Features August 2019 Issue

How to Know When Your Chest Pain Might Be Serious

Pain in the chest may signify a heart attack-or not. Here's how to tell whether your chest pain needs immediate attention.

A sensation of pressure, pain or squeezing in the center of your chest is a classic symptom of heart attack. It's common for this pain to radiate to your jaw, neck, back or arm. Even if it spreads outside the chest, it's called chest pain or, in medical terms, angina. But people can experience chest pain for reasons other than a heart attack. So how can you tell whether your chest pain is an emergency?

1 HeartPain

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Not all chest pain is serious, yet the symptoms of heart attack vary widely. Use good judgment. Call 911 unless you can rule out a heart attack quickly and with confidence.

"If your discomfort lasts for three minutes or more, or quickly worsens, and particularly if you also feel short of breath, lightheaded, nauseated, intensely fatigued, break out in a cold sweat or have a sense of doom, there's a real possibility you are having a heart attack or are about to have one," says Cleveland Clinic preventive cardiologist Luke J. Laffin, MD. "Seeking immediate medical attention may save your life."

If you experience any type of chest pain, answering these questions can help you identify the source of your symptoms:

1. Is the pain sharp or dull? A key differentiator is the intensity of pain.In the movies, heart-attack victims often clutch their chest and grimace in pain before collapsing. But it is unusual for a heart attack to produce intense pain. Heart-attack pain is generally described as an unrelenting sensation of pressure, like an elephant sitting on your chest.

A sharp, stabbing pain of short duration-like an electric shock-is more likely to come from a bone or nerve problem, such as a cracked rib or pulled muscle.

"This type of pain may be actually more painful than a heart attack, but it will go away fairly quickly," says Dr. Laffin. "Chest pain from a heart attack can last 30minutes-sometimes longer."

2. Does changing positions help? Does the pain go away or lessen when you change positions? For example, do you feel better if you bend over or sit up in bed? If so, your chest pain likely comes from a lung problem such as pneumonia or asthma.

"If you are having a heart attack, you will not be able to find a position that makes the pain go away," says Dr. Laffin. "Heart‑attack victims describe the discomfort as relentless."

3. Does self-medicating make it better? If taking a drink, popping antacids or taking deep breaths eases the pain, it's unlikely to be heart-related.

4. Does exercise help? Angina will worsen if you try to exercise. If exercise makes the pain go away, it's not a heart attack.

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