Q: How can someone tell the difference between cardiac chest pain (from the heart) and pain from another source?
A: Let’s face it, chest pain can be frightening. However, it doesn’t always mean something is wrong with the heart. Chest pain can come from many parts of the body, including the heart, lungs, muscles, digestive system or even from stress and anxiety. While not all chest pain is cardiac, it still should always be taken seriously.
Heart-related chest pain classicly is described as pressure, tightness, heaviness or squeezing. It may come on during physical activity or emotional stress and ease with rest (or nitroglycerin). The discomfort can spread beyond the chest to areas such as the arm, neck, jaw, shoulder or back and may be accompanied by shortness of breath, nausea, sweating, lightheadedness or unusual fatigue. However, it’s important to note that symptoms are not the same for everyone. Women, older adults and people with diabetes may experience more subtle or atypical symptoms, sometimes without significant chest pain at all.
Chest pain that is not related to the heart often has different features. It may feel sharp and worsen with movement, deep breathing or coughing. Pain that can be reproduced by pressing on the chest wall is more likely related to muscles or joints. Discomfort caused by acid reflux often feels like burning and may occur after eating or when lying down. Anxiety-related chest pain can come on suddenly and improve as breathing and heart rate slow.
Even with these general patterns, there is no safe way to diagnose the cause of chest pain without a medical evaluation. Therefore, new, worsening or unexplained chest pain should never be ignored. If symptoms are severe or accompanied by shortness of breath, fainting or sweating, immediate medical care is critical.
When it comes to chest pain, it is always better to be cautious. If there is any doubt about whether the pain could be heart-related, getting checked promptly can be lifesaving.
Dr. Samuel Jones specializes in cardiology and electrophysiology with The Chattanooga Heart Institute and is a member of the Chattanooga-Hamilton County Medical Society.