MemorialCare Health System Your Health: I Have Chest Pain. Now What?

Chest pain is one of the most common reasons that people 15-years-old and older visit the emergency department. In fact, the number of non-injury emergency department visits, where chest pain was the primary reason, was 5.5 million in 2007–2008.

Emergency department visits can be expensive and time consuming, and since many people assume that all heart attacks involve sudden severe chest pain a common reaction is to seek immediate medical attention. However, severe chest pain only occurs in about half of all heart attack cases.

In a 2005 survey taken by the Center for Disease Control and Prevention, 92 percent of respondents recognized chest pain as a symptom of a heart attack, but only 27 percent were aware of all the major symptoms and knew to call 911 when someone was having a heart attack. Chest pain is a common symptom of heart attacks, angina, panic attacks and heartburn.

So how do you know when to take an antacid or when to call 911? In order to prevent sudden cardiac death, the MemorialCare Heart & Vascular Institute at Long Beach Memorial recommends you learn the common symptoms of a heart attack. Learning the major symptoms can save your life, or the life of a loved one.

Heart Attack

Coronary artery disease (CAD), the most common type of heart disease develops when plaque — a waxy substance made up of cholesterol deposits — builds up in the arteries that supply blood to the heart. When buildup continues, your arteries can narrow over time, making it harder for blood to reach the heart. This causes lack of oxygen to the heart muscles. This slow process, called atherosclerosis, can eventually lead to a section of the heart muscle dying or being severely damaged. In other words, a heart attack.

The MemorialCare Heart & Vascular Institute recognizes the following as the major warning signs of a heart attack:

• Chest pain or discomfort in the center of the chest that lasts more than a few minutes or that goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness or pain
• Pain or discomfort in the jaw, neck, back, arms or shoulders
• Feeling weak, light-headed or faint
• Shortness of breath

Signs that are more common for women who are experiencing a heart attack can include:

• Heart palpitations or abnormally weak and/or rapid pulse
• Lightheadedness, dizziness, fainting or a sick stomach
• Gray facial color
• Vomiting
• Indigestion
• Weakness
• Fatigue
• Dizziness
• Lightheadedness
• Shoulder blade pain
• Change in migraine pattern or migraine with aura
• Jaw pain

Angina

Another symptom of CAD that may lead to a heart attack is angina pectoris, a common type of chest pain or discomfort that also happens when the heart muscle is not receiving enough oxygen-rich blood. Angina may feel like pressure or squeezing in your chest. The pain also can occur in your shoulders, arms, neck, jaw or back. The pain is a message telling your body that there is a shortage of blood to the heart.

Angina pectoris is often referred to as stable angina because with rest and the proper medical attention it can be predictable and manageable. This type of angina usually occurs during periods of high emotions, stress or physical activity. The difference between stable angina and a heart attack is that angina doesn't permanently damage the heart muscles.

However, chest pain that occurs unexpectedly and while during periods of rest is a sign of unstable angina, also known as acute coronary syndrome. Unstable angina is a result of reduced blood flow to the heart muscles when arteries become narrowed by plaque buildup similar to the blockage that causes a heart attack. If you are experiencing severe unexpected chest pain, seek immediate medical attention.

Panic Attack

Panic attacks can be so intense, and the symptoms so similar, that many people believe they’re experiencing a heart attack. Many people will experience at least one panic attack in the course of their lifetime. There are no known medical causes for panic attacks, but factors like sudden changes, traumatic events or significant stress often are at the core of an attack. Panic attacks usually come with no warning signs and most peak within 10 minutes, while heart attack symptoms can start slow and last for longer periods.

Some of the common symptoms of a panic attack include:

• Chest pain or discomfort
• Dizziness or faintness
• Feelings of fear
• Nausea or upset stomach
• Numbness or tingling in the hands, feet or face
• Palpitations, fast heart rate or pounding heart
• Shortness of breath
• Sweating, chills or hot flashes
• Trembling or shaking

Heartburn

Most people will experience the occasional heartburn brought on by triggers like pregnancy, certain foods, alcohol and some medications. Heartburn is a non-cardiac chest pain that occurs when stomach acid backs up into your esophagus — the tube that carries food from your mouth to your stomach — and irritates it. Most heartburn can be relieved with over-the-counter medicine.

Signs of heartburn can include:

• A sharp, burning sensation just below the breastbone or ribs that can last a few minutes to several hours
• Chest pain usually occurring after meals, when lying on the back, exercising or experiencing anxiety
• Burning in the throat or hot, sour, acidic or salty-tasting fluid at the back of the throat

The occasional heartburn is common but consistent heartburn, more than twice a week, may signify gastroesophageal reflux disease (GERD), a chronic digestive disease. With GERD, the muscles at the end of your esophagus do not close tightly enough. This allows contents of the stomach to back up, or reflux, into the esophagus and irritate it. If left untreated overtime, GERD can lead to more serious complications.

Knowing the reason behind your chest pain can be life-saving, but don't let a heart attack be your first sign of heart disease. To find out if you're at risk for heart disease, take our quick heart disease risk assessment.

Specialists at the MemorialCare Heart & Vascular Institute at Long Beach Memorial help patients determine their risks for cardiovascular disease and peripheral vascular disease, and provide them with valuable preventive strategies. Individualized screening programs also are offered to measure risks for heart attack, stroke and other related diseases, at a low-cost.