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    Home - Health & Wellness (Specialized) - Understanding Chest Pain: Is It Always a Heart Attack?
    Health & Wellness (Specialized)

    Understanding Chest Pain: Is It Always a Heart Attack?

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    Understanding Chest Pain: Is It Always a Heart Attack?
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    While many doctors like Becker urge the public to err on the side of caution and get immediate medical attention when chest pain appears to be serious, some types of discomfort in the chest may be the symptom of a less serious problem.

    Adriana Quinones-Camacho, MD, a cardiologist with NYU Langone Health, suggests that if chest pain occurs only when pushing on the chest, it is more likely to be a musculoskeletal issue related to muscles or bones. “If you touch the area and elicit pain, it may be due to something in the muscles in the chest wall,” she says. “Still, even if it’s less likely to be a heart attack, people present in very different ways.”

    GERD

    “Most common but less dangerous causes of chest pain that are often mistaken for heart attack are indigestion, acid reflux, or gastroesophageal reflux disease,” says Dr. Quinones-Camacho, adding, however, that severe heartburn can be hard to tell apart from a heart attack, even for some physicians.

    The Cleveland Clinic estimates that gastroesophageal reflux disease (GERD, otherwise known as chronic acid reflux) accounts for 50 to 60 percent of non–heart related chest pain cases.

    Typically, heartburn feels like a burning in the chest that is actually in the esophagus (the muscular tube through which food passes from the throat to the stomach), and it often occurs after eating or while lying down or bending over, according to the Mayo Clinic.

    Getting relief from an antacid (or even burping) suggests that the discomfort is from heartburn, but if the burning is accompanied by sweating and trouble breathing, it may be more likely that it is a sign of heart trouble.

    “If the discomfort comes only when the person is eating certain foods — whether it’s spicy chili or something else — and never at other times, then it is most likely indigestion,” says Dr. Quinones-Camacho.

    Angina

    Angina can cause a feeling of tightness or squeezing in your chest; the pain may radiate to your arms, neck, back, shoulders, or jaw. Angina is caused by narrowing of the arteries, which can temporarily reduce blood flow to the heart. With a heart attack, blood flow is reduced for a longer period and can cause permanent damage to the heart muscle.

    With angina, rest or medication (nitroglycerin) can quickly stabilize the heart, but if you’re having a heart attack, rest or medication does not ease symptoms.

    Angina can sometimes be a warning sign of heart attack, so if the condition does not improve quickly or worsens, call 911.

    Costochondritis

    Costochondritis is a condition caused by inflammation of the cartilage that connects your breastbone (sternum) to your ribs. The pain can closely mimic a heart attack or other cardiac problems, but costochondritis is not life-threatening and usually doesn’t cause any complications.

    The sharp, aching pain can worsen with upper-body movement or with deep breaths because it involves joints that flex when you inhale. And the pain is often felt on the left side, notes the Mayo Clinic.

    Costochondritis is typically caused by some kind of mechanical stress — coughing too hard or reaching too far and straining your body. Costochondritis can happen to people with rheumatic diseases like rheumatoid arthritis and psoriatic arthritis, in which inflammation affects your rib cartilage. But it can also be partially caused by noninflammatory conditions, such as fibromyalgia.

    Pneumonia

    Chest pain, particularly if it develops suddenly and is on one side, is a common sign of pneumonia. But if you have pneumonia, you’ll likely also be experiencing other symptoms, such as chills and fever (higher than 100.4 degrees F), a cough lasting more than three weeks, shortness of breath or rapid breathing, bloody mucus, and drowsiness or confusion.

    Panic Attacks

    When you have a panic attack, stress hormones like adrenaline and cortisol flood your body, leading to a sudden and overwhelming physiological and emotional response. Chest pain, along with a rapid heart rate and hyperventilation, can be part of a panic attack. As with a heart attack, sweating and nausea may occur. But unlike a heart attack, during a panic attack you may experience other symptoms like trembling, a choking sensation, feelings of intense terror and fear, or feeling detached from reality.

    While there can be a number of noncardiac causes of chest pain, it’s always worth getting chest pain checked. The bottom line: When in doubt, check it out and seek medical attention.



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