Chest pain can vary greatly in its severity and duration. In some instances, chest pain will be mild and only last a few brief minutes. In other cases, pain can be severe or last for weeks.
The immediate conclusion many people suffering from chest pain jump to is that it is related to their heart. While the concern is valid, it may relieve some anxiety to understand how health care providers think about chest pain. It is also important to understand that there are other things besides the heart that can cause chest pain.
When a patient comes into the clinic reporting chest pain, their doctor will ask questions that address major contributors to heart disease. They will ask if the patient:
* Smokes (number one risk factor; preventable)
* Has diabetes
* Has hypertension (high blood pressure)
* Has high cholesterol
* Has a family history of heart disease
* Assess age
Heart Attack Symptoms
The doctor will also be comparing the patient’s symptoms to those of a typical heart attack:
Character: A heart attack is often described as dull sensation or like something heavy is sitting on their chest. Pain that is sharp, burning, stabbing, or aching, could be caused by some other condition like heartburn, acid reflux, costochondritis, aortic dissection, or pleurisy.
Location: Since the heart is on the left side of the chest, pain in this area is cause for concern. Should pain be on the right side, a heart attack is rarely the cause. Additionally, heart attack pain is often non-localized and difficult to pinpoint. If the location of the pain is easily identifiable, it probably is not a heart attack. It is worth noting that because of the way nerves in this area of the body overlap, heart-related pain may occur to the left arm and left side of the neck. This is called referred pain.
Duration/timing: Heart attack pain may be continuous or intermittent and symptoms can last a couple minutes or a few hours. Should chest pain continue for multiple days, week, or months, it is not likely to have been caused by a heart attack.
Things that improve or worsen symptoms: Because the heart is less active during rest, heart attack pain is often relieved by resting (unless it was a massive heart attack in which case, rest will not alleviate symptoms). If chest pain is triggered by other variables, such as eating food (acid reflux) or pressing on the area (bone or muscle issue), the doctor will likely look for causes of the chest pain that are not heart related.
Other factors: While a heart attack is often accompanied by shortness of breath, this symptom could prompt the doctor to check the patient’s lungs. Other symptoms like chills, fever, and phlegm-producing cough, are generally not associated with heart attacks. The exception would be if the patient has pneumonia in addition to a heart attack.
Given chest pain can stem from issues originating with the heart, lungs, gastrointestinal tract, or musculoskeletal system, identifying the root cause can be challenging. Because of this, it is always advisable to seek medical attention for proper evaluation, diagnosis, and treatment.