Chest Pain; When to Worry

Our bodies are blessed with many duplicate parts; two eyes, two ears, two lungs, two kidneys, two legs, two arms, etc.  If we loose a finger in the table saw, it’s a terrible thing, but unless we make a living as a musician, we can usually compensate.  However, we’ve only one heart.  When it goes, there are no backups! Because heart disease is the leading cause of death in the United States and chest pain is the most common symptom of heart disease, chest pain is something that cannot be taken lightly or joked about.  Not all chest pain comes from the heart, but I’m especially concerned when:

1. You have a history of previous heart problems or have one or more risk factors for heart disease.  These risk factors include:  age (men over age 40 and women over age 50), tobacco use, severe obesity, sedentary life style, family members who have had heart disease, or a  history of high blood pressure, high cholesterol, or diabetes.  (As a side note, it’s important that you have regular medical checks to determine if you are at risk and to begin reducing your risks through treatment.)
2. The pain is mid chest with a squeezing or heaviness sensation ( it feels like there’s a weight on your chest or a band being tightened).
3. The pain is worsened by exertion.  If the pain gets worse every time you strain or get your heart rate up, you need an evaluation. 
4. The pain is severe.  If you’re hurting bad, you need to be seen.
5. The pain is accompanied by shortness of breath, nausea or perspiration.

Finally, I’d like to urge all patients with chest pain to have a medical evaluation.  Chest pain may also be related to problems with the lungs, chest wall, nerves or esophagus.  While trouble with these organs may not be as critical as heart problems, they can still be dangerous.  Also, at times it can be difficult to determine the origin of chest pain.  Could that chest pain be simple indigestion?  Yes, but remember, you’ve only one heart.

Jeff Chappell, M.D.

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