Causes-Of

The Center for Disease Control estimated in 2005 that chest pain is the second most common complaint in Emergency Departments in the United States and causes about 6 million visits annually.  Many emergency room patients presenting the most at-risk and life-threatening type chest pain may appear quite healthy and without extreme distress so determining the cause of chest pain can be extremely critical.

Leading causes of chest pain in ambulatory care include musculoskeletal, gastrointestinal, and pulmonary disorders; as well as a combination of these and psychiatric diagnoses such as panic disorders (PDs). Rarely, life-threatening causes are the source of chest pain in outpatient settings, but must be excluded.

Accute Coronary Syndrome (ACS)
Acute coronary syndrome (ACS) or coronary vascular disease continues to lead the cause of death of adults in developed countries at approximately 10 percent during a 28 day case mortality rate for ACS, but can vary with disease severity and patient treatment received.  However, statistics show that:

“less than 15 to 30 percent of patients who present to the emergency department with non-traumatic chest pain have ACS, which includes myocardial infarction and unstable angina.”

always get chest pain checked out

“Chest pain can be a clue to underlying coronary artery disease, but it can also be caused by non-cardiac conditions, most of which are less serious.  Proper attention to the quality of the pain and the factors that preceded it can be used as a tool to determine whether the origin is cardiac or not. A stress test is indicated when there is doubt,”  reports Peter F. Cohn, MD, Stony Brook University Health Sciences Center in New York.

Two Major Categories of Chest Pain

According to the Mayo Clinic staff, there are two major categories for the causes of chest pain – cardiac and non-cardiac as follows:

Cardiac causes of chest pain may include:

• Heart Attack—blood clot blocks blood flow to heart
• Angina—temporarily restricted blood flow from arteries to your heart
• Other Cardiac Causes—pericarditis (inflammation of the sac surrounding your heart); a rare, life-threatening condition called aortic dissection; and coronary spasm (Prinzmetal’s angina)
• Heart-Related Conditions—metabolic syndrome and endothelial dysfunction.

Non-cardiac causes of chest pain may include:

• Heartburn
• Panic Attacks
• Pleurisy
• Costochondritis
• Pulmonary Embolism
• Other Lung Conditions—collapsed lung (pneumothorax), high blood pressure in the arteries carrying blood to the lungs (pulmonary hypertension) and asthma
• Sore Muscles—chronic pain syndromes
• Injured Ribs or Pinched Nerves
• Swallowing Disorders—painful muscle spasms
• Shingles—produce pain and a band of blisters from back around to chest wall
• Gallbladder or Pancreas Problems— abdominal pain radiates to chest
• Cancer—rarely, may spread from another part of the body

Gender Differences & Chest Pain

Additionally, there are gender differences in the causes of chest pain that should be addressed according to Brenda M. Eden APRN, BC, MS, in “The Nurse Practitioner: The American Journal of Primary Health Care.”

Chest Pain in Women
Chest pain is the cause of 1% (2.9 million) of total visits to primary care clinicians, and is often difficult to diagnose due to variability in symptoms, especially in women.  Up to one-half of women with chest pain who undergo coronary angiography do not have coronary artery disease (CAD).  In recent years, researchers have explored the differences between men and women in how chest pain is described and reported.

Women are less likely to seek medical care when the symptoms initially present, which delays diagnosis and early intervention. Reasons women delay seeking medical care are related to knowledge deficits, cost, transportation, previous experiences with the healthcare system, perception of pain, fear of not being taken seriously, and self-doubt about the severity of their symptoms.

Although only a limited number of studies have explained a physiologic basis that accounts for gender differences, it is evident that women must be evaluated uniquely. An accurate diagnosis depends on the practitioner’s ability to elicit pertinent information through the patient’s history and physical examination. Algorithms and tools may help determine priority differential diagnoses and appropriate selection of diagnostic tests. Primary care practitioners must integrate gender-specific assessment strategies to successfully treat the underlying cause of chest pain in women.

Whether or not the cause is known, experts agree:

“Patients with chest pain should go immediately to the nearest emergency room, preferably traveling by ambulance. They should not drive themselves. Call 911 or the local emergency number.”

Sources Include

[1] http://www.uptodate.com/patients/content/topic.do?topicKey=~/BLiwvS.f48

[1] http://www.circ.ahajournals.org/cgi/content/full/106/5/530

[1] http://www.mayoclinic.com/health/chest-pain/DS00016/DSECTION=causes

[1] http://www.nursingcenter.com/prodev/cearticleprint.asp?CE_ID=773072

[1] http://www.umm.edu/patiented/articles/how_serious_coronary_artery_disease_000003_2.htm

According to James Hansen, the head of the Goddard Institute for Space Studies, NASA’s top institute studying the climate, global warming is accelerating as recent research reports massive losses of ice to the sea from the melting arctic and to Antarctica.

“Climate change is really happening,” reports Ralph Cicerone, president of the nation’s leading institute of science, the National Academy of Sciences.  Cicernone explains that greenhouse gases are causing the changes: “Carbon dioxide and methane, and chlorofluorocarbons and a couple of others, which are all — the increases in their concentrations in the air are due to human activities.  It’s that simple.”

“Climate change is really happening.”

In an article published May 15, 2008, in the journal Nature, a NASA-led study has shown the reality of human-caused climate change impacting a wide range of earth’s natural systems “from permafrost thawing to plants blooming earlier across Europe to lakes declining in productivity in Africa.”

Linking physical and biological impacts since 1970 with temperature increases, Cynthia Rosenzweig of NASA’s Goddard Institute for Space Science in New York and scientists at 10 other institutions reported, “This is the first study to link global temperature data sets, climate model results, and observed changes in a broad range of physical and biological systems to show the link between humans, climate, and impacts.”

glaciers and global warming

Causes of Global Warming

Primarily, humans cause global warming by burning fossil fuels that increase the amount of carbon in the atmosphere leading to an increase in the Greenhouse Effect. Experts at the Woods Hole Research Center report:

While the concentrations of almost all greenhouse gases have been increasing since the Industrial Revolution, carbon dioxide has had the greatest effect on changing the climate. During the 1980’s humans released 5.5 billion tons of carbon dioxide into the atmosphere annually by burning fossil fuels (coal, oil, natural gas) for heat, transportation, and electricity. An additional 1.6 billion tons was released from anthropogenic (human-induced) changes in land-use (i.e. clearing land for agriculture, pastures, etc.) mostly through deforestation in the tropics. Where does that 7.2 billion tons of atmospheric carbon go? Ocean modelers find that the ocean takes up approximately 2 billion tons a year. Around 2 billion tons are taken up by a presently unidentified “sink” or reservoir of carbon. This leaves a remainder of 3.2 billion tons of CO2, and global atmospheric measurements indicate that this amount is simply being added to existing concentrations already present in the atmosphere. The result is that the atmospheric concentration of carbon dioxide is increasing at a rate of approximately 1.5 ppm (parts per million) per year and overall it has increased about 30% since the beginning of the Industrial Revolution.

According to reports by the Ecobridge Organization, Carbon Dioxide emissions from the following sources are major causes of global warming:

Power Plants
In 2002 about 40% of U.S. carbon dioxide emissions stem from the burning of fossil fuels for the purpose of electricity generation. Coal accounts for 93 percent of the emissions from the electric utility industry.

Car Emissions
About 33% of U.S carbon dioxide emissions comes from the burning of gasoline in internal-combustion engines of cars and light trucks (minivans, sport utility vehicles, pick-up trucks, and jeeps). The United States is the largest consumer of oil, using 20.4 million barrels per day.  If car manufacturers were to increase their fleets’ average gas mileage about 3 miles per gallon, this country could save a million barrels of oil every day, while US drivers would save $25 billion in fuel costs annually.

Airplane Emissions
The UN’s Intergovernmental Panel on Climate Change estimates that aviation causes 3.5 percent of global warming, and that the figure could rise to 15 percent by 2050.

Buildings
Buildings account for about 12% of carbon dioxide emissions.

Methane
The Ecobridge study adds, “While carbon dioxide is the principal greenhouse gas, methane is second most important. According to the IPCC, Methane is more than 20 times as effective as CO2 at trapping heat in the atmosphere.  Methane is derived from sources such as rice paddies, bovine flatulence, bacteria in bogs and fossil fuel production.

In some recent studies reported by PlanetSave, the food industry, with the meat industry taking the lead as major contributor, is a primary source of greenhouse gases. They estimate that the average food item travels at least 1000 miles from the farm to your able. While agricultural uses massive amounts of petroleum-based fertilizers, cows are emitting a greenhouse gas even more potent than carbon, Methane.

According to the National Climate Data Center (NCDC), water vapor is the most prevalent greenhouse gas on the planet, but its increase is the result of warming caused by carbon dioxide, methane and other greenhouse gases, and it holds onto two-thirds of the heat trapped by all the greenhouse gases. The NCDC further explains, “future monitoring of atmospheric processes involving water vapor will be critical to fully understand the feedbacks in the climate system leading to global climate change.”

Nitrous Oxide
The National Climate Data Center (NCDC) claims “Concentrations of nitrous oxide also began to rise at the beginning of the industrial revolution and is understood to be produced by microbial processes in soil and water, including those reactions which occur in fertilizer containing nitrogen. Increasing use of these fertilizers has been made over the last century. Global concentration for N2O in 1998 was 314 ppb, and in addition to agricultural sources for the gas, some industrial processes (fossil fuel-fired power plants, nylon production, nitric acid production and vehicle emissions) also contribute to its atmospheric load.”

Deforestation
The EcoBridge Organization also explains how deforestation is the second leading cause of atmospheric carbon dioxide after carbon emissions caused by humans:

After carbon emissions caused by humans, deforestation is the second principle cause of atmospheric carbn dioxide. (NASA Web Site) Deforestation is responsible for 20-25% of all carbon emissions entering the atmosphere, by the burning and cutting of about 34 million acres of trees each year. We are losing millions of acres of rainforests each year, the equivalent in area to the size of Italy. [22]  The destroying of tropical forests alone is throwing hundreds of millions of tons of carbon dioxide into the atmosphere each year. We are also losing temperate forests. The temperate forests of the world account for an absorption rate of 2 billion tons of carbon annually. [3] In the temperate forests of Siberia alone, the earth is losing 10 million acres per year.

Other Major Factors

Other major factors reported in various studies that should be further examined in the study and consideration of the causes of global warming include both controllable and uncontrollable factors.

City Gridlock
1996 Texas A&M study reports drivers in Los Angeles and New York City alone wasted 600 million gallons of gas annually while just sitting in traffic. The 600 million gallons of gas translates to about 7.5 million tons of carbon dioxide in just those two cities.

Carbon in Atmosphere and Ocean
U.S.Global Change Research Information Office reports the atmosphere contains about 750 billion tons of carbon, while 1020 billion tons are dissolved in the surface layers of the world’s ocean.

Permafrost & Tundra
Permafrost and Tundra are two more sources of releasing carbon dioxide in the atmosphere.

Permafrost is a solid structure of frozen soil, extending to depths of 2,200 feet in some areas of the arctic and subarctic regions,  containing grasses, roots, sticks, much of it dating back to 30,000 years.  About 25% of the land areas of the Northern Hemisphere hold permafrost, which is defined as soil whose temperature has been 32 degrees Fahrenheit (0 degrees Celsius) for a period of at least 2 years. In a study reported in the journal Science June 16, 2006 (see San Francisco Chronicle article) researchers say that thawing permafrost may add to the buildup in atmospheric greenhouse gases significantly, stating that present climate models do not include releases of Siberian carbon dioxide from permafrost.

Estimates of 50 billion tons of carbon are held in a frozen state in the tundra. Experiments in the 1970s and 1980s conducted by University of California biologist Walter Oechel found the tundra had already warmed and dried enough, that its historic role as a carbon sink had reversed and changed. It was now losing carbon dioxide to the atmosphere. Oechel adds, “That was totally unexpected.”

Sources Include

http://www.causesofglobalwarming.net/global_warming_research.html

http://esciencenews.com/dictionary/permafrost.thaw

http://www.nasa.gov/centers/goddard/news/topstory/2008/human_impact.html

http://whrc.org/resources/online_publications/warming_earth/culprits.htm

http://whrc.org/resources/online_publications/warming_earth/culprits.htm

http://planetsave.com/blog/2009/04/18/human-global-warming-what-are-the-main-causes/

http://www.ncdc.noaa.gov/oa/climate/gases.html#wv

http://www.ncdc.noaa.gov/oa/climate/gases.html#wv

http://www.ecobridge.org/content/g_cse.htm

http://www.ecobridge.org/content/g_cse.htm