Is Your Chest Pain a Sign of a Heart Attack, or Something Else?

Chest pain is frightening and must be taken seriously. So know this: If you are having severe discomfort in the chest—especially if the chest pain is radiating to your neck, jaw or arms—and it’s accompanied by shortness of breath, dizziness and sweating, call 911 immediately. Some people (especially women, diabetics and older adults) may not have chest pain at all during a heart attack, but they may have the other symptoms listed. In that case, it’s still best to call 911.

But sometimes chest pain isn’t a heart attack. It might have a different cardiac cause or be totally unrelated to your heart. Here are three clues that it’s not a heart attack:

  1. Pinpointed chest pain. If a sharp pain seems to be coming from a very specific location, it’s probably not heart pain. The pain associated with a heart attack is generally dull and diffusely located in the chest.
  2. Chest pain that shows up in different areas. For example: One day your chest pain is on the right side of your chest, and the next day it’s on the left side of your chest. Heart pain can radiate into the arms, jaw and between the shoulder blades, but it rarely moves from place to place on different days.
  3. Chest pain that gets worse when you take a breath. This could be anything from pericarditis (a swelling of the membrane surrounding the heart) to a cracked rib.

If you are experiencing chest pain like this, call your doctor to make an appointment.

Chest pain that isn’t a heart attack can be heart-related (cardiac) or not (noncardiac).

The Three Most Common Causes of Noncardiac Chest Pain

  1. Gastrointestinal pain. This is the most common type of noncardiac chest pain. It can include acid reflux, esophageal spasm and acidity.
  2. Muscular/skeletal pain. This pain is caused when you pull a muscle or injure a bone. It often occurs after patients have done physical activities such as working in the yard.
  3. Lung pain. A condition like pneumonia or pleurisy, which is inflammation of the tissues around the lungs, can cause pain in the chest that is sometimes mistaken for a heart attack.

Cardiac Pain That Isn’t a Heart Attack

Cardiac pain, or angina, refers to discomfort in the chest because of something going on with the heart. The first thing a cardiologist will try to determine in a patient with cardiac pain is whether the pain is caused by clogged arteries.

Several conditions of the heart can cause cardiac pain but aren’t related to clogged arteries, including:

  • Pericarditis: inflammation of the two thin layers of tissue that surround the heart
  • Dissection: when the aorta splits and causes severe chest and back pain
  • Myocarditis: inflammation of the heart muscle
  • Cardiomyopathy: diseases of the heart muscle

Know What Is a Heart Attack

A heart attack requires immediate emergency care. Symptoms include:

  • Discomfort in the form of tight, heavy pressure or a dull, burning sensation in the chest
  • Pain that radiates to the shoulders, arms, neck, jaw or back
  • Pain that is hard to precisely locate with a single finger
  • Sweating
  • Nausea
  • Dizziness or faint feeling
  • Shortness of breath

If you have any of these symptoms, call 911.

Want to know more about your risk for heart disease? Take a free HeartAware online risk assessment. Learn more about our cardiac care at UNC REX Healthcare and UNC Medical Center or find a cardiologist near you.