When is Chest Pain Serious?

When should you run to the ER?

Rob Lamberts, MD,
February 17, 2010
Episode #035

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When is Chest Pain Serious?

It’s 2 AM and you wake up with chest pain.  What should you do?  Maybe it’s just indigestion, but maybe it’s a heart attack. How do you know what to do?

When is Chest Pain Serious?

Heart attacks kill more people in the U.S. than any other single disease, and the main symptom that people have from a heart attack is chest pain.  But the term chest pain is actually misleading.  Heart pain is not always described as being painful, and it’s not always in the chest.  For that reason, I like the Latin term angina pectoris, which means “sensation in the chest.”  This is not just a vocabulary lesson; people die because what they are feeling isn’t actually chest pain and so they stay at home and have a heart attack. 

Today I’ll focus on the symptom that brings people into my office, and then over the next few weeks I’ll cover the cause and the treatment of heart disease.

When Is Chest Pain a Heart Attack?

So how can you tell if you should worry with your angina symptoms?  There are two main factors that help me decide when to worry and when I can safely rule out heart disease: the actual symptom, and the risk of the person having those symptoms.

The typical symptoms of angina are:

  • Chest “tightness,” “squeezing,” or “heaviness.”  People describe this feeling as a weight or as a band being tightened around their chest. The pain is usually located on the left side of the chest above the bottom of the ribcage, but it’s often hard to define its exact location.

  • Shortness of breath

  • Sweating, nausea, and an anxious feeling

  • A pain in the left arm, neck, and jaw