Sunday, February, 12, 2012

Chest pain

Table of Contents

  • You have sudden crushing, squeezing, tightening, or pressure in your chest.
  • Pain spreads (radiates) to your jaw, left arm, or between your shoulder blades.
  • You have nausea, dizziness, sweating, a racing heart, or shortness of breath.
  • You know you have angina and your chest discomfort is suddenly more intense, brought on by lighter activity, or lasts longer than usual.
  • Your angina symptoms occur while you are at rest.
  • You have sudden, sharp chest pain with shortness of breath, especially after a long trip, a stretch of bedrest (for example, following an operation), or other lack of movement, especially if one leg is swollen or more swollen than the other (this could be a blood clot).

Your risk of having a heart attack is greater if:

  • You have a family history of heart disease
  • You smoke, use cocaine, or are overweight
  • You have high cholesterol, high blood pressure, or diabetes

Call your doctor if:

  • You have a fever or a cough that produces yellow-green phlegm
  • You have chest pain that is severe and does not go away
  • You are having problems swallowing
  • Chest pain lasts longer than 3 to 5 days

What to expect at your health care provider's office

Emergency measures will be taken, if needed. You may need to go to the hospital if your heart problem is serious, or the cause of the pain is unclear.

The doctor will do a physical exam and monitor your vital signs (temperature, pulse, breathing rate, blood pressure). The physical exam will focus on the chest wall, lungs, and heart. Your doctor may ask questions such as:

  • Is the pain between the shoulder blades? Under the breast bone? Does the pain change location? Is it on one side only?
  • How would you describe the pain? (Severe, tearing or ripping, sharp, stabbing, burning, squeezing, tight, pressure-like, crushing, aching, dull, heavy)
  • Does it come on suddenly? Does the pain occur at the same time each day?
  • Is the pain getting worse? How long does the pain last?
  • Does the pain go from your chest into your shoulder, arm, neck, jaw, or back?
  • Is the pain worse when you are breathing deeply, coughing, eating, or bending?
  • Is the pain worse when you are exercising? Is it better after you rest? Does it go away completely, or is there just less pain?
  • Is the pain better after you take nitroglycerin medicine? After you drink milk or take antacids? After belching?
  • What other symptoms do you have?

Which tests are done depends on the cause of the pain. Often, one or more of the following tests may be done first:

  • Blood tests such as troponin, to rule out a heart attack
  • ECG
  • Echocardiogram
  • CT scan of the chest
  • X-rays of the chest

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Review Date: 05/23/2011
Reviewed By: Michael A. Chen, MD, PhD, Assistant Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)