Chest pain patomechanism the presence of risk factors and predisposition causes the

occurrence of a disease in patients. one of the predisposing factors that aggravate the patient's
disease is smoking causes the accumulation of toxins in the blood vessels that cause
atherosclerosis which ultimately leads to hypertension. As a result of these atherosclerotic
plaques, the lumen of blood vessels narrows and facilitates occlusion (blockage) of blood
vessels, especially in the coronary arteries. This occlusion causes inadequate coronary blood
flow. As a result, myocardial ischaemia develops. There is a decrease in cardiac perfusion
resulting in decreased oxygen intake and accumulation of metabolic results of chemical
compounds. This accumulation of metabolites arises from inadequate oxygen supply, so
myocardial cells compensate by anaerobic aspiration. As a by-product of lactic acid. Lactic
acid makes the cell pH decrease. This metabolic change in myocardial cells stimulates pain
receptors through symphatetic afferent in the primary sensory cortex area (Broadman's 3,2,1,1
area), which causes pain in the chest.

References :
1. Ibid, hal.56.
2. Swartz, Op.cit., hal. 196-197
3. Price. Op.cit., Volume 2, hal. 1076-1077.
4. Price, A. Sylvia, dan Wilson, Lorraine M., 2006,Patofisiologi Konsep Klinis Proses-
proses Penyakit Edisi 6 Volume 1,Penerbit Buku Kedokteran EGC, Jakarta.