Features February 2017 Issue

Know How to Interpret Different Types of Chest Pain or Discomfort

Itís not always easy, but distinguishing between heartburn and a heart attack may save you some stress and save your life.

Chest pain is by far the most common symptom of a heart attack. But if you’ve ever had heartburn, certain types of respiratory problems or even an anxiety attack, you know that chest discomfort can have plenty of causes unrelated to your heart.

But how can you know if the chest pain you’re dealing with is or isn’t signaling you to a heart attack? How can you be sure it’s not heartburn caused by some extra-spicy curry?

The truth is, you can’t always tell the difference, especially if heartburn is a new experience and you’ve never had a heart attack or angina≠—a condition in which narrowed arteries in the heart lead to chest pain.

One helpful tool is to be aware of other symptoms you may be experiencing while you’re sorting out your chest pain. For example, if you have heartburn caused by gastroesophageal reflux disease (GERD), you may notice worse symptoms when lying down.

“Usually heart-associated symptoms happen during exertion, since the heart requires more blood flow and oxygen with exertion,” says Leslie Cho, MD, co-section head of Preventive Cardiology and Rehabilitation at Cleveland Clinic. “GERD at night, exacerbated by food, does not come on with exertion.”

She adds that pain caused by strains of your chest muscles or by fractured bones in the chest will usually change based on how you’re sitting or lying down. “Chest pain that is musculoskeletal gets worse with positional changes,” Dr. Cho says.

If you have chest pain while breathing, it’s more often the case that you’re grappling with pneumonia or costochondritis, an inflammation of ligaments in the rib cage, she adds.

What to Do When Chest Pain Starts

We tend to think of heart attacks as sudden events that come on without warning. But Dr. Cho explains that there are often warning signs that should clue us in when chest pain†starts.

“There can be increasing shortness of breath, fatigue, chest pressure or pain with exertion in the days leading up to a heart attack,” Dr. Cho says.

If you’re ever unsure about your chest pain, and you’re at a higher risk of a heart attack, get help immediately, Dr. Cho says. “If you are having severe pain, call 911. Let the professionals decide,” she advises.

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