The Doctor Is In: Dealing With Chest Pains – Medical Advice

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By Eugene H. Eisman, MD FACP

Chest pain should always be taken seriously. I don’t have any recent data, but back when I was in medical school (the Cretaceous Period), this is what they taught me. Eighty percent of the deaths from acute myocardial infarctions (heart attacks) occurred in the home. Myocardial means heart, and infarction means death of tissue. The reason so many people die at home, is that people get chest pain, and instead of calling 911, they sit at home, and die from an abnormal heart rhythm that could have been detected, and treated, if the victim was on a heart monitor in the hospital.

So, what do you watch out for? Typical heart pain is a sensation of squeezing or pressure in the chest. It does not go away when you take an antacid, such as Tums, and often radiates down the left arm. The problem is, is that the above symptoms are “typical,” but be on your guard. I have had patients with no chest pain, but jaw pain or upper abdominal pain who have had myocardial infarctions.

There are many other causes of chest pain: Muscle sprain, cracked rib, acid reflux from the stomach are some of the benign causes. There are some other causes that are not so benign. There could be a blood clot in a lung (pulmonary embolis), or the aorta is enlarging and about to result in a quick death due to a massive bleed (this is what took Einstein).

So, how do you know that you have a more serious chest pain, rather than a benign process? You don’t, and the wise thing is to call 911. So you cry wolf, and take an unnecessary trip to the ER. It is still better than staying home and dying.

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