Chest Pain in Heart Attack

Chest pain is very fearsome for common people due to its association with a heart attack. No doubt, chest pain should be taken seriously especially in old age and in those with risk factors for heart attack such as diabetes mellitus, hypertension, etc. But remember one thing that all chest pains are not due to heart and all heart attacks do not necessarily produce chest pain. So, knowledge about chest pain is essential for every individual.

In this article, I am going to tell you when chest pain should and when should not be taken seriously. First, let us see the common characteristics of heart attack pain and heart attack patients:

1. Chest pain due to a heart attack is usually, but not always, in the center of the chest.
2. Chest pain is diffuse but may be localized in some patients.
3. Its character is like pressure, heaviness, tightness, and squeezing pain.
4. It may radiate to or be solely present in the neck, jaw, left shoulder, left arm, both arms, and upper abdomen.
5. It comes on suddenly, but not instantaneously, may increase in intensity over minutes, and lasts for more than 20 minutes.
6. Can occur any time during exertion, rest, or even sleep, but sometimes, heart attack pain is preceded by angina (angina pectoris is the pain in the chest that occurs on exertion and relieves on rest or with medicines) by few hours to days.

Such type of pain should be taken seriously in all patients but especially in following patients:

1. Patients aged 50 and above but not impossible in youngers.
2. Patient with diabetes mellitus, hypertension, high cholesterol, tobacco addiction, obesity, or overweight.
3. Patients with first degree relatives with heart attack or stroke, especially at age less than 65 years in case of female and less than 55 years in case of males.
4. Patients who have a sedentary lifestyle.

In these patients, any type of chest pain should be taken seriously and should rush to the emergency department of a hospital for evaluation.

Now, let us see which type of pain is usually not cardiac pain:

1. Instantaneous onset of chest pain.
2. Chest pain that can be localized with a finger.
3. Chest pain that aggravates with respiration, cough, movement, body position changing, or pressure.
4. Chest pain that wanders here and there within the chest.
5. Pricking, stabbing, and piercing type of chest pain.
6. Chest pain with an obviouscause such as trauma, pneumonia, bony infection, or inflammation.

Such type of chest pain is usually, but not always, noncardiac, especially in following people:

1. Those aged less than 40 years and especially females.
2. Those who live an active life.
3. Those who do not have hypertension, diabetes mellitus, family history, or high blood cholesterol levels.
4. Those who are not addicted to tobacco, alcohol, and other illicit drugs.

So, now you know when and in which people, chest pain should be taken seriously and should reach an ER without delay.

Above information, though applicable for about 90 % of patients, cannot be generalized. So, it does not replace proper history and physical examination by registered physician or doctor and should not be used for self-assessment of any patient with chest pain.