When Chest Pain Is Not What It Seems
Ask an Expert. Emergency Physician Dr. Daniel Wu explains how chest pain is evaluated and which symptoms raise concern
What is the first thing going through your mind when a patient comes in with chest pain?
Chest pain can come from many different causes, but the first priority is always to rule out anything life-threatening, such as a heart attack, pulmonary embolism, or aortic dissection.
A pulmonary embolism is a blood clot in the lungs, and an aortic dissection is a tear in the main artery leaving the heart. In medicine, we start by assuming the worst so we do not miss something dangerous.
What do most patients get completely wrong about chest pain?
Many people expect crushing, dramatic chest pain like they see on TV.
In reality, serious heart problems are often much more subtle. They can feel like heartburn, mild discomfort, or even just unusual fatigue.
What are the biggest red flags with chest pain?
Chest pain along with symptoms like shortness of breath, sweating, nausea, dizziness, or fatigue is especially concerning. These are often considered red flags, meaning warning signs that may suggest a more serious underlying problem.
Just as important, people often have a sense when something is not right. That instinct should not be ignored.
It is also important to know that serious conditions do not always present with obvious chest pain. Heart attacks can sometimes occur without chest pain at all, especially in women and in people with conditions like diabetes.
THE BOTTOM LINE
Chest pain has many possible causes, but the focus in the ER is identifying the dangerous ones first. Symptoms can be subtle and when something feels off, it is always better to get checked.
About the Expert
Dr. Daniel Wu is a Board-Certified Emergency Physician.
He is a Professor of Emergency Medicine at Emory University School of Medicine and serves as Chief of Emergency Medicine and Chief Medical Information Officer for Grady Health System.
This article is for educational purposes only and is not a substitute for medical advice from your own healthcare provider.