Chest pain is not something to be taken lightly! But how do you know if the chest pain you’re experiencing is a medical emergency? I asked
Timothy D. Henry, MD, Medical Director, at
The Carl and Edyth Lindner Center for Research and Education at The Christ Hospital Health Network, some questions about what we all should know about chest pain.
So, just what kind of things can cause chest pain other than a heart attack? Dr. Henry said, “Patients can have chest pain because they have spasms of the coronary artery. Chest pain also can develop because of inflammation on the lining of the heart (pericarditis). Chest pain also can be caused by non-cardiac problems. For example, heartburn, panic attacks, lung disease or musculoskeletal problems.”
It seems like indigestion could get confused for a heart attack pretty easily, so I asked Dr. Henry how often that happens. He said, “Indigestion or heartburn can frequently be confused for chest pain from the heart. Patients with true heart attacks occasionally have symptoms similar to ‘GI’ pain and nausea can be associated as well. If in doubt, call your doctor or go to the emergency department. If you feel short of breath or sweaty, or if chest pain is severe, call 911.”
Good to know! Again, chest pain can be scary! But how can you know what kind of chest pain is from a heart attack? Dr. Henry said, “Chest pain from the heart most commonly develops from two specific situations. Angina is chest pain that results from blockages in your coronary arteries that develop over time. These blockages (coronary artery disease) are related to cardiac risk factors: smoking, high blood pressure, diabetes, high cholesterol and family history. As blockages become more severe, patients may experience chest pain when they exercise or are under stress. This chest pain is in the middle of the chest and may radiate to the left arm. It is commonly associated with shortness of breath, nausea, and diaphoresis (sweating). Angina pain usually comes on with exercise and goes away when you rest or with nitroglycerin.”
A myocardial infarction, or heart attack, occurs when the blockages break open and a blood clot forms, causing an acute decrease in blood flow to the heart. This is a heart attack! The heart muscle is dying from lack of blood flow. The chest pain can occur with rest or exercise, is usually more severe and less likely to go away with nitroglycerin. There is a lot of variability in how severe a patient’s symptoms are and what symptoms they have. In fact, up to 20% of patients with a heart attack may have minimal or no symptoms at all.”
But, I’m wondering…at what point do go to the ER or call a doctor? Dr. Henry explained, “Patients who have known blockages in their arteries (coronary artery disease) should be aware of their angina and have nitroglycerin available to take when they develop chest pain. These patients have usually had a discussion with their doctor and have a good feeling about when the pain requires urgent treatment, for example, when it doesn’t go away with the use of nitroglycerin. Patients who have not had chest pain before should strongly consider calling 911 or seeing doctor as soon as possible, in particular if their chest pain is associated with shortness of breath, sweating or nausea.”
If you’re feeling some unexpected chest pain, when in doubt, get checked out! Click to learn more about how The Christ Hospital Heart & Vascular program can help you or a loved one.