There are many potential causes of chest pain. Because they range from relatively minor heartburn to a life-threatening heart attack, it’s important to take chest pain seriously and deal with it in a timely manner, says Dr. Mark Clark, an emergency medicine physician and Program Director of the Emergency Medicine Residency Program at Mount Sinai St. Luke’s and Mount Sinai Roosevelt.
“Chest pain is classified as any pain or discomfort that occurs in locations in and around the chest, including the upper abdomen, the ribs, the back, the shoulders and the jaw,” he says. “It can begin in one place and radiate or move to another area. The pattern of where the pain shows up, and where it moves to, can help us figure out what’s going on.”
Q. How do I know if I’m having a heart attack?
A. People show up in the Emergency Department with chest pain, concerned they may be having a heart attack. “In a majority of cases, if chest pain is related to an issue with the heart, there are additional associated symptoms that serve as warning signs,” Dr. Clark says. Red flags include:
- Shortness of breath
- Pain brought on with exertion or exercise
- Chest pain that radiates to the right or left shoulder
“Any chest pain that is new — something you haven’t experienced ever before — should be concerning, as is chest pain that lasts more than 20 minutes,” Dr. Clark says. “Unusual severe symptoms should prompt a trip to the Emergency Department in anyone who is 50 years old or older.” Besides age, other risk factors for heart disease include a family history, high blood pressure, high cholesterol, and being a smoker.
Q. What else could be causing my chest pain?
A. One of the most common causes of chest pain that isn’t heart-related is costochondritis, an inflammation of the cartilage that connects the ribs and breastbone, or the costosternal joint. Most cases are idiopathic, or have no apparent cause, and come and go on their own. “This tends to happen in young people, and presents with a sharp or dull pain that can be disturbing to the patient,” says Dr. Clark. Other causes of chest pain include rib injury, acid reflux (GERD) or other gastrointestinal problems, gall bladder problems like gallstones, and inflammation of the pancreas.
Q. Do I really need to go to the ER?
A. People sometimes feel silly about making what they perceive as an unnecessary trip to the Emergency Department, but if it is serious, ignoring the pain could lead to heart damage and even death. “With a simple history, physical and EKG, we will quickly know the severity. If it is a heart attack, we have many effective interventions to help treat and take care of patients. It’s always better to come to the Emergency Department than to ignore a potentially serious problem,” Dr. Clark says.
For more information about the Mount Sinai St. Luke’s-Roosevelt Emergency Residency Program, call 1-855-411-LWNY (5969) or visit the program’s website.