by Chris Prakash, MD – eParis Extra!
Dr. Chris Prakash
Q: I am a healthy 30 year old woman. I had an episode of sharp chest pain which lasted a few seconds. I did not go to the doctor. Should I have? Could I have had a heart attack?
A: Chest pain is a symptom that can be perplexing, and a cause for anxiety for both the patient as well as the doctor. Is that pain you are having in the chest, a sign of a heart attack? Should you rush to the ER? Or should you just blame it on “gas” and move on?
These are questions that millions of people and their doctors face each year. It’s a problem because chest pain can stem from dozens of conditions besides heart attack, ranging from pancreatitis to pneumonia to panic attack.
Once you get to a doctor, the doctor will use several pieces of information, from your history, EKG, and blood tests to determine if indeed there is something wrong with your heart. But the problem is how you know when to go to the doctor!
So, what should you look for, to decide if the chest pain is a sign of heart attack? The following box (some information obtained from Harvard Heart Letter) illustrates some of the differences between “dangerous” and “not so dangerous” chest pain:
| More likely to be a heart attack | Less likely to be a heart attack |
| Pain or pressure, tightness, or squeezing sensation | Sharp or knifelike pain brought on by breathing or coughing |
| Gradual onset of pain over the course of a few minutes | Sudden stabbing pain that lasts only a few seconds |
| Pain that extends to the left arm, neck, or jaw | Pain that is localized to one small spot |
| Pain accompanied by difficulty breathing, a cold sweat, or sudden nausea | Pain that lasts for many hours or days without any other symptoms |
| Pain or pressure that appears during/ after physical exertion or emotional stress (heart attack) or while at rest (unstable angina) | Pain reproduced by pressing on the chest or with body motion |
More than six million Americans with chest pain are seen in hospital emergency departments each year (Harvard Heart Letter). Only 20% of them have a heart related problem, such as a “heart attack” or “unstable angina”. A few have another potentially life-threatening problem, such as pulmonary embolism (a blood clot in the lungs) or aortic dissection (a tear in the aorta). But most of the six million, though, had a condition unrelated to the heart.
Remember:
- Chest pain is only one of the many ways a heart attack can present (it can cause nausea, fatigue, fainting, cold sweat etc).
- Don’t play doctor at home. Go to the doctor or Call 911 if you have any concerning signs.
- You are never too young to have a heart attack (even 20-somethings can have heart attacks).
This information is strictly an opinion of Dr Prakash, and is not intended to replace the advice of your doctor. Dr Chris Prakash is a contributing columnist, and author of eParisExtra’s “The Doctor is In” column. He is a medical oncologist at Texas Oncology Paris. He is board certified in Internal Medicine, Oncology and Hematology. He lives in Paris, TX with his wife and two children, and can be reached at 9037850031, or Sucharu.prakash@usoncology.com