That dull, burning sensation in the chest that doesn’t seem to be going away, or is getting worse – is it a sign of a heart attack? Or is it something else?
This question troubles many individuals every year because of two main reasons:
- Even though chest pain is a major sign of heart attack, it can stem from dozen other conditions besides a heart attack, like pneumonia, pleuritis, infection or panic attack.
- Different people experience heart attack in different ways. While some have classic chest pain, other may have jaw or back pain, shoulder pain, breathlessness, and nausea or fatigue too.
How to know if chest pain is a warning sign for heart attack?
Heart attack symptoms can vary greatly, even in people who have had a heart attack in the past. Here are some heart-related signs that could suggest an impending heart attack:
- Uncomfortable pressure, fullness, burning, squeezing pain or tightness in the centre of the chest.
- Uncomfortable sensations like pain, numbness, prickling or pinching in one or both arms, neck, jaw, back or stomach.
- Shortness of breath.
- Sudden nausea or vomiting.
- Heat or flushing or cold sweat.
- Unexplained fatigue.
- Excessive sweating.
The following table distinguishes symptoms of heart attack likely to be due to a heart attack from those that could be due to other reasons:
Signs of heart attack
Signs less likely to be heart attack
|Pain, pressure, tightness or burning sensation in chest||Sharp, knifelike pain caused by breathing or coughing|
|Pain that develops gradually over few minutes||Sudden, stabbing pain that lasts for only few seconds|
|Diffused pain, in the middle of the chest||Pain on one side of the body or other|
|Pain extending to the left neck, arm, jaw or back||Pain localised to one spot|
|Pain may be accompanied by other signs like cold sweat, sudden nausea or difficulty in breathing||Pain that may last for many hours without any other symptoms|
|Pain or pressure feeling after physical activity, emotional stress, or even at rest||Pain felt by pressing on the chest or with body motion|
Distinguishing chest pain: Heartburn or heart attack?
A common confusion that occurs between heartburn and heart attack involves mistaking a burning sensation in the chest for something else. It is important to learn the difference between heartburn and something serious that could affect life or death.
Knowing when it’s heartburn: Heartburn usually occurs after eating or while bending or lying down. It is characterised by a burning sensation in the chest that may start in the upper abdomen and go all the way up to the neck. The sensation may last for a short time or continue for few hours. Heartburn leaves a sour taste in the mouth, of stomach acid that moves up the oesophagus, especially when lying down.
Under normal conditions, digestive acids in the stomach are kept from moving upwards by a ring of muscles around the oesophagus. However, overeating, lying down too soon after meals, or certain foods like alcohol or caffeine can cause the muscles to weaken or increase production of stomach acid, leading to heartburn.
Other causes of chest pain
Lung problems: Some problems with lung too can cause chest pain. These include:
- Pneumonia, or lung infection causes deep chest ache accompanied by fever and chills.
- Pleuritis, or inflammation of lining of the lung or chest causes chest pain due to bacterial or viral infection, along with sharp pain during breathing or sneezing.
- Pulmonary embolism is caused when a blood clot travels through the bloodstream and lodges in the lungs; it is indicated by troubled breathing and rapid heartbeat.
- Pneumothorax is often caused due to an injury to the chest when a part of the lung collapses; causes pain with every breath.
- Asthma, causing shortness of breath accompanies with wheezing and coughing.
Gastrointestinal problems: Some GI tract problems that can cause chest pain include:
- Gastroesophageal reflux disease (GERD) or acid reflux
- Oesophageal contraction disorders (spasms in oesophagus), oesophageal rupture, or oesophageal hypersensitivity
- Peptic ulcer (painful sores in stomach lining)
- Hiatal hernia, which occurs when the top of stomach pushes into lower chest after a meal.
- Pancreatitis, which causes pain in lower chest
- Gallbladder issues, or pain in the lower right chest region or upper side of abdomen, especially after a fatty meal.
Bone, muscle or nerve problems: Pain from rib fracture may worsen upon coughing or deep breathing, or hard coughing can injure or inflame tendons or muscles between ribs, or chest pain may occur due to shingles caused by the varicella zoster virus.
Do not ignore chest pain
Chest pain should not be ignored or shrugged off till tomorrow. Any discomfort in chest accompanied by pain in left arm, upper back or jaw, faint feeling, nausea, or cold sweat must be treated as emergency. It is common to ignore a possible heart attack chest pain with the following reasons:
- “I am too young.”
- “I am physically active.”
- “It could be nothing. I will only embarrass myself at the hospital.”
The key is not to play doctor on self and not to diagnose chest pain that could be a potential heart attack, at home.
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