Is Your Chest Pain Cardiac or Non-Cardiac Related? Don’t Self-Evaluate – Get to ER.

Written by Board Certified Cardiologist Will C. Hurley, MD, FACC

Sometime during the night or perhaps your neck and arms. You ask, “could I be angina, pericarditis, arrhythmia, aortic early Monday morning as you prepare experiencing a heart attack and should I dissection, and coronary spasm. for a busy workday you suddenly feel a go to the emergency room?” CARDIAC Causes: pain in your chest. The “pain” really feels This is the type of scenario that many more like a discomfort or tightness or Heart Attack: A heart attack typically people experience when confronted burning. You wait to see if it will go away occurs due to a blood clot and/or plaque with chest pain symptoms. Chest pain and consider whether it is heartburn that is blocking blood flow to heart does not always mean a heart attack, or indigestion or a muscle pull. As you muscle and characteristically presents as and often there may not be any prior wait and try to ignore it, the discomfort pressure, fullness, squeezing, or crushing history of heart disease. However, “the is worsening and now is radiating into pain in the chest that can last several heart” of the problem is that many minutes or longer. The pain may radiate people spend critical time trying to self- into the back, neck, jaw, shoulders, and diagnose or determine the reason for the both arms, especially in the left arm. pain and this delay has the potential to Other symptoms may include shortness cause heart damage. Chest pain is one of breath, sweating, dizziness, and of the most common reasons people nausea. call for emergency help, and each year nearly 5 million Americans arrive at the Angina: Angina occurs due to fatty emergency department for help. deposits built up in the arteries that carry blood flow, and is especially noticeable Chest pain can have many potential during effort or exertion. Usually, angina causes and all require medical attention – is a pressure or tightness sensation in the particularly if it is severe or persistent. mid-chest usually brought on by physical The causes are categorized into cardiac effort or stress and usually goes away (heart) and non-cardiac causes. The after this effort or stress is stopped. Other cardiac causes include heart attack, cardiac causes including pericarditis For more information or to schedule an appointment please call 605-665-1082. Is Your Chest Pain Cardiac or Non-Cardiac Related? Don’t Self-Evaluate – Get to ER.

Written by Board Certified Cardiologist Will C. Hurley, MD, FACC

are typically more sharp and piercing gallbladder or pancreas problems, or angioplasty or coronary bypass surgery and may even occur at rest and may be cancer. These causes may have similar would depend on angiogram results. accompanied by fever. symptoms to cardiac causes and Non-cardiac evaluation and treatment therefore also need medical attention. will be applied once more threatening Aortic Dissection: Aortic dissection is less cardiac causes are ruled out and can be common but can be life threatening and If you experience chest pain that is managed electively as an outpatient. occurs due to a tear in the main artery to unexplained or is persistent, particularly the heart often associated with a history if accompanied by other symptoms Taking charge of your heart health of high blood pressure. such as shortness of breath or radiating is important especially if you are pain seek emergency medical help. This symptomatic or have a history of heart Although these descriptions of cardiac could prevent heart damage or save your disease. This includes regular checkups, causes of chest pain are characteristic, life or simply bring relief that serious controlling blood pressure, checking many people will have atypical or health problems are not present. In the cholesterol levels, not smoking, regular unusual descriptions of these symptoms emergency room, evaluation will include exercise, maintaining a healthy weight, and these atypical presentations are history and examination, and tests such eating a heart-healthy Mediterranean more common in women and people as ECG, blood tests including cardiac diet including fruits and vegetables, with Diabetes Mellitus. enzymes, chest x-ray, nuclear scan, managing stress, a yearly influenza and echocardiogram. Further invasive NON-CARDIAC Causes: testing may be needed such as coronary vaccine, and if you consume alcohol – Non-cardiac causes may include catheterization (angiogram). do so in moderation. heartburn or stomach complaints, panic attack, pleurisy, costochondritis, Initial treatment may include medication Chest pain has multiple possible causes pulmonary embolism or other lung like nitroglycerine, beta-blockers, ACE and can be potentially serious. Therefore, conditions, sore muscles or muscle inhibitors, statin cholesterol medication, seek medical attention for chest pain related pain, injured nerves or pinched oxygen, calcium channel blockers, symptoms, and don’t delay because time nerves, shingles or infectious causes, and Aspirin and other blood thinners. may save heart muscle and ultimately swallowing or esophageal problems, Other invasive treatments such as your life.

For more information or to schedule an appointment please call 605-665-1082.