Chest pain is often linked to heart attack, but that’s not always the cause. In fact, many factors can cause chest pain, including anxiety, indigestion, illness and injury.
It’s important to understand the various symptoms of chest pain and what they might mean.
In this video, San Diego Health host Susan Taylor talks with Christina Adams, MD, an integrative cardiologist at Scripps Clinic John R. Anderson Medical Pavilion and Scripps Clinic Jefferson in Oceanside, about possible causes of chest pain and what to do about them.
Angina chest pain strikes when oxygen-rich blood flow to the heart is temporarily restricted, often due to activity or anxiety. Angina symptoms include chest tightness or squeezing sensations, often with pain in the neck, shoulder or arm. Pain usually improves with rest or medication called nitroglycerine.
Angina is a symptom of a problem with blood flow to the heart, but it is not the same as a heart attack. During a heart attack, blood flow through an artery is completely blocked, and the heart muscle may be permanently damaged.
“When you have obstruction to blood flow to the heart vessels, the muscle screams out for oxygen. It's in pain,” says Dr. Adams. “Chest pain from a heart attack is quite severe and typically happens with other symptoms like shortness of breath, profuse sweating and nausea.”
Sudden, severe chest pain should immediately be checked out at the emergency department. Even if it is not a heart attack, it’s better to be safe than sorry.
Chronic inflammation around the heart sac (pericarditis) or of the heart muscle itself (myocarditis) also may cause heart-related chest pain.
A panic attack is an unexpected, sudden feeling of fear or loss of control that often seems to come out of nowhere. Panic attack symptoms can feel very similar to a heart attack and may include chest tightness, difficulty breathing, rapid heart rate and trembling. However, unlike heart attack symptoms, panic attack symptoms may go away as quickly as they came.
Despite their similar symptoms, it can be reassuring to know that a panic attack cannot lead to heart attack.
If your chest pain is due to an injury, you should be able to trace it back to an activity or event, such as a blow to the chest or a strained muscle. A chest contusion, which is a bruise on the chest muscle, often results from being struck by an expanding airbag or falling onto bicycle handlebars. A pulled muscle is a common injury from weightlifting or sports; repeating the motion should trigger the pain.
Pain from chest injury shouldn’t have symptoms associated with a heart attack or panic attack, such as shortness of breath, sweating or nausea. Still, if the pain doesn’t improve after several days, it’s a good idea see a doctor to rule out a broken rib or other injury.
Indigestion symptoms include pain, burning or discomfort in your upper abdomen, so they may feel like they’re in your chest. Also called heartburn or acid reflux, indigestion usually occurs after a meal, especially if you are sensitive to rich or spicy foods or eat more than usual.
However, symptoms of heart attack may feel like indigestion, especially among women. If your acid reflux symptoms seem associated with activity or exertion, you should get checked for cardiac issues, says Dr. Adams.
Chest pain treatment depends on the cause of the pain. Counseling and behavior changes can help control frequent panic attacks; sometimes, simply acknowledging what is happening and taking deep, focused breaths can subdue a panic attack. Injuries may heal on their own or need medical care. Indigestion may respond to changes diet and activity after eating.
“If it’s chest pain because of poor blood flow to the heart, that can be treated with stents, bypass or medications,” says Dr. Adams. “Overall though, we recommend blood pressure control, cholesterol control, diabetes control and exercise. The best treatment for heart disease is prevention.”
If you develop new or worrisome chest pain, adds Dr. Adams, always go to the emergency department – it’s always best to get checked out when your symptoms are active.