Chest Pain and Heart Disease

How do you know when chest pain signals a heart attack? That's the life-and-death question medical professionals have been attempting to answer for years. Unfortunately, there is still no definite way for individuals to tell on their own whether that stabbing chest pain is caused by a heart attack, indigestion, anxiety, or any number of other health conditions.

Recent statistics from the U.S. Centers for Disease Control and Prevention (CDC) show that the leading cause for visits to hospital emergency rooms is chest pain. This is not surprising. One of the first thoughts a person has when a sudden and unfamiliar pain springs up in their chest is "heart attack."
Worried about your heart health? Find a cardiologist in your area.

Getting to the Heart of Chest Pain

When chest pain occurs, heart attack and angina are the two major issues of concern.

Heart attack. A heart attack happens when a vessel carrying blood to the heart muscle becomes blocked. The pain may feel like a squeezing sensation or sense of fullness in your chest. You may feel it steadily for several minutes or more, or the sensation may come and go. The pain and other uncomfortable sensations don't always stay in your chest, either: You may also experience them in your arms, neck, or jaw.

According to the medical journal American Family Physician, if the pain is radiating from your chest out to your arms, it's more likely that you are indeed experiencing a heart attack. On the other hand, if the pain you feel is a "sharp" pain, a heart attack is less likely to be the cause.
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Although both men and women commonly have pain or discomfort in the middle of their chest, women are more likely than men to have additional symptoms aside from the chest pain, including nausea, vomiting, or difficulty breathing.

Angina. Angina occurs when the heart muscle isn't getting as much blood as it needs to function properly. The pain from angina can feel similar to the pain from a heart attack, but it is when the pain occurs that can provide important clues as to its cause.

If the pain occurs after physical exertion and is a familiar sensation that disappears after you rest or take a prescription medicine (e.g., nitroglycerin), you may have what is called stable angina. But if the pain occurs when you're already at rest or lasts for more than a few minutes, it could be due to unstable angina, which can point to an impending heart attack.

Other Possible Causes of Chest Pain

Common triggers of chest pain that don't involve the heart include:

* Acid reflux. Gastroesophageal reflux disease (GERD) may be the most common cause of non-heart related chest pain, and the pain may be very difficult to differentiate from angina. It may feel like a burning sensation that gets worse after meals, but may also share many qualities with heart-related emergencies such as a heart attack.
* Pulmonary embolism. Caused by a blockage in an artery in your lung, this cardiovascular condition may cause pain accompanied by shortness of breath or the coughing up of blood.
* Pneumonia. This lung infection (typically caused by a bacterial infection) can produce sharp pains that often feel worse during deep breathing or coughing. This type of chest pain is often accompanied by difficulty breathing and a fever.
* Pleuritic pain. This is a stabbing pain when you inhale, like a "catch" in your side. It is caused when the membrane that covers your lungs (called the pleura) comes into contact with the lining of your chest wall, says Bob Flint, MD, an American Heart Association spokesperson in Indianapolis, Indiana. Pleuritic pains typically lasts for just a few seconds.
* Chest wall soreness. Inflammation in the cartilage between the ribs and breastbone — a condition called "costochondritis" — can cause achiness that can last hours or days, Dr. Flint says. The area feels tender when you press on your chest.
* Panic disorder. This is more likely to be the cause of chest pain if you've recently had symptoms of sudden anxiety or a racing heartbeat.

When to Seek Medical Attention

"If you're experiencing any kind of chest pain that's new, it needs to be investigated NOW, in capital letters," Flint says. Any pain that you've never felt before that lasts for more than 10 minutes or that doesn't go away after taking a prescription medication (such as a beta-blocker) that normally treats the pain should warrant an immediate call for emergency medical help.

One important note: Some people may experience a heart attack and not feel any chest pain. In these cases, warning signs may include unexplained bouts of nausea, vomiting, sweating, and lightheadedness. If you experience these symptoms and can't identify a cause or find relief, it's important to get checked out by a medical professional as soon as possible. Doctors often rely on high-tech tests to help them figure out the exact cause of chest pain, so don't feel embarrassed if you seek help and the problem turns out to be from a relatively minor cause.
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