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Feeling pain or pressure in the chest at one time or another happens to us all. Non-life-threatening causes can be due to stress, heartburn and even musculoskeletal aches and pains. But how do we know when the pain is heart-related? There are many conditions that can cause chest pain. However, the important thing is knowing when it might be related to your heart, and whether it requires emergency treatment.
Non-life threatening causes of chest discomfort can include digestive disorders such as heartburn and peptic ulcer that can cause bloating and gas; or lung inflammations such as asthma, pneumonia and bronchitis, and benign chest wall pain caused by irritation of the membrane surrounding the lungs. Anxiety, stress and panic attacks can lead to muscle contractions and spasms in the chest wall, and musculoskeletal trauma often results in stretching of chest muscles and ligaments or fractures in ribs. More serious non-cardiac causes of pain include blood clot in the lung (pulmonary embolism), collapsed lung and a tear in the upper gastrointestinal tract.
Causes of pain due to heart disease also run the gamut of non-life-threatening to requiring prompt emergency care. The most serious is a heart attack, caused by a complete blockage of a coronary artery that cuts off oxygen to the heart muscle. Typical heart attack symptoms include squeezing or crushing pressure in the chest that can be accompanied by sweating, nausea, shortness of breath and dizziness, fatigue and intense pain that can radiate into the shoulders, arms, back and jaw. The pain typically gets worse and does not subside. In women, heart attack symptoms can be less pronounced and also include insomnia, indigestion and anxiety. If you are overwhelmed with the above symptoms and believe you are having a heart attack, call 911 immediately. The longer you wait, the more heart muscle damage you will incur.
Another serious cardiac disorder causing severe chest pain is when the aortic lining tears (aortic dissection), also requiring immediate emergency treatment. Symptoms are often described as a tearing pain below the breastbone.
Angina is caused by narrowing in coronary arteries which can cause chest pain upon exertion or after a large meal and is due to an oxygen-starved heart muscle. Like a heart attack, symptoms can include classic squeezing and radiating chest pain, shortness of breath, nausea, sweating, dizziness and fatigue. Angina that persists at rest requires emergency attention.
Non-emergency cardiac pain can be caused by inflammation of the heart sac (pericarditis) and mitral valve prolapse (MVP), resulting from abnormalities of the mitral valve.
When does chest pain require emergency treatment?
It’s not always easy to determine whether your chest pain warrants an emergency visit to the ER. Here are a few tips:
When chest pain warrants emergency treatment:
- Heart attack symptoms (described above)
- Chest pain when you’re over 40 with high coronary artery disease risk factors including smoking, high cholesterol, diabetes, family history, obesity, hypertension
- Chest pain you’ve never felt before that gets worse within 15 minutes
- A feeling that something is terribly wrong with you
When chest pain is not an emergency:
- Momentary chest pain
- Chest pain that becomes apparent only with body movement
- History of chest pain that a doctor determined is not related to a cardiac condition
Treatment for chest pain is usually determined by what’s causing the pain. If it’s cardiac related, then prompt or even emergency treatment is necessary, followed by drug therapies or invasive procedures such as catheterization, angioplasty or bypass surgery, if necessary. MDCA cardiologists are experts in diagnosing chest pain disorders and will be able to pinpoint whether a cardiac condition is the source.