Chest pain is one of the commonest reasons why people come to see, or are referred to, the cardiologist. This is because it is a classic symptom of one of the most feared diagnoses – a HEART ATTACK.
But…….. chest pain is also a very common symptom generally and all types of chest pain are not necessarily related to the heart.
CHEST PAIN ≠ HEART DISEASE
So how do you know if YOUR chest pain is serious?
First of all, all chest pain should be taken seriously but not all chest pain needs medical attention or treatment. Pain of any kind is a sign from your body that something isn’t right. And, there are other serious medical conditions other than heart attacks which can cause chest pain and which can be life-threatening.
How do you know if you are having a heart attack or when should you seek medical attention?
• Chest pain or discomfort in the centre of the chest that lasts for > 5 minutes or goes away and comes back (heaviness, tightness, pressure, aching, burning, fullness or squeezing, sometimes mistakenly thought to be indigestion or heartburn, “gas”)
• Pain or discomfort in other areas of the upper body including either arm, upper back, neck or throat, jaw, or stomach
• Difficulty breathing or shortness of breath
• Sweating or "cold sweat"
• Nausea (bad feelings) or vomiting
• Light-headedness, dizziness, extreme weakness or anxiety
• Rapid or irregular heart beats
Women's symptoms sometimes differ
Although chest pain/discomfort is the commonest symptom of a heart attack in both men and women, women are slightly more likely than men to report unusual or vague symptoms. More women than men may report:
• Upper back or shoulder pain
• Jaw pain or pain spreading to the jaw
• Light headedness
• Pain that spreads to the arm
• Unusual fatigue for several days
In one study of 515 women who had heart attack, the most frequently reported symptoms were unusual fatigue, sleep disturbances, shortness of breath, indigestion and anxiety.
People’s symptoms vary in type and severity. Some people have mild pain, others very severe. Some have very few symptoms. However, the more symptoms you have the more likely you are to be having a heart attack. Many people who have heart attacks had symptoms preceding the event for days or weeks or even longer, which they ignored.
Many people delay seeking medical attention for symptoms which later turn out to be due to a heart attack, sometimes for hours or even days. The longer you delay the greater is the chance that more damage will occur to your heart or that you may not survive.
Reasons people delay:
• They are young and don't believe a heart attack could happen to them
• Symptoms are not what they expected
• They may deny the symptoms are serious and wait until they go away
• They may ask the advice of others, especially family members
• They may first try to treat the symptoms themselves, using aspirin or antacids
• They may think the symptoms are related to other health problems (upset stomach, arthritis)
• They may put the care of others first (take care of children or other family members) and not want to worry them
WHAT SHOULD YOU DO IF YOU THINK YOU ARE HAVING A HEART ATTACK?
1. If you have chest pain or other symptoms of heart attack that last longer than 5 minutes - do not ignore it - seek emergency care to rule out a heart attack.
2. Call your doctor to get advice or go to the emergency room
3. Your doctor may advise you to chew and swallow an Aspirin (do not take Aspirin if you think you are having a stroke)
4. Even if you are not having a heart attack there are other important conditions which may be causing chest pain
5. Other important causes of chest pain include:
- Clot in the lung (pulmonary embolism)
- Pneumonia
- Inflammation around the heart
- A tear in an artery in the chest or abdomen
- Bleeding or perforated ulcer
Any of these could be medical or surgical emergencies
