While a heart attack is the first thing that comes to mind when someone mentions having chest pains, it’s important to remember that several other medical issues can cause this symptom.
Not all injuries are life-threatening; for example, you injured a muscle in your chest while working in the garden last fall. The consequences for others, though, can be much direr.
When Health.com surveyed three of the nation’s top cardiologists, all three agreed on a single point. If you’re experiencing chest pain and aren’t sure what’s causing it, you should contact a medical professional or dial 911 immediately.
Sharonne Hayes, a doctor at the Mayo Clinic in Rochester, Minnesota, adds, “I know of one individual who died, and the last item in their search bar was ‘heart attack symptoms.'”
Cleveland Clinic cardiologist Dr. Christine Jellis, Ph.D., MD, agrees. Instead of having someone “come to us” too late and with irreparable harm, “as a doctor, I would much rather let someone know that it’s nothing to worry about,” Dr. Jellis says.
Here are the seven most common causes of chest pain and the self-care measures to alleviate the discomfort.
Pericarditis
Pericarditis is inflammation of the tissue layers that surround our heart. It can manifest as a sudden, severe discomfort in the chest in those who have been fighting a virus for several days.
Autoimmune diseases like rheumatoid arthritis and lupus can also play a role, but respiratory infections are more common. Pericarditis is mostly harmless, although it can severely affect one’s quality of life.
After ordering tests such as an electrocardiogram, CT scan, or chest x-ray, your doctor may be able to make a diagnosis. However, suppose you rest and take an anti-inflammatory medication like ibuprofen. In that case, your pericarditis should go away in a few days or weeks.
Costochondritis
According to a review published in 2009 in the journal American Family Physician, between 13 and 36 percent of adults who seek medical attention for sudden chest pain are diagnosed with costochondritis or inflammation at the point where a rib bone meets the cartilage. Often, doctors cannot determine what precipitated the disease, but viral infections and chest traumas are two possible causes.
Common symptoms include a dull ache in the chest and discomfort to the touch, much like a strained muscle.
Here, a doctor will likely begin by asking about your health background and conducting a physical examination. The primary focus of a doctor’s analysis will be to exclude cardiac and other life-threatening conditions. They’ll have to rule things out before making a diagnosis. Pain from costochondritis is usually temporary and relieved by taking over-the-counter pain medication.
Muscle strain
You may want to reconsider signing up for that CrossFit session on the weekend if it’s been more than a couple of years since you lifted anything more than a MacBook.
Dr. Jellis warns that a pulled chest muscle could be misunderstood for a heart attack. A patient “came in with chest pain, and he was scared that he had a heart attack,” she recalls. I gathered from his background that he had recently relocated and hadn’t had to move any large objects in years. However, coming in was the correct move on his part.
Patients are not expected to be able to distinguish between a heart attack and a torn chest muscle. Still, a solid rule of thumb is that if pressing on the chest wall makes the discomfort worse, it is more plausible to be a musculoskeletal problem than an issue with your heart.
Coronary artery disease
Plaque buildup in the arteries supplying blood to the heart is the root cause of coronary artery disease (CAD). Blood flow is obstructed, and chest discomfort is experienced when cholesterol deposits settle in the artery walls over time.
A heart attack is not the only thing CAD can do to your heart, it can also lead to heart failure and irregular heartbeats. A diagnosis of coronary artery disease may prompt your doctor to prescribe statins, recommend angioplasty with stent placement, or arrange bypass surgery.
Shingles
The chickenpox virus might still be in your system even after the rash has faded. Varicella-zoster can indeed reactivate as shingles in adulthood (often affecting those over the age of 50).
Itchy, painful skin is the first sign. If the discomfort is felt in the region above the chest, it could be misdiagnosed as a heart attack or cardiac condition.
However, the characteristic rash and blisters may appear a few days later.
Call your doctor immediately if you have any symptoms associated with shingles. If used within 72 hours of the rash emerging, antiviral drugs can reduce pain and minimize the length of symptoms. Prescription painkillers are available if antiviral treatment has already been delayed.
Heartburn
Maybe you’re wondering how someone might confuse the signs of acid reflux with those of a heart attack, but there is a name for this condition (heartburn), and it’s not because it’s pleasant.
Reflux of stomach contents into the esophagus, the tube connecting the throat to the stomach, is called gastroesophageal reflux condition.
The acid in your stomach is very acidic, which is why it burns so severely behind your breastbone. It has a pH of roughly 2 (PDF), which puts it around battery acid and vinegar. (The lining of the stomach protects it from stomach acid, but the lining of the esophagus does not.)
However, if you suffer reflux more than twice a week, you could have gastroesophageal reflux disease (GERD). Suppose you have GERD and don’t get it treated. In that case, you may get chest congestion, asthma, and a condition called Barrett’s esophagus, which raises your risk of developing rare cancer.
Pancreatitis
A person’s chest pain may not be due to a heart attack, but it doesn’t make it any less severe. Acute pancreatitis is a condition in which the pancreas, which sits below the stomach, suddenly becomes inflamed. Pain in the abdomen might be so powerful that it spreads to the chest.
Moreover, the suffering from pancreatitis is typically severe and pervasive.
Gallstones, typically composed of hardened cholesterol, are a common cause of pancreatitis and are more common in women than in males. Seek immediate medical assistance if you suspect you have pancreatitis; you will likely need to spend several days in the hospital receiving antibiotics, pain meds, and intravenous fluids. Your doctor will likely prescribe additional tests, including bloodwork and maybe a CT scan or abdominal ultrasound, if necessary.
Final words
The cardinal rule our cardiologists emphasized is that if you’re having chest pain, you should see a doctor immediately.
Getting people to seek medical attention when they experience chest pain has been a major public health campaign.
Sadly, there are still those among us who refuse to pay attention to our bodies, who experience chest pain but dismiss it as nothing more than stress. We know what it’s like to worry, “What if the ambulance pulls up to my door and I return later, and it was just indigestion?” Too many people have died in their own homes from what turned out to be heart attacks but were misdiagnosed as indigestion.
Do not call your significant other or drive yourself if this is a new symptom you have never had before or if the pain is coming and going or getting worse. Don’t hesitate to call 911.
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