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CHEST PAIN

(CHEST PAIN ON EXERTION)
Chest Pain

WHAT YOU NEED TO KNOW:

What causes chest pain? Chest pain can be caused by a range of conditions, from not serious to life-threatening. It may be caused by a heart attack or a blood clot in your lungs. Sometimes chest pain or pressure is caused by poor blood flow to your heart (angina). Infection, inflammation, or a fracture in the bones or cartilage in your chest can cause pain or discomfort. Chest pain can also be a symptom of a digestive problem, such as acid reflux or a stomach ulcer. An anxiety attack or a strong emotion such as anger can also cause chest pain.

What other symptoms might I have with chest pain?

  • Fever or sweating

  • Nausea or vomiting

  • Shortness of breath

  • Discomfort or pressure that spreads from your chest to your back, jaw, or arm

  • A racing or slow heartbeat

  • Feeling weak, tired, or faint

  • A burning feeling behind your breastbone

How is the cause of chest pain diagnosed? Your healthcare provider will examine you. Describe your chest pain in as much detail as possible. Tell him where your pain is and when it began. Tell him if you notice anything that makes the pain worse or better. Tell him if it is constant or comes and goes. Your healthcare provider will ask what medicines you use and if you have other medical conditions. You may also need any of the following tests:

  • An EKG is a test that records your heart's electrical activity.

  • Blood tests check for heart damage and signs of a heart attack.

  • An echocardiogram uses sound waves to see if blood is flowing normally through your heart.

  • An x-ray, CT, or MRI scan may show the cause of your chest pain. You may be given contrast liquid to help your heart show up better in the pictures. Tell the healthcare provider if you have ever had an allergic reaction to contrast liquid. Do not enter the MRI room with anything metal. Metal can cause serious injury. Tell the healthcare provider if you have any metal in or on your body.

How is chest pain treated? You may need any of the following, depending on the cause of your pain:

  • Antiplatelets, such as aspirin, help prevent blood clots. Take your antiplatelet medicine exactly as directed. These medicines make it more likely for you to bleed or bruise. If you are told to take aspirin, do not take acetaminophen or ibuprofen instead.

  • Prescription pain medicine may be given. Ask how to take this medicine safely.

What are some healthy living tips? The following are general healthy guidelines. If your chest pain is caused by a heart problem, your healthcare provider will give you specific guidelines to follow.

  • Do not smoke. Nicotine and other chemicals in cigarettes and cigars can cause lung and heart damage. Ask your healthcare provider for information if you currently smoke and need help to quit. E-cigarettes or smokeless tobacco still contain nicotine. Talk to your healthcare provider before you use these products.

  • Eat a variety of healthy, low-fat foods. Healthy foods include fruits, vegetables, whole-grain breads, low-fat dairy products, beans, lean meats, and fish. Ask for more information about a heart healthy diet.

  • Ask about activity. Your healthcare provider will tell you which activities to limit or avoid. Ask when you can drive, return to work, and have sex. Ask about the best exercise plan for you.

  • Maintain a healthy weight. Ask your healthcare provider how much you should weigh. Ask him to help you create a weight loss plan if you are overweight.

  • Get the flu and pneumonia vaccines. All adults should get the influenza (flu) vaccine. Get it every year as soon as it becomes available. The pneumococcal vaccine is given to adults aged 65 years or older. The vaccine is given every 5 years to prevent pneumococcal disease, such as pneumonia.

What is cardiac rehab? Your healthcare provider may recommend cardiac rehab if your chest pain is caused by a heart problem. Cardiac rehab is a program run by specialists who will help you safely strengthen your heart and prevent more heart disease. This plan includes exercise, relaxation, stress management, and heart-healthy nutrition. Healthcare providers will also check to make sure any medicines you are taking are working. The plan may also include instructions for when you can drive, return to work, and do other normal daily activities.

Call 911 if:

  • You have any of the following signs of a heart attack:
    • Squeezing, pressure, or pain in your chest that lasts longer than 5 minutes or returns

    • Discomfort or pain in your back, neck, jaw, stomach, or arm

    • Trouble breathing

    • Nausea or vomiting

    • Lightheadedness or a sudden cold sweat, especially with chest pain or trouble breathing

When should I seek immediate care?

  • You have chest discomfort that gets worse, even with medicine.

  • You cough or vomit blood.

  • Your bowel movements are black or bloody.

  • You cannot stop vomiting, or it hurts to swallow.

When should I contact my healthcare provider?

  • You have questions or concerns about your condition or care.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.