Chest pain: When is it an emergency?

A vital decision in assessing chest pain is yours – whether to behave as if it is an emergency and seek medical care. Chest pain encompasses various kinds of symptoms and medical conditions. Some of these conditions are considered trivial and benign but some are dangerous and life-threatening.

If chest pain is considered as an emergency, how will you know? Actually, there are no concrete rules and oftentimes, even minor chest symptoms turn out to be coronary artery disease (CAD). In almost 30% of heart attacks, they are accompanied by minor symptoms that the individual could not notice them or simply ignores them. In such cases, it is called as a “silent” heart attack.

Indications that you should seek medical care

Chest pain is likely to indicate a dangerous condition and must be treated as an emergency if any of the following are present:

  • Individual is 40 years old or older with one or more risk factors for CAD (smoking, family history, obesity, high cholesterol, sedentary lifestyle, diabetes)
  • Pain that radiates to the arms, shoulders or jaw
    Chest pain

    Pain is described as squeezing, tight, heavy or crushing

  • Any age with a strong family history of early heart disease
  • Pain is described as squeezing, tight, heavy or crushing
  • Pain occurs along with nausea, weakness, shortness of breath, dizziness, sweating or fainting
  • Pain is more severe than any that the individual had before
  • The pain is accompanied by an uncontrollable sensation that something is wrong, usually a “sense of impending doom”
  • Pain gets worse over the initial 10 or 15 minutes
  • The pain is new in which the individual has not experienced before

In case any of these conditions pertain to the chest pain experienced by the individual, it should be managed as an emergency.

Indications that chest pain is less likely dangerous

The chest pain is not likely a life-threatening heart condition if the following are present:

  • Pain is fleeting or momentary
  • Pain reproducibly and reliably changes with body position
  • There is similar pain in the past and a heart condition was ruled out

In case the pain somewhat fits into the “dangerous” category, the individual should be taken to the nearest emergency department or at least inform a doctor about the symptoms.

Assessment of chest pain in the emergency department

Once an individual decides to seek care for chest pain, the safest thing to do is to call for emergency assistance and be taken to the closest emergency department.

The responding medical team can perform a rapid baseline assessment and help in stabilizing the medical condition of the individual even before arrival at the healthcare facility.

Once a doctor is available, the initial assessment is aimed on determining whether the chest pain is new (acute) or if it represents a chronic issue.


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