Much like a headache or sore throat, chest pain can be a difficult symptom to diagnose without a doctor. The key is recognizing the difference between common aches and pains and when the severity or nature of the pain makes it something that requires a visit with a healthcare professional. Much of that decision depends on the individual patient. For cardiologists at the CHI St. Vincent Heart Institute, it comes down to underlying risk factors for cardiovascular disease.
The cardiologists see many patients with chest pain or cardiac etiology. That’s why they have to be sure they’re looking at each patient based on the risk factors that increase the probability that the pain is coming from the heart. These risk factors could be conditions such as diabetes, hypertension, high cholesterol, smoking or a family history of early onset heart disease.
One of the most common types of chest pain is angina, which is caused by reduced blood flow to the heart. It can present itself in different forms, including pressure, tightness, squeezing, heaviness or pain in the chest, while also often spreading to the jaw, shoulders, arm or neck.
If a patient says their chest pain is brought on by exertion and relieved by rest — with the associated symptoms like shortness of breath or sweating — then this is likely classic angina. There are rare cases where cardiologists see patients come in with chest pain that is atypical and non-cardiac, which could be caused by acid reflux or other muscular or skeletal causes.
The patient’s understanding of their own body will often help in determining the necessary cause of action for angina. If the pain is severe and sudden onset with symptoms like shortness of breath, profuse sweating, nausea, vomiting or abdominal pain, emergency medical services should be called immediately. If the symptoms are mild, patients should call their primary care provider and make an appointment.
Treatment for angina varies depending on the patient and the symptoms presented. Those who are treated in an emergency room setting will require different medications from those treated in an outpatient clinic.
If cardiologists know a patient has angina, and their symptoms are not escalating and their pain is easily relieved by rest or medication, they call it stable angina. Some of those patients might require nitroglycerin for their symptoms.
Nitroglycerin provides relief to angina patients by relaxing and widening blood vessels, allowing blood to flow more easily to the heart. However, there are steps that should be taken before ultimately taking a nitroglycerin capsule. A cardiologist will explain these necessary steps if nitroglycerin is part of their patient’s continued care plan.
Any time someone has chest pain that doesn’t go away or chest pain they have never had before, they should call 911. They should not get in a car or else have someone drive them to the emergency room, especially if the symptoms are escalating.
If a patient says their chest pain is brought on by exertion and relieved by rest—with the associated symptoms like shortness of breath or sweating—then this is likely classic angina.