The puzzle of chest pain


A pain that started in the middle of your chest, just an ache at first, but getting sharper and radiating down your arm. Is it your heart? Or is it something else?

I remember my years as a rookie in the ER: always anxious to get in on the action when an individual would present with chest pain. Instead I was frequently relegated to the job of gofer, or told to manage the feverish child in room three, or the broken arm in room two. The savvy ER nurse (eventually I would include myself in that category) could see a coronary in the making within 1-2 minutes and three or four questions. I learned it was something about the patient’s color, the way they carried themselves, the beads of sweat on their forehead in spite of the cool temperature outside. Many of them never really did complain of chest pain, but rather pain in the jaw, teeth, or wrist, with a little nausea thrown in. Those were the ones you worried about! At that point you cut with the questions, called your coworker and the ER doc, and the technology of the modern ER would rain down on the chest pain in trauma room three.

Now, if you get the feeling there is no exact set of symptoms, age range, sex, body size or shape for determining whose chest pain is related to their heart, and whose isn’t, that’s good. Let the doctor decide. The families of a DOA (dead on arrival) had a much harder time dealing than those who had a live but cantankerous family member to take home. Coronary artery disease leading to a myocardial infarction, (MI) or heart attack, is a class four emergency and is still a leading cause of fatality in men and women in the US.

What are some of the other symptoms related to serious heart-related chest pain? The patient may suffer from any or all of the following: sweating, shortness of breath, pain radiating to the arm, wrist, neck or jaw, or chest pain that worsens with exertion or when breathing cold air, nausea or vomiting, extreme weakness that worsens with exertion, dizziness, rapid or irregular pulse, or feelings of panic and anxiety.

Are there other risk factors involved that may lead to heart attack? If you are a smoker, seriously overweight, suffer from diabetes, high blood pressure, high cholesterol, are genetically predisposed to coronary artery disease, have an inactive life style or high stress levels you should be under medical care, and check in with your doctor if you are experiencing symptoms of chest pain.

When the chest pain turns out not to be related to heart disease, what else would cause that kind of pain? According to the experts at the Cleveland Clinic, overexertion and emotional stress can also cause pain or tightness in the chest. It can be a symptom of panic disorder where the heart races or pounds, you feel sweaty and nauseous and short of breath. Or, you could be suffering with some form of esophageal spasm, hiatal hernia, a gall bladder attack or an inflammation of the rib cartilage common in some chronic degenerative diseases such as fibromyalgia and some kinds of arthritis. There are medical as well as some natural therapies for handling most of these conditions.

Can’t I treat my chest pain myself? NO, absolutely not. There are some good herbs, supplements and vitamins along with an improved diet that can add life to your years following a coronary insult, key words: following a coronary insult.

Take chest pain seriously, no matter how foolish you may feel when you leave the ER with orders to rest and take Mylanta.

Till next time, Rebecca