Chest pain as a symptom of Heart Attack

This article is part of Medika’s series on heart health and seeks to educate patients about the symptoms of heart disease and how these symptoms present.

What does heart related chest pain feel like?

This is discomfort or frank pain in the area of the chest. Usually, it is “substernal,” which means it is behind the breastbone. It can be sharp, or stabbing, or sometimes burning. Many individuals experience the feeling of pressure on or about the chest area. This feeling is aggravated by exercise and tends to stop or lessen if the person rests. This pressure can be described as a weight placed on the rib cage or constrictive bands pulled tight around the chest.

Why does your heart cause this symptom?

When the heart suffers from a lack of blood flow, it causes pain in the chest area. There are a number of conditions associated with your heart that can cause pain in your chest.

• Coronary Artery Disease, or CAD
• Myocardial infarction (heart attack)
• Myocarditis (inflammation of the heart muscle)
• Pericarditis (inflammation of the covering of the heart)
• Coronary artery dissection (tearing of the blood vessels in the heart)
• Hypertrophic cardiomyopathy (abnormal thickening of the heart muscle)
• Mitral valve prolapse (abnormal function of one of the heart valves)

Accompanying symptoms

Frequently, pain in the chest is accompanied by nausea, sweating, shortness of breath, dizziness, or lightheadedness. Sometimes, the pain can also travel from the chest to the jaw or down the left arm. Sometimes, the pain can also travel to the back. If your chest pain is accompanied by any these symptoms, seek immediate medical help.

Gender prevalence for chest pain

Women experience this symptom far less than men do. For men, it is a typical red flag, but women may not experience any chest pain at all. Women are also more likely than men to feel their chest pain while they’re resting or sleeping, while men tend to feel it when they’re active.

Does age, race or other factors affect chest pain?

Conditions such as diabetes can affect how symptoms of chest pain are experienced. In some diabetics, due to the nerve damage from diabetes, they may not suffer from any chest pain at all.

Alternate Causes of chest pain

Heartburn can also cause chest pain, and it can mimic symptoms of a heart attack. Viral inflammation of the heart (such as can be caused by SARS CoV-2), blood clots in the lungs, inflammation of the sac around the heart, and tearing of the blood vessel wall (aortic dissection) can be the culprit.

Your chest covers quite a lot of other things that could be causing that pain. Layers of muscle, bones, cartilage, nerves, your stomach, lungs and esophagus could all be responsible for pain in your chest. Issues with your stomach or gastrointestinal area can often be mistaken for heart-related pain. So can pain caused by inflammation of the cartilage that connects your ribs to your breast bone. Asthma, pneumonia and panic attacks can also cause pain in your chest.

Lungs: The following lung conditions can be responsible for chest pain. Pleuritis (pleuresy), pneumonia or lung abscess, pulmonary embolism, pneumothorax, pulmonary hypertension and asthma.

Gastro intestinal:Gastroesophageal reflux disease (GERD), Esophageal contraction disorders, Esophageal hypersensitivity. Esophageal rupture or perforation. Peptic ulcers, Hiatal hernia, Pancreatitis and Gallbladder problems.

Bone, muscle and nerves: Rib problems, muscle strain, shingles

Even doctors can struggle to distinguish if it’s your heart that causing the pain, so it is wise to always consult your doctor if you are experiencing pain or discomfort in your chest. Don’t self diagnose, it could cost you your life.

Are there clear signs it’s your heart?

There are a few tell tale signs that would indicate the pain in your chest is related to your heart.

• Pain that lasts a few seconds usually isn’t heart related, but if the pain persists for any period of time, then it’s time to call 911 or head down to your ER.
• Pressing on your chest shouldn’t affect the pain. If it does it is more likely to be muscular and not your heart.
• Taking a deep breath shouldn’t aggravate the pain. If it does, then again, this is more likely a lung or muscle related pain.
• Your current physical state. If you’re young, fit, healthy and don’t smoke or suffer from any of the risk vectors like diabetes, high blood pressure or obesity, then it is less likely to be your heart.
• Nausea, sweating, shortness of breath, dizziness, or lightheadedness are a serious indicator if they accompany chest pain,

Dispelling Myths about chest pain

• Chest pain means you’re having a heart attack – False: You can experience chest pain for a number of different reasons, see above.
• Everyone experiences the symptoms in the same way – False: for example, women, diabetics and older people tend to have very atypical chest pain. It’s different for each person.

When to call your Doctor or 911

If you are experiencing chest pain of any kind, especially if it travels to your jaw or down your arm, and are having associated symptoms of nausea, dizziness, sweating, or shortness of breath, call 911 right away.

If you are in an at risk group for heart disease (elderly, diabetic, obese, overweight, smoker or high blood pressure) then you should treat any chest pain very seriously. The more prolonged the discomfort or pain is, the faster you should seek medical care. Dial 911 or visit your nearest ER