths. It is caused by the inflammation of the lung linings, often as a result of injury or infection such as pneumonia. It is important to seek medical help for pleurisy because, as S. Kass, Pamela Williams, and Brian Reamy have written, the symptoms (chest pain when breathing deeply) and the condition (the cause of the inflammation) both need to be treated.
Panic attacks, pulmonary embolisms, and pleurisy are a few types of chest pain when breathing deeply. Some other possibilities include costochondritis (sometimes called slipping rib syndrome), pain caused by collision injuries, and muscular chest pain.
If you are experiencing chest pain when breathing deeply, or any type of chest pain, you should seek help from a licensed medical care practitioner for a proper diagnosis and treatment.
Works Cited
De Milo, Lori. “Pulmonary Embolism.” The Gale Encyclopedia of Medicine . 4:3rd ed. (2006). Web. 29 June 2011.
Kass, S., Williams, Pamela, and Reamy, Brian. “Pleurisy.” American Family Physician 75:9 (2007): 1357-1364. EBSCOhost. Web. 3 June 2011.
“Panic Attacks and Panic Disorder.” MayoClinic.com. Mayo Foundation for Medical Education and Research, 1998-2011. Web. 15 June 2011.
Peate, Ian. “Caring for the Person with Pleurisy.” British Journal of Healthcare Assistants 03:10 (2009): 480-483. EBSCOhost. Web. 3 June 2011.
Pucin, Diane and Brown, Eryn. “Serena Williams Has Health Scare.” Los Angeles Times. 3 Mar 2011 Home Ed. Lexis Nexis. Web 27 June 2011.
Ross, Cecily. “The heart of the matter; smoking, high blood pressure, cholesterol … we all know the physical risks. But now doctors say that for cardiac patients, treating the mind is just as important as treating the body.” The Glove and Mail. 18 Dec 2004. LexisNexis. Web. 15 June 2011.
Different Types of Right Chest Pain
There are different types of right chest pain and it can be difficult to determine what the cause of the pain actually is. Sometimes, even locating the pain precisely can be a challenge since it can manifest either as a stabbing pain or a burning sensation around the chest area. Keep reading for a few different causes of right chest pain.
Some possible causes include rib problems, lung issues leading to pleuritic chest pain, muscular issues such as those caused by pulled muscles, or heart problems.
Gallbladder Pain
The gallbladder is located along the right bottom of the chest by the liver, and it’s possible to feel right chest pain along that area. Dr. Miriam Stoppard notes that gallbladder pain is sometimes similar to angina (heart pain) or peptic acid pain (small intestine or stomach pain).
One common gallbladder problem is gallstones. Thomas Lynch describes gallstones as “small, pebble-like gritty deposits” that form from the bile the liver secretes to the gallbladder. Stones form if the liquid solidifies. They often pass naturally, but if they cause a blockage it will often result in pain. And if the blockage does not clear up on its own, it will become worse and require a medical procedure, possibly even the gallbladder’s removal. (These days, most gallbladder surgeries are done laparoscopically with only a small incision and a short recovery time.) The pain resulting from a gallstone problem can sometimes be felt along the right side of the chest.
Costochondritis
Another type of pain, known as Costochondritis pain, can be experienced specifically on the right side of the chest. Per the Gale Encyclopedia of Medicine, this is described as inflammation and tenderness of the cartilage attached to the front of the ribs. The severe pain is usually felt on one side of the chest at a time, and can increase noticeably when sitting or lying down.
On the other hand, Costochondritis may sometimes be confused with Tietze Syndrome. There is, however, a significant differentiating symptom between the two conditions, which is that Tietze Syndrome also includes swelling. Dr. Gifford-Jones reports that Tietze’s syndrome is a common cause of undiagnosed chest pain.
Since sitting for a long time and bad posture can increase the pain for both costochondritis and Tietze Syndrome, be sure to sit up straight like your gym teacher told you to, and walk away from your computer on a regular basis (no matter how adorable that next kitten video looks!)
If you have right chest pain (or any type of chest pain), or if a chest pain you have already seen your doctor about has worsened or intensified, you should seek medical attention. While it’s true that many types of chest pain are not life threatening, your physician needs to make a thorough diagnosis to be sure.
Works Cited
“Costochondritis.” The Gale Encyclopedia of Medicine. Vol. 2. 3rd ed. P 1036-1037. Web. 19 June 2011.
Gifford-Jones, W. “The Doctor Game.” The Globe and Mail. 23 Aug 1984. LexisNexis. 20 May 2011.
Kochar, Suneeta and Cornelius, Paul “Clinical – Respiratory – Spotting the Signs of Pneumothorax.” Independent Nurse. 2:32 (2009): 32. LexisNexis. Web. 7 June 2011.
Lynch, Thomas. “The Gritty Reality Behind Gallstones.” The Irish Times. 25 Aug 2009. Web. 20 June 2011.
Steefel, Lorraine. “Pneumothorax.” The Gale Encyclopedia of Medicine 4. 3 ed. (2006). Web 14 June 2011.
Stoppard, Miriam. “Health Focus: When a Fry-Up is Agony: Gallstones.” The Mirror. 27 July 2000. Web. 20 June 2011.
Left Chest Pain: It Might Not Be What You Think
There are a variety of causes for left chest pain that are not heart attack related. We will be discussing panic attacks, internal injuries from collisions, and heartburn/GERD.
It is also possible for pneumothorax and rib or muscle injuries to be specific to the left side of the chest and for gallbladder, liver problems, and other chest pains to be felt on the left side of the chest instead of the right or center.
Pain receptors can be deceptive, and everybody experiences pain differently.
Panic Attacks
Imagine that for no reason, your heart starts racing, it becomes difficult to breath, and you feel a sharp pain in the left side of your chest. You suddenly become frightened. The Mayo Clinic notes that sudden occurrences of major physical reactions that accompany extreme, uncaused fear are panic attacks.
Panic attacks can increase your heart rate, cause left chest pain, difficulty breathing or swallowing, and a feeling of “impending doom or death” as well as other physical effects. The Mayo Clinic lists stress, genetics, and changes in brain functions as possible causes of panic attacks.
It is important to seek help if you experience these symptoms to verify the cause of your left chest pain. Panic attacks can also lead to other complications within your life if they are not treated.
Delayed Pain
Left chest pain might not reveal itself until days after it was caused. Impact sports sometimes lead to bumps, bruises, and broken bones. They can also cause internal injuries. Rollin Perkins and James Sterling have written about the difficulty diagnosing chest and abdominal injuries in athletes.
Left chest pain, especially when taking breathes and accompanied by chills, fever, nausea, or night sweats, can be a sign of an enlarged spleen that occurred during a collision at a sports event, traffic accident, or other type of impact. However, there is often a delayed reaction of several days that can cause confusion for you in understanding this type of left chest pain.
Stomach-related Causes
Sometimes left chest pain follows its trigger very closely. Heartburn is aptly named because of the painful, burning sensation created when stomach acids leak into the esophagus. The opening of the stomach is on the lower left side of the chest, and heartburn can be experienced on the left or center of the chest.
Overeating or consuming spicy, greasy, or acidic foods can cause heartburn. MedLine Plus notes that long-term heartburn can be the result of GERD, gastroesophageal reflux disease, when the muscle that closes the esophagus from the stomach does not work properly and stomach contents back-up into the esophagus “burning” it.
Long-term damage to the esophagus can create serious problems, so get it off your chest. Go to the doctor to find the root of your left chest pain problem.
These are many possible causes of left chest pain. If you are experiencing chest pain or if a previously diagnosed pain has worsened, seek help immediately. A medical care practitioner is best prepared to help you find treatment so you can feel better soon.
Works Cited
“GERD.” Medline Plus. Web. 15 June 2011.
Perkins, Rollin and Sterling, James. “Left Lower Chest Pain in Collision Athlete.” Abstract: The Physician and Sportsmedicine 19.3 (1991): 78. Web 15 June 2011.
“Panic Attacks and Panic Disorder.” MayoClinic.com. Mayo Foundation for Medical Education and Research, 1998-2011. Web. 15 June 2011.
Pleuritic Chest Pain: It Isn’t Necessarily Pleurisy
“Pleuritic chest pain” and “pleurisy” are not the same thing, although the two words are often used interchangeably. Pleuritic chest pain is pain someone experiences, and pleurisy is a medical condition.
Many people assume pleuritic chest pain has to be caused by pleurisy because of the similarity between the two words, but pleuritic chest pain is caused by an irritation between the pleura, the linings of the lungs, so, the resultant pain is called “pleuritic chest pain.” However, if chest pain within the pleura is caused by pneumothorax (a rib injury), pleurisy, or any other reason, it is still called pleuritic chest pain.
Stabbing Pain
Sara Kass, Pamela Williams, and Brian Reamy writes that people with pleuritic chest pain report sharp, stabbing pain that becomes worse with movement. The pain will also become worse with deep breaths, speaking, coughing, or sneezing. They noted that people experiencing pleuritic chest pain try to move their upper body as little as possible to avoid setting off the pain. This can be difficult since some of the causes of pleuritic chest pain result in coughing, sneezing, and other respiratory issues, and it can also be problematic to refrain from changing positions, standing up, etc.
What would you do if you or a young man in your family suddenly experienced sharp chest pain? Spontaneous pneumothorax is a common cause of pleuritic chest pain among teenage boys. According to Dr. Suneeta Kochar and Dr. Paul Cornelius, pneumothorax is when air is trapped in the space between the pleura. They noted a significantly higher rate of pneumothorax in young, healthy men between the ages of ten and thirty as compared to women of the same age. Smoking does increase their risk of pneumothorax up to twelve percent. It is interesting to note that these figures refer to young men who are not experiencing other health issues.
Pleurisy, sometimes called pleuritis, is reported by Ian Peate to be when the linings of the lungs become inflamed and the fluid between the pleura is congested so the pain receptors in the sensory fibers between them becomes irritated. Pleurisy is often the result of viral respiratory infections such as the flu, bronchitis, and viral pneumonia. Peate noted that rib injury is another main cause of pleuritic chest pain. He reported other causes included tuberculosis, lupus, cancer, and sickle cell. He also listed pneumothorax-related causes.
When you visit your doctor about chest pain symptoms, Peate pointed out that it might be difficult to discuss your issues due to problems breathing and speaking through the pain. However, it is important to communicate with your doctor so you can receive proper treatment. Part of your diagnosis might include an electrocardiogram and a chest x-ray so your doctor can identify the specific cause of your pleuritic chest pain. It is important that they identify the proper cause before they begin treatment. Remember, if you are experiencing chest pain or difficulty breathing, or if previously diagnosed chest pain has become worse, you should contact your doctor immediately.
Works Cited
Kass, S., Williams, Pamela, and Reamy, Brian. “Pleurisy.” American Family Physician 75:9 (2007): 1357-1364. EBSCOhost. Web. 3 June 2011.
Kochar, Suneeta and Cornelius, Paul “Clinical – Respiratory – Spotting the Signs of Pneumothorax.” Independent Nurse. 2:32 (2009): 32. LexisNexis. Web. 7 June 2011.
McIntosh, Deborah. “Chest Pain.” The Sun Herald. 20 May 2011, Late Edition. LexisNexis. Web. 20 May 2011.
Peate, Ian. “Caring for the Person with Pleurisy.” British Journal of Healthcare Assistants 03:10 (2009): 480-483. EBSCOhost. Web. 3 June 2011.
Chest Pain in Women: A Variety of Causes
Women do not have the same biology as men. We remember this when it comes to so-called “women’s health issues” such as pregnancy and menopause. However, it is not something we think about when it comes to experiencing chest pain.
What Actually Causes Chest Pain in Women
So what causes chest pain in women? Dr. Ellie Cannon notes that heartburn and indigestion are common causes of chest pain. As is well known, indigestion can cause pain, bloating, gas, and heartburn. But gas can actually cause chest pain when the upper bowl presses up into the chest cavity. Heartburn is a burning sensation behind the breastbone that often worsens when you bend over. Frequent causes of heartburn are overeating, acid reflux, ulcers, and gallstones.
Women can also experience chest pain from pleurisy. Deborah McIntosh reported that when the lining around the lungs swells, the pain becomes very strong and will often sharpen during intakes of breath. Pleurisy is often caused by bronchitis, pneumonia, or other viral infections. Coughing and wheezing will increase the pain, and it can also result in muscle strain.
When discussing chest pain in women, Dr. Ellie Cannon reported that “muscular chest pain or chest-wall pain is quite common” and that the joints between the ribs and the cartilage can become inflamed. The chest muscles are like every other part of the body, and when they are overexerted, they become sore.
Emotional Stresses and the Body
Stress, anxiety, and other powerful emotions can affect the heart and lungs resulting in chest pain and difficulty breathing. Emotional responses can even cause heart palpitations and physical responses within the heart.
Some women do not receive an actual diagnose after visiting their doctor and undergoing various tests for their chest pain. Dr. Gifford-Jones reports that Tietze’s syndrome is a common cause of undiagnosed chest pain. Tietze’s syndrome causes a general aching sensation where the ribs meet the sternum and can also result in sharp, stabbing pains.
Dr. Gifford-Jones lists Texidor’s Syndrome as another cause of undiagnosed chest pain. Most women have experienced this precordial “stab” or “catch” at some point in their lives. It is usually experienced while slumped in a seat. It causes a sharp, sudden pain in the left side of the chest that can be eased within a few minutes by a position change and a switch to shallow breathing.
Interestingly, Sharon Kirkey reports that research from the University of Arkansas shows that 43% of the women studied did not feel chest pain while experiencing their heart attacks. Instead, they experienced a variety of other symptoms such as fatigue before the event, pain in the back and high chest, sleep disturbance, shortness of breath, indigestion, and anxiety. When a woman experiences chest pain, it does not mean she is having a heart attack. In fact, chest pain is not one of the main symptoms of heart attacks in women.
Chest pain in women has a variety of causes. If you are experiencing chest pain or if a previously diagnosed chest pain has worsened, seek help immediately.
Not all chest pain is immediately life threatening, but a medical care practitioner should make the diagnosis.
Works Cited
Cannon, Ellie. “Chest Pain is Not Always the Sign of a Heart Attack.” Mail on Sunday. 1 Nov 2009. Nexis. 30 May 2011.
Gifford-Jones, W. “The Doctor Game.” The Globe and Mail. 23 Aug 1984. Nexis. 20 May 2011.
Kirkey, Sharon. “Fatigue a Warning for Women.” National Post. 4 Nov 2003, Late Edition. Nexis. 31 May 2011.
McIntosh, Deborah. “Chest Pain.” The Sun Herald. 20 May 2011, Late Edition. Nexis. 20 May 2011.
