Chest Pain: When is it dangerous?

Jun 11, 2017 Dr Zulfikar Bux, Features / Columnists

By Dr Zulfikar Bux

Assistant Professor of Emergency Medicine

Approximately 10% of visits to emergency departments are because of chest pain. About 13% of

Dr. Zulfikar Bux

these patients with chest pain will be having a heart attack. It is not always straightforward if someone’s chest pain is related to a heart attack or another life-threatening event.

Today we will try to help this situation by sharing information on chest pain that may help you decide when it should be taken more seriously.

WHAT ARE SIGNS THAT MY CHEST PAIN MAY BE DANGEROUS?

The following are chest pain symptoms that should not be ignored and requires a doctor visit:

Chest pain that is new or severe

Chest pains that happens along with shortness of breath
Chest pain that lasts more than a few minutes
Chest pain that gets worse when you walk, climb stairs, or do other types of physical activity
Chest pain that scares or worries you

Having chest pain does not necessarily mean you are having a heart attack. Most often the pain is usually caused by less serious problems, such as muscle pain, heartburn, or anxiety. Even so, you should not take any chances.

People often delay seeking help for a heart attack because they think the symptoms are not serious or will go away. When they do that, they risk permanent damage to their heart – or even death.

IS CHEST PAIN THE ONLY IMPORTANT SYMPTOM OF A HEART ATTACK?

No. Other symptoms are important, too. Sometimes people do not go to the hospital because they do not have any pain at all. But it is possible to have a heart attack without pain. This is more likely in women, people with diabetes, and people older than 60.

It is important to pay attention to any of the symptoms of a heart attack, which can include:

Pain, pressure, or discomfort in the centre of the chest

Pain, tingling, or discomfort in other parts of the upper body, including the arms, back, neck, jaw, or stomach
Shortness of breath
Nausea, vomiting, burping, or heartburn
Sweating or having cold, clammy skin
A racing or uneven heart rate
Feeling dizzy or lightheaded or even fainting

These symptoms are important if they last more than a few minutes or keep happening over and over (coming and going). If you think you might be having a heart attack, call for help right away. Do not try to get to the hospital on your own.

IS HEART ATTACK THE ONLY CAUSE OF CHEST PAIN?

No. Chest pain can be caused by lots of other problems, including:

Heart problems other than heart attacks, such as infection around the heart
Muscle soreness after an activity that involves the chest muscles
Diseases that cause pain, such as arthritis
Shingles (herpes zoster), a condition linked to the chickenpox virus that also causes a painful rash
Any kind of injury to the chest, including surgery
Digestive problems such as heartburn, acid reflux, stomach ulcers, or irritable bowel syndrome
Problems affecting the lungs, such as pneumonia (an infection in the lungs) or blood clots in the lungs
Psychological problems, such as panic disorder or depression
Weakening of the lining of the big blood vessel in the chest (called the aorta)

WHAT WILL HAPPEN IF I GO TO THE EMERGENCY ROOM?

The staff treating you in the emergency room will examine you and then run tests to try to find the cause of your pain. But don’t be surprised if you do not find out right away why you have pain. The cause of chest pain is not always easy to find. Even so, doctors can usually tell if your heart is in trouble.

The tests you might have include:

An electrocardiogram (ECG or EKG)– This test measures the electrical activity in your heart. It can help doctors find out if you are having a heart attack. You may require multiple of these tests
An X-ray- This will help doctors rule out other dangerous causes of chest pain
Blood tests– During a heart attack, the heart releases certain chemicals. If these chemicals are in your blood, it might mean you are having a heart attack.

You may be admitted to do other tests depending on your situation.

WHAT IF I AM HAVING A HEART ATTACK?

If you are having a heart attack, the doctor will give you treatments to reduce the damage to your heart and relieve your pain. These may vary from getting a high dose of aspirin to getting injections. In some cases you may be taken to a “heart lab” to get a stent placed.

The sooner you get treated for a heart attack, the better the treatment will work. Every minute counts when it comes to keeping your heart muscle alive! Do not leave your chest pain to chance!

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