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What Your Chest Pains Could Mean

Harmless or harmful? When should we take chest pain seriously?
What Your Chest Pains Could Mean

Your worst fear has come true: a pain in the chest. "This is the Big One," you think, "a heart attack, the end of me." You clutch your left pec and wait for it to pass. It doesn't. And then it does.

You're fine. False alarm.

But what was that weird feeling? And how can you tell if it might be a heart attack, so you're better prepared next time. Read on for the essential guide to learn what your chest pains could mean. It takes a heartbeat to read, and is worth every second.

Signs You May Be Having a Heart Attack

Not all heart attacks manifest with chest pain. Conversely, not all chest pains are symptoms of a heart attack.

If you feel:

Pressure or constriction in the center of your chest, or in your jaw, neck, arms, back, or stomach—particularly if coupled with:

  • A sense of doom
  • Nausea
  • Fatigue
  • Or lightheadedness

…get to the emergency room as quickly as possible. It may be a heart attack. However, other types of chest pains, especially if the pain is briefer and fleeting, could be stemming from something outside of cardiovascular distress.

Millions of Americans are rushed to the ER every year after they experience some sort of chest pain—but only 20 percent are diagnosed with a heart attack or angina (cardiac pain that can signal an impending heart attack). Many other parts of your body could be causing chest pain — from your lungs and esophagus to a variety of other muscles.

Heart attack pain is usually unrelenting, often lasting five minutes or more (up to half an hour or, rarely, two hours). If you think you may be having a heart attack, taking immediate action may save your life. So it's crucial to call 9-1-1 to get emergency treatment as quickly as possible. Check out 20 Warning Signs Your Heart Sends You to learn more. Knowing what to look for might save you an unnecessary trip to the hospital.

Here Are Five Clues That It May Not Be a Heart Attack:

1. Chest discomfort or pain that becomes better with exercise
Heart-related pain tends to worsen with exercise. Sharp chest pains that get better with physical activity are more likely to be caused by something else, like acid reflux.

2. Pinpoint chest pain
If you feel a sharp pain that seems to be coming from a precise location, it's likely not heart-related. Heart pain is typically diffuse or radiating.

3. Chest pain that gets worse when you take a breath
If your breathing is affecting your pinpointed chest pain, it could be anything from a broken rib to pericarditis (swelling of the membrane surrounding the heart) to something involving the lungs, like pneumonia or asthma.

4. Chest pain that manifests in different areas
For instance, one day, your chest pain is on the left side just above your ribs, the next it's on the upper right. While cardiovascular pain can radiate into your arms, neck, back, or jaw, it rarely moves from place to place on different days.

5. Momentary chest discomfort or pain–like an electric shock or bolt
Heart-related pain is typically unrelenting, lasting for at least several minutes at a time. If your chest pain is momentary, it's likely caused by a musculoskeletal injury like a cracked rib or pulled muscle, or possibly nerve pain, like the kind that can be caused by shingles involving the chest.

Here Are the Four Most Common Causes of Non-Cardiac Chest Pain:

Chest pain that is not a heart attack can be either cardiac or noncardiac in nature. You could be having a problem with inflammation around your heart (which by the way requires immediate doctor attention) that could be causing chest pain or you could be suffering from something totally not heart-related, like bad indigestion.

1. Gastrointestinal pain
They don't call it heartburn for nothing. GI issues are the most common type of noncardiac chest pain; culprits often include acid reflux, GERD (chronic acid reflux), or esophageal spasm.

2. Musculoskeletal pain
Weekend warriors, consider yourselves warned! If you haven't lifted anything more substantial than your iPhone for more than a couple years, you might just want to ease into that new HIIT class you signed up for. You may feel like you're having a heart attack, but it's more than likely you may have suffered a strained chest muscle.

3. Lung pain
Pneumonia or a condition like pleurisy, which is an inflammation of the tissues surrounding the lungs, can cause pain in the chest that might be mistaken for a heart attack.

4. Panic attack
Often described as extremely intense, panic attacks can present itself with such similar symptoms to a heart attack that many people believe they're in cardiac arrest when they're not. At the core of an attack are factors like significant stress, traumatic events, or sudden life changes. Panic attacks typically come with few or no warning signs and tend to peak within 10 minutes, whereas heart attack symptoms may start slowly and last for more extended periods.

Here Are the Four Most Common Causes of This Type of Cardiac Chest Pain

Angina — or cardiac pain — refers to discomfort in the chest due to something being wrong with the heart. A cardiologist will want to first determine that the chest pain you may be having is related to clogged arteries (think: atherosclerosis or heart attack). Various conditions of the heart can cause angina but are unrelated to the dangers of clogged arteries.

1. Pericarditis
Pericarditis occurs when the sac that surrounds your heart — the pericardium — becomes inflamed. Most people are better in 7 to 10 days and won't suffer serious problems from this condition.

2. Myocarditis
It's an inflammation of the heart muscle — or myocardium — which can impact your heart's ability to pump, causing a rapid or abnormal heart rhythm. Generally caused by a viral infection, myocarditis can also result from a reaction to a medication or inflammatory condition.

3. Cardiomyopathy
Cardiomyopathy refers to diseases of the heart muscle, which have many causes, warning signs, symptoms, and treatments. With cardiomyopathy, the heart muscle becomes thickened or enlarged, making it more rigid. Less commonly, cardiac muscle is replaced with scar tissue. As this condition worsens, the heart becomes weaker — and is less able to pump blood throughout the body and maintain normal sinus rhythm.

4. Aortic dissection
It's a serious condition in which the inner layer of the aorta, the large blood vessel that branches off the heart, tears. Blood fills the tear, causing the inner and middle layers of the aorta to separate or "dissect." If the tear ruptures through the outside aortic wall, the aortic dissection has a high likelihood of being fatal.

Chest pain can be frightening, regardless of its cause. Please listen to your body. If you're having severe pain in your chest that's radiating to your neck, jaw, arms, or back — which is accompanied by nausea, fainting, shortness of breath, and cold sweats — call 9-1-1 immediately. You can't beat a healthy heart.

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