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Chest pain: A Warning Sign You Shouldn't Ignore

Unlike pain in other organs or other parts of the body, chest pain immediately rings warning bells in the mind. Could it be a heart attack? While not all chest pain is caused by a heart attack, it is a symptom that can be an indicator of many underlying problems. Whether chest pain is mild or sharp, or simply an aching discomfort, it is a cause for concern. It is widely considered to be one of the main symptoms of cardiovascular health emergencies.

”Don’t take a chance with chest pain,” says Dr. PK Hazra, Director, Cardiac Sciences & Head of the Department, Cath Lab, AMRI Dhakuria. “Chest pain could be a symptom of heart attack, pneumonia, COVID-19, use of anti-diabetic medicines, gallbladder stones, ulcers, and blood clot, among many other conditions. Visit your cardiologist immediately to avoid an emergency.”

In this article, we review some of the most common causes of chest pain, demonstrating why you must never take it casually

Angina

Chest pain may be caused by lack of blood flow or poor blood flow to the heart (angina), caused by sudden blockage in the coronary arteries that may lead to a heart attack. However, due to the complex system of nerves in the body, often the pain may radiate from other parts such as stomach or abdomen, leading to discomfort. This is known as referred pain. In case it is a heart attack, urgent medical treatment is required to prevent damage.

Chest pain felt during angina feels more like pressure on the heart rather than pain. There are two types of angina: 

Stable angina - occurs when you exert yourself and your heart pumps harder

Unstable angina: occurs for no particular reason

Treatment of stable angina is much easier, whereas unstable angina may be a sign that the patient is at risk of heart attack. 

 

Heart attack

Doctors use the type of pain or discomfort to identify whether the chest pain is a symptom of a heart attack or other heart diseases. Typically, patients note one or more of the following:

  • Fullness, burning sensation, pressure or tightness in the chest area
  • Searing pain that extends to your back, neck, jaw, shoulders, one or both arms
  • Shortness in breathing
  • Dizziness
  • Nausea
  • Pain that lasts for more than a few minutes and aggravates with exertion

 

Cardiomyopathy

This is a progressive disease of the heart muscle that makes it difficult for the heart to pump blood to the rest of the body and can result in heart failure. Cardiomyopathy can lead to:

  • Chest pain
  • Palpitations
  • Arrhythmia
  • Swollen Ankles
  • Shortness of breath 

Any of the above symptoms could be an indicator of cardiomyopathy.

Aortic dissection

This is a serious condition that involves the main artery leading from your aorta and it happens due to splitting of the layer of the wall of the aorta and causes a searing pain in the chest that radiates to the back.  The dissection sometimes extends to the origin of the aorta and blocks off one or more coronary arteries. Since this may lead to a heart attack, aortic dissection is a medical emergency.

Pericarditis 

Pericarditis is inflammation of the sac around your heart and causes sharp pain, which gets worse when breathing or lying down. 

Pulmonary Embolism

Pulmonary embolism or PE is when a blood clot or thrombus is lodged in a lung artery, blocking the blood flow to the lung. Typically, PE arises from thrombosis in the deep venous system of the body. Clots that form in the body are dislodged into the arteries of the lung and result in chest pain, breathlessness and rapid heart rate. The pain can worsen if you cough or try to take deep breaths. 

Pulmonary embolisms are a medical emergency and chest pain is one of its most noticeable symptoms. One should seek immediate help if one suspects the symptoms are similar to those of PE.

Congestive heart failure

Heart conditions that persist over a prolonged period of time cause long term damage to the heart leading to congestive heart failure. This means the heart’s function as a pump is no longer efficient to meet the body’s ongoing needs. Many of the above mentioned diseases can impair the pumping function of the heart.  One of the key symptoms, however, is again chest pain. 

Apart from angina, heart attack, aortic dissection or pericarditis, chest pain can be caused by a number of other causes such as:

  • Asthma
  • Acid Reflux
  • Anxiety
  • Panic attack
  • Gallbladder or pancreas issues
  • Shingles
  • Injured ribs or muscles

Why must chest pain be taken seriously?

Unlike tooth pain or achy knees, chest pain shouldn’t be put off until tomorrow. Self-diagnosis is also not an option when you experience chest pain. Instead of googling the symptoms or playing doctor yourself, it is recommended to seek medical attention as soon as possible. 

If you suspect that the accompanying symptoms are worrisome, namely nausea, cold sweat, vomiting, etc. call for emergency medical attention, preferably an ambulance. 

Dr P.K. Hazra of AMRi Hospitals points out that the symptoms might need urgent attention: “If there is excessive sweating or asphyxia, breathing issues when walking, gastro-acid refluxes, and pain that radiates to the chest, belly, jaw or head, it requires immediate follow up. “

What happens when you are admitted to the hospital?

Hospitals will first evaluate your symptoms for a heart attack and only once they can rule that out as a cause of your symptoms, doctors look for other underlying causes. There could be a number of reasons, ranging from indigestion, panic attack, asthma or something more serious like an angina or pericarditis.   A cardiologist will look at your symptoms, take ECG, X-ray and other diagnostic tools where required. 

Additionally, some other ways in which doctors reach a conclusion about what you are experiencing during the initial assessment:

  • The centre of your pain
  • The exact sensation - numbness, burning sensation, pressure, tightness or shooting pain
  • History of similar pain
  • The duration for which the pain lasted
  • If the pain has gotten worse or stayed the same
  • Is the pain constant or spasmodic 

Once the doctors have identified the exact cause of your chest pain, you will receive the diagnosis, treatment and further instructions based on these results. 

Conclusion

One must never take chest pain lightly. While it is a broad symptom, there is much that is housed in the chest region of the body, making the stakes high.  
The sooner you take action, the better are your chances of dealing with a heart condition or other emergencies. At best, chest pain might be indigestion and at worst it might be heart attack. but it is advisable to err on the side of caution when it comes to matters of the heart.