If you’ve ever felt a pain in your chest you couldn’t quite put your finger on, you’re not alone. According to research published by the American Heart Association, chest pain is the most common cause of Emergency Room admissions for adults in the United States, with upwards of eight million individuals visiting the ER with this troubling symptom each and every year.
And while any chest pain can be alarming, the reality is that most of the time this symptom isn’t actually related to a life-threatening condition. In fact, researchers at the University of California, San Francisco found that just 5.5 percent of ER visits for chest pain yielded a serious diagnosis.
“Chest pain is one of the more common reasons why people go to the hospital. In the worst case scenario, when you have chest pain, it’s a heart attack, so when people have chest pressure or chest pain that doesn’t go away, they’re told to go to the ER,” says Dr. Sanjiv Patel, MD, cardiologist at MemorialCare Heart & Vascular Institute at Orange Coast Medical Center in Fountain Valley, CA.
In fact, in many cases, that chest pain may be something easily treated. “If it’s just a few seconds of pain, it’s not much of an issue,” admits Dr. Patel. “But more importantly, if the chest pain is occurring with a symptom associated with it—difficulty breathing or neck pain—it needs to be treated.”
So, before you start panicking, find out what your chest pain really means. And when you want to know how well your heart is working, discover these 10 Surefire Signs Your Heart is Super Strong.
You’re stressed out.
While that sudden-onset chest pain can be shocking and scary, it doesn’t necessarily mean there’s something serious wrong. According to research conducted at the University of Gothenburg in Sweden, stress is frequently a contributing factor to chest pain, and tends to be exacerbated by conditions like anxiety, depression, and a lack of exercise. “Sometimes anxiety can cause chest pains,” confirms Dr. Patel. And when you want to get rid of the stress threatening to do you in, discover these 30 Easy Ways to Fight Stress.
You have inflammation in your heart.
That intense pain in your chest could be the sign of something wrong with your heart muscle.
“Myocarditis is inflammation of the muscle of the heart,” says Dr. Patel. “Most of the time, there’s a virus or upper respiratory infection that can cause this inflammation. You can also get inflammation of the heart with very bad immune diseases, like lupus.”
So, what are some signs your pain is related to myocarditis?
“Myocarditis can cause chest pressure, shortness of breath, or heaviness. It can be a positional pain and it’s going to be a continuous pain until you get anti-inflammatories or steroids in the worst cases.”
If your pain is ongoing, it’s important to see a doctor, advises Patel. “Myocarditis can be life-threatening, because an inflamed heart muscle can either work or not work. The people who are in trouble are the ones who have a weakened heart muscle in addition to the inflammation. Those people need to be treated very closely.”
Your blood pressure is too high.
While high blood pressure can increase your risk of heart attack, your blood pressure on its own may be behind those chest pains. Individuals with pulmonary hypertension frequently find themselves with chest pain, and considering that one in three Americans has high blood pressure, it’s not unlikely that high blood pressure could be to blame. And when you want to get your blood pressure under control, start with these 40 Ways to Lower Your Blood Pressure After 40.
Your heart valves aren’t working properly.
If you’re experiencing chest pain, especially one that comes with shortness of breath, heart palpitations, or if you’ve been diagnosed with a heart murmur, it’s time to get to a doctor. These symptoms could be a sign of mitral valve prolapse, a potentially serious condition in which a valve on the left side of the heart is significantly weakened.
“It’s like a two-door entry in your house. Mitral valve prolapse is basically a problem with the door itself. The door is not strong enough to withstand the pressure. If you make it with soft wood, the door will buckle from the pressure. With mitral valve prolapse, the material that makes the mitral valve is weakened,” explains Dr. Patel.
However, if left untreated, mitral valve prolapse can cause serious problems, including blood leakage passing in the wrong direction between the chambers of the heart. The good news? Mitral valve prolapse can be repaired, but an operation is typically required to do so. And when you want to make your heart healthier, make sure to ask for these 9 Heart Tests Better Than Cholesterol Count.
You’re dealing with acid reflux.
That burning in your chest can be unpleasant, but it’s unlikely the result of a fatal heart issue; instead, it’s likely acid reflux, or GERD. One good way to gauge how serious it is? If you sit up and the pain gets better, that’s a good sign you’re dealing with reflux.
“If you have a severe burning, typically after eating a spicy food or eating tomato sauce,” that’s probably GERD, says Dr. Patel. “If you lie down and feel a severe burn in your stomach or the middle of your chest and you sit up and feel better, you can probably get better by changing position or taking Tums or Zantac or Pepto-Bismol. Those are more common symptoms of GERD, or acid reflux, but they also mimic symptoms of heart attacks, as well.”
You have aortic dissection.
If you find that your chest pain is moving from the front of your chest to the back, or came on suddenly after an accident, it’s time to get to the ER, as this could be a sign of aortic dissection.
“Aortic dissection is a tear in the aorta,” says Dr. Patel. However, it’s not just pain in your chest you might experience.
“The aorta goes from the heart from the front of the chest to the back of the chest and down into the abdomen. Any part of the aorta, from the heart to where it separates before your legs, can tear…The emergency situation is when the tear happens in the part of the aorta above the heart,” says Dr. Patel. “If the tear is closer to the back of the chest, you can sometimes wait and see. These sometimes heal themselves.”
You’re having a panic attack.
That sudden pressure in your chest that comes on out of nowhere, those sweaty palms, and the feeling that something terrible is about to happen may all seem like typical heart attack symptoms, but that’s not always the case. In fact, according to a study published in the American Journal of Medicine, chest pain is one of the most common symptoms of a panic attack. The good news? Stress-relief techniques, therapy, and medication can all keep that pain from recurring.
You have angina
Sometimes, those symptoms you’re sure are related to a heart attack are the sign of something else altogether, like angina.
“Angina is basically a term used to describe pain from having a narrow artery in the heart. The coronary artery, or the artery that feeds the heart, if it gets narrowed enough—70 percent or more blocked—that limitation of the flow, if it involves a large part of the heart, can cause pain. And that pain is called angina,” says Patel. So, how do you know if it’s serious? “Patients who wake up and suddenly have chest pressure at rest, that’s a very critical blockage.”
However, if your pain gets better with rest, that’s considered stable angina, and may not require emergency treatment. If it comes and goes with no rhyme or reason, it’s unstable. “If it’s unstable, you need emergency care. If it’s stable, you have time,” says Patel. And if you’re ready to make your heart stronger in a hurry, find out How to Build a Heart of Steel.
You have a broken rib.
With heart conditions contributing to such paralyzing fear, it’s often easy to forget that there are other structures in the chest that might be a source of pain, like your ribs. If you’ve recently had a bout of bronchitis or pneumonia, that pain in your chest could be a fractured rib. A good way to tell? If it hurts when you touch your rib cage, the pain likely isn’t related to your heart.
Your heart muscle is thicker than normal.
That pain rooted deep inside your chest? It could be hypertrophic cardiomyopathy, or a thickening of the heart muscle. So, why is this such a pain, so to speak?
“The heart muscle needs a certain thickness to push the blood out. If it’s too thick, it’s too hard. If it’s too thin, there’s not enough pressure to pump the blood,” explains Patel. However, if you’re experiencing deep internal chest pain or have a family history of heart problems, it’s definitely worth seeing a doctor, especially since this condition can lie dormant for years. While this condition may lead to smaller problems, like arrhythmia, it can also trigger sudden death.
You have COPD.
Pain in your chest, particularly if it hurts worse when you breathe, might not be a sign of chronic obstructive pulmonary disease, or COPD. This inflammatory lung condition may not be on your radar, but it’s the third-leading cause of death in the United States, so it’s worth talking to your doctor about if you’re experiencing difficulty breathing and chest pain, especially if you are a current or former smoker.
You have lung cancer.
Pressure, pain, and fullness in your chest can all be signs of a heart problem, but in many cases, they start in your lungs. Lung cancer can present with similar symptoms as a heart condition, but generally causes difficulty breathing, as well. If your chest pain is accompanied by bone pain, it’s of the essence to get to a doctor soon, as this may be an indication that your cancer has metastasized.
You have a collapsed lung.
If that chest pain started following a fall, car accident, pneumonia, or lung cancer diagnosis, you could be dealing with a collapsed lung. And while this condition can resolve itself, in some cases, it can prove fatal if left untreated.
You have esophagitis.
The esophagus—the tube connecting your throat to your stomach—is a surprising source of some of the more debilitating cases of chest pain. When the esophageal tissue is damaged, whether from allergies, GERD, infection, or trauma, it can cause chest pain. And though esophagitis can be healed without treatment, if it’s related to an infection, it could cause sepsis and death. However, that’s not the only way your esophagus can contribute to chest pain: “Your esophagus can cause pain if you have a dysfunction, or a muscle spasm,” says Dr. Patel.
You have pneumonia.
That never-ending cough and crushing pain in your chest could be a sign that you have pneumonia. Pneumonia, typically a complication of an upper respiratory infection, causes the air sacs in the lungs to become inflamed and fill with fluid. And while over a million people are diagnosed with pneumonia in the U.S. each year, it’s important to get treated if you suspect you have it, as it can prove lethal.
You have a pulmonary embolism.
If your chest pain started following a long trip, you could be dealing with a pulmonary embolism. This condition, in which a blood clot makes its way to your lungs, potentially causing death, is no laughing matter. In fact, in terms of chest pain causes, Dr. Patel says this is the third most-dangerous condition.
“The heart is obviously the worst. The second-worst is a tear in the aorta in the chest. The third is a clot in the lung, say if someone had a long-duration flight, and had a blood clot in the leg that can cause pain and swelling,” says Patel.
You have asthma.
Difficulty breathing coupled with bad chest pain is a classic presentation of asthma. And while many people assume this to be a childhood condition that largely disappears by adulthood, that’s not always the case. In fact, many people develop an asthma relapse later in life, and others discover the condition’s sudden onset in response to certain allergens.
You have pericarditis.
While many of the conditions that present with chest pain aren’t heart-related, those that are can turn serious fast. Pericarditis, for instance, is an inflammation of the membrane covering the heart. Usually caused by a viral infection, this condition can rapidly progress, spreading to the heart muscle if not treated quickly.
You have an ulcer.
Those pains in your belly and the ones in your chest might not be as unrelated as you imagine. In many cases, ulcers—which can occur anywhere in your digestive tract—can cause chest pain, especially when they’re accompanied by acid reflux. And while, in many cases, ulcers can be treated with medication, it’s important to have them treated quickly—the H pylori bacteria associated with ulcers is also associated with the development of stomach cancer.
You have an abscess in your lung.
Bronchitis and pneumonia aren’t the only lung conditions that could be at the root of your chest pain. Lung abscesses, bacterial infections that cause necrotic tissue or fluid to pool inside the lungs, can cause severe chest pain, and have a high rate of mortality, even with antibiotic treatment, according to one study. If your chest pain starts after a bout of pneumonia, it’s imperative you get checked for a lung abscess, as the former often precedes the latter.
You have fibromyalgia.
Fibromyalgia, a chronic pain condition that can cause tenderness throughout the entire body, is often a surprising source of chest pain. Typically, this is due to costochondritis, an inflammation of the connective tissue and ribs. A common sign of this unpleasant ailment? Pain when pressure is applied to the ribs.
“Some people more commonly have chest pain when you touch their chest—the breast bone and the ribs in front—and those are typically not coming from the heart,” says Dr. Patel.
You have pleurisy.
Pleurisy, a swelling of the pleurae, the membranes that cover the lungs, can cause serious chest pain that starts suddenly. However, unlike heart-related pain, pleurisy tends to get worse when taking a deep breath. If you find yourself struggling to breathe and experiencing chest pain, it’s worth checking out, however—while generally associated with other infections, pleurisy can also sometimes accompany an autoimmune disorder or cancer.
You’re having a heart attack.
If nothing seems to be making that chest pain better, or if it’s spreading to other parts of your body, it’s time to call 911. Heart disease is the biggest killer of both men and women in the United States, and time is of the essence when you think you’re having a heart attack. The good news? There are some tells that will let you know if your pain is likely heart related.
In addition to your age and family history being potential contributing factors, the amount of time the pain lasts is a good indicator of whether it’s heart-related or not.
“If it lasts for 15 to 20 minutes and it doesn’t get better, you should get help. If it lasts for just a few minutes, don’t panic, because it’s unlikely to be a blockage or life-threatening emergency,” says Dr. Patel. Likewise, if you feel better after changing positions, or if it gets worse when you touch your chest, it’s unlikely to be a heart attack. “Heart pain will never get worse by touching or moving your arm or body.”
So, what should you look for? If the pain spreads to your arms or neck, if you’re feeling nauseated, if you have sudden difficulty breathing, or if you’re sweating profusely, those are all signs of a heart attack.
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