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When To Worry About Chest Pain

by Dr. Shani Saks Feld

So you have pressure in your chest; when is it time to panic?  Everyone experiences pain differently, but here are some common features of chest discomfort that could indicate a heart problem:

1) Chest discomfort in the middle or toward the left side of the front of your chest that is usually described as a pressure or squeezing, not actual pain. Classically it can feel like “an elephant sitting on my chest,” or a band wrapping around the chest, although is not always this dramatic in presentation. If the discomfort occurs with exercise or exertion and resolves with rest, this is more concerning for a heart-related issue. 

2) The discomfort usually lasts at least a few minutes, from two to ten minutes continuously, or may come and go.  A fleeting discomfort or cramp that lasts a few seconds at a time is less likely to be a heart blockage type of discomfort. 

3) The discomfort can spread to the left arm, left shoulder, jaw, or upper back.  There can also be shortness of breath, nausea, cold sweats, or dizziness. These symptoms may be more severe than the actual chest discomfort, especially in women.

If you experience any of the above, you should consult your physician. There are many other medical conditions that can mimic a heart attack, including indigestion/GERD, esophagus problems, lung issues, musculoskeletal problems, blood clots in the lungs, and problems with the aorta. Your physician will assess you based on your symptoms and risk factors for developing heart problems and should perform an EKG (electrocardiogram) which gives a lot of information about your heart rhythm, size, and whether there is any blood flow problem in the heart. Further testing on your heart may be necessary depending on your specific situation.

If you experience any concerning chest discomfort, especially if it reoccurs without any obvious cause, you should contact your doctor right away and insist on further testing.  

This article is not intended to treat any medical condition and is for educational purposes only.  

Dr. Shani Saks Feld is a Phoenix-based, board-certified cardiologist.

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