When is Chest Pain Serious?

When is chest pain (angina) serious enough that you should visit the ER? 

Rob Lamberts, MD,
September 28, 2016
Episode #035

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When is Chest Pain Serious?

It’s 2 AM and you wake up with chest pain, aka angina. 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 disease 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. It’s also the leading cause of death in women in the US, according to the Centers for Disease Control and Prevention. 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. 

See Also: 6 Heart Attack Risk Factors 

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: the details of the actual symptoms, and the patient's risk factors for heart disease.

The typical symptoms of angina are described as:

  • 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 sometimes hard to define its exact location.

  • Shortness of breath

  • Sweating, nausea, and an anxious feeling

  • Radiation of the chest pain into the left arm, neck, and jaw


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