Chest pain can have many causes, but it’s often linked to heart problems. This pain can vary from mild discomfort to severe and may signal a heart attack (MI), unstable angina, or aortic dissection. However, it can also be due to lung issues (like pulmonary embolism), chest or shoulder muscle problems, or stomach and digestive problems (like acid reflux or ulcers).
Heart-related chest pain typically builds up for several minutes and might spread to the neck, shoulder, or arms. It’s important to take any chest discomfort seriously.
Doctors use patient history, physical exams, and electrocardiograms (ECGs) to estimate the likelihood of a heart problem. High-sensitivity troponin tests can be very helpful, especially when ECGs don’t provide clear results.
Unstable angina feels similar to a heart attack but is often triggered by activity and responds faster to anti-angina medication.
Aortic dissection usually starts with sudden, severe chest pain that can spread to the back. The pain’s location can give clues about where the dissection is happening.
If someone has back pain or risk factors like high blood pressure, further tests like transesophageal echocardiography, CT, or MRI might be needed.
Other conditions, like pericarditis or pulmonary embolism, can cause chest pain too. It’s important to distinguish between these possibilities.
In patients with heart disease, symptoms can be diverse, and sometimes there are no symptoms at all. Therefore, it’s crucial to carefully evaluate patients for early signs of heart disease and provide appropriate treatment.
Although there has been progress in diagnosing and treating heart disease, it remains a significant cause of death. Regular check-ups with a primary care doctor, especially for those over 65, can reduce the overall risk of death from heart disease.
In urgent situations like suspected heart attack, unstable angina, aortic dissection, pulmonary edema, or pulmonary embolism, quick evaluation and tests are essential to determine the problem and start treatment promptly.
Chest discomfort that comes and goes can happen due to various reasons, both heart-related and not. One way to find out if it's related to heart problems is to perform stress tests. These tests can help identify if there's temporary reduced blood flow to the heart muscle (myocardial ischemia) as the cause of the chest discomfort.