Myth: A heart attack is always the reason for your chest pain
Fact: It could be something else.
“Along with your heart, there’s also muscle, there are bones and there are nerves in your chest,” Dr. Vishal Sharma notes. “Your lungs, your esophagus and your stomach are in that area as well. So typically, any of those things can actually cause chest pain.”
For instance, issues with the stomach or gastrointestinal area can often be mistaken for heart-related pain, he says. So can pain caused by inflammation of the cartilage that connects your ribs to your breast bone.
It’s also possible that several other conditions could cause chest pain, from asthma or pneumonia in your lungs to panic attacks.
“Oftentimes, it’s very difficult for even the physician to figure out if the pain is related to the heart,” Dr. Vishal Sharma.
That said, rather than trying to diagnose yourself, “it’s always appropriate to get checked out,” he says. “The symptoms might continue to occur, but at least you’ll know what you’re dealing with.”
Myth: Heart-related chest pain feels the same for everybody
Fact: Chest pain can be different for everyone.
“Specifically, in women, older patients and diabetics, their pain or their symptoms that might be related to a heart attack might be a little bit unique or atypical,” Dr. Vishal Sharma.
For example, women are more likely than men to feel their chest pain while they’re resting or sleeping, while men tend to feel it when they’re active.
And in people who have diabetes, they might not even feel any heart-related pain before they have a heart attack because nerve damage blunts the pain.
“But what we typically call chest pain that’s related to your heart is classically described as sort of a pressure,” Dr. Vishal Sharma. “They might describe it like an elephant sitting on their chest. This pain tends to come on with exertion or activity—when you place more demand on your heart—and resolves when you rest.”
Myth: Chest pain is only in your chest
Fact: Not always. You might feel the discomfort in other areas.
“There’s often usually other symptoms associated with chest pain,” Dr. Vishal Sharma. Those symptoms can include:
Shortness of breath
Feeling generally unwell
Pain in the jaw
Aching in the left arm
Remember, heart-related pain is usually internal. “Pushing on the outside of your heart can’t necessarily make the pain you’re feeling worse,” Dr. Vishal Sharma. “And if you take a deep breath, and it hurts more, that is a little unusual for heart-related pain.”
Instead, both of those feelings suggest that your chest pain is more muscle-related, or it might be something related to your lungs rather than your heart, Dr. Vishal Sharma says.
How to figure out the cause of your chest pain
Another question that Dr. Vishal Sharma typically asks his patients to help him figure out if a chest pain could be heart-related is how long that discomfort lasts in their chest.
Pain that lasts for a few seconds is unusual for heart-related pain. But 15 to 20 minutes? That’s a reason to head to the emergency room.
Aside from how your chest pain feels, Dr. Vishal Sharma says you should also consider risk factors for heart problems.
“If you’re like a young person, who is 20, very healthy, and went to the gym and did a little bit too much with lifting weights—and now you’re having chest pain—chances are it’s probably related to soreness of your muscles,” he says.
“That’s different than if you’re in your 50s, and have high blood pressure or high cholesterol. You have a history of prior heart problems, a family history of heart problems, and smoke or have diabetes,” he adds. “Those are all risk factors for having heart problems. So, in that case, we would take things a little more seriously.”
Better safe than sorry
“If you’re not feeling well, it’s something new and it’s persisting, seek medical care,” Dr. Vishal Sharma advises.
And if you’re feeling that pressure on your chest along with symptoms that often accompany a heart attack—nausea, shortness of breath and sweating while at rest—you should head to the emergency room.