Chest pain is a common symptom, ranging from mild to severe. While often concerning for heart issues, it can arise from various conditions. Knowing when chest pain signals a medical emergency requiring immediate evaluation is important.
Identifying Critical Symptoms
Chest pain can indicate life-threatening conditions such as a heart attack, pulmonary embolism, or aortic dissection. A heart attack often presents as discomfort in the center of the chest, described as pressure, squeezing, fullness, or pain that is persistent or recurring. This discomfort might spread to one or both arms, the back, neck, jaw, or stomach. Other symptoms can include shortness of breath, cold sweat, nausea, vomiting, or lightheadedness. Women may experience less typical heart attack symptoms, such as pain in the back, shoulders, neck, arms, or abdomen, along with unusual fatigue, nausea, or vomiting.
A pulmonary embolism, a blood clot in the lungs, causes sudden shortness of breath and chest pain that worsens with deep breathing or exertion. Other signs include a rapid heart rate, coughing (sometimes with bloody mucus), sweating, anxiety, dizziness, or fainting. An aortic dissection, a tear in the body’s largest artery, causes sudden, severe pain in the chest, back, or abdomen. This pain is often described as tearing or ripping and can radiate to the neck, arms, legs, or jaw. Associated symptoms may include difficulty breathing, weakness, loss of consciousness, or a rapid, weak pulse.
Immediate Action Steps
If you or someone experiences serious chest pain symptoms, contact emergency medical services immediately. Call 911 or your local emergency number without delay. Do not drive yourself or the person experiencing symptoms to the hospital. Emergency medical services (EMS) personnel can initiate treatment en route and are equipped to manage potential complications.
While waiting for emergency responders, the person experiencing chest pain should remain calm and rest, ideally in a semi-seated position. Loosening any tight clothing around the chest can help with comfort. If conscious and not allergic, they can chew and swallow a 250 mg dose of aspirin, which helps thin the blood and prevent further clotting. Always prioritize calling emergency services before administering any medication.
What to Expect at the Emergency Room
Upon arrival at the emergency room for chest pain, a medical professional conducts a rapid assessment. This begins with questions about symptoms, medical history, and family health history. The medical team’s primary goal is to quickly determine if the chest pain is due to a life-threatening condition.
Initial diagnostic tests include an electrocardiogram (ECG or EKG), which records the heart’s electrical activity and can quickly indicate an acute heart problem. Blood tests are also performed, looking for elevated levels of troponin, a protein released when heart muscle is damaged. Other evaluations may involve a chest X-ray to assess the lungs and surrounding structures. These tests help healthcare providers rapidly rule out or diagnose serious conditions and guide subsequent treatment decisions.
Understanding Less Urgent Chest Pain
Not all chest pain indicates a life-threatening emergency. Numerous other conditions can cause discomfort in the chest area. These less urgent causes include muscle strain, acid reflux (gastroesophageal reflux disease or GERD), or anxiety. Inflammation of the cartilage connecting the ribs to the breastbone, known as costochondritis, can also cause chest pain.
While these conditions can cause significant discomfort, they are not immediately life-threatening. However, these diagnoses are made only after healthcare professionals have thoroughly evaluated and ruled out more serious causes. Therefore, any new, severe, or persistent chest pain should always be promptly assessed by a medical professional to ensure appropriate diagnosis and care.