Chest pain is one that holds not only disease behind its name but also fear. There have been countless movies that depict this entity as the first and, scary enough, last symptom of sudden cardiac death. As a result, any slight perception of chest pain leads to anxiety, which unfortunately enough, mimics the signs of serious cardiac illnesses and worsens the anxiety starting a vicious cycle.
One way to combat such fears and unnecessary mental turmoil is to better understand the characteristics of the chest pain that is linked to cardiac illnesses. But beforehand, it's wise to delve into the causes other than of cardiac origins. This can be done by simply mentioning the components that make up the human chest. We can start superficially from the skin to the underlying muscle tissue, to the ribs, to the lungs, the esophagus and stomach, the great vessels, and last but not least, the heart. It is also good to recall the psychological causes such as anxiety itself. All these structures can be affected by one disease entity or another to cause the dreaded chest pain.
So now the question lies, "How do I know the chest pain I feel is of something wrong with my heart?"
Before the characterization of the pain, let's first see who is at more risk of developing cardiac illnesses. These risk factors include older age, male sex, diabetes mellitus, hypertension, obesity, dyslipidemia, and family history of similar illness. This list is however not exhaustive but highlights some of the more prominent factors. When it comes to the chest pain itself, it can be characterized as substernal by location, with the quality described as heaviness, squeezing, and increased pressure, with some patients even likening it to the sensation of an elephant sitting on their chest. The pain is known to radiate to the left arm, especially the more medial side but also to the jaw, shoulder, stomach even to the right arm. Now depending on the severity of the disease, it can occur during exercise or heightened emotion, lasting approximately 5-10 mins and then decrease during rest, or in more severe cases, it can occur during rest and last for more than 15 mins.
If the above risk factors and chest pain features are present, it is best to seek medical attention as quickly as possible. With all this said, it is also wise to be aware that even in the absence of the above scenario, cardiac illnesses can still be present, with some presenting with atypical features such as heartburn in special cases. This article is more of a general guiding tool rather than an exhaustive description to be better equipped to deal with such physical presentations for the general public.
Reference Loscalzo, J., Fauci, A. S., Kasper, D. L., Hauser, S., Longo, D., & Jameson, J. L. (2022). Harrison’s Principles of Internal Medicine, Twenty-First Edition (Vol.1 & Vol.2). McGraw Hill Professional.
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