Not all chest pain is the same

Not all chest pain is the same

Many people wisely think “heart attack” when someone has chest pain. Nearly 800,000 Americans have heart attacks every year, according to the Centers for Disease Control and Prevention.

So if you think you may be having a heart attack, call 9-1-1. Don’t wait. And don’t drive yourself to the hospital even if you feel OK for a little while. Your condition can change quickly, and you will put others on the road in danger if you lose consciousness.

Symptoms of heart attacks can be tricky. Not everyone who’s having a heart attack has chest pain. And not all chest pain is a heart attack.

You should talk to your doctor if you feel chest pain. When talking about it, your doctor may refer to “angina” or “angina pectoris.” That’s a medical term for chest pain. The terms encompass pressure or tightness in the chest, and angina is not the same as a heart attack.

Heart attacks usually come on suddenly, and the symptoms last longer – typically longer than 15 minutes. Angina tends to result from stress or exertion, and symptoms could go away in 5-10 minutes or with some rest.

The pain from a heart attack may be described as extreme pressure, squeezing or fullness. And while some have no pain, angina is usually described as discomfort.

And a heart attack can cause permanent damage to your heart. Angina doesn’t.

Other than a heart attack, chest pain can be caused by heart conditions such as:

  • Mitral valve prolapse: Your heart’s mitral valve doesn’t close correctly.
  • Myocarditis: A heart muscle inflammation. Along with chest pain, you may have a fever, fatigue and trouble breathing.
  • Pericarditis: An infection or inflammation of the sac around your heart. Pain from pericarditis tends to be sharp and steady. You’ll feel it along your upper neck and shoulder muscles. The pain may get worse when you breathe, swallow food or lie on your back.
  • Aortic dissection: A life-threatening tear develops in your aorta — your largest artery. This uncommon tear causes sudden severe, ripping pain in your neck, back or abdomen.

Chest pain can come from one of the other organs in your chest. The source could be your lungs, esophagus, diaphragm (the muscle that draws air into your lungs) or your liver. You also have other muscles, tendons, ribs and lots of nerves in your chest that can be a source of chest pain. For example:

  • Heart burn, stomach ulcers, an inflammation of your stomach lining (gastritis) or gallstones
  • Lung problems such as blood clots, an infection (can result in pneumonia) or a collapsed lung
  • A chest muscle or tendon strain
  • Asthma
  • Panic attack

Now that we’ve reviewed some basic reasons other than a heart attack for chest pain, we want to reiterate a key point:

If you think you may be having a heart attack, call 9-1-1. You won’t know how serious it is until you see your health care professional. If you wait to “see what happens,” you may not get to.

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About the Author

Dr. Michael Otte
Dr. Michael Otte

Michael L. Otte, MD is a family medicine physician at Aurora Health Center - Germantown.