Decoding chest pains: Are they a cause for concern?

Published on 26 March 2024

Is it too soon to worry about chest pains? Here’s what to do when the symptoms get serious.  

Have you ever experienced that twinge in your chest and wondered whether it is just indigestion or something more ominous?

According to Dr Sim Hui Wen, a Cardiology consultant at Ng Teng Fong General Hospital (NTFGH) and National University Heart Centre, Singapore (NUHCS), “Chest pain is a common complaint among patients worldwide, with up to 25 per cent of the general population experiencing it in some form during their lifetime.”

Encountering about 25 to 50 cases of chest pain monthly, Dr Sim emphasised that while it’s a frequent complaint, not all instances point to heart-related concerns.

Understanding different types of chest pain

It’s natural to consider the possibility of a heart attack when experiencing sudden chest pains. However, other conditions like indigestion, heartburn, muscle strain and anxiety attacks may present with similar symptoms.

Noting the difference in how the pain manifests is important. The discomfort from a heart attack is typically a feeling of pressure or squeezing lasting 20 to 30 minutes. It is also often exacerbated by physical exertion. Some patients have described the pressure feeling like an elephant sitting on their chest.

Anxiety-induced chest pain, on the other hand, tends to be sharp and stabbing, accompanied by panic sensations, rapid heartbeat, rapid breathing, and a sense of impending doom.

While anxiety, indigestion or heartburn are generally not life-threatening, their resemblance to heart-related chest pain underscores the importance of seeking medical evaluation for accurate diagnosis and appropriate treatment, advised Dr Sim.

   
How to tell if chest pain is serious

When chest pain catches you off guard or feels different from your usual episodes of discomfort, it’s a clear signal to consult a doctor promptly. Additional symptoms like shortness of breath, dizziness, cold sweat or nausea, especially if accompanied by discomfort in your arms, neck, or jaw, may indicate a potential underlying heart condition.

Various risk factors like age, smoking, a sedentary lifestyle, and a family history of heart-related incidents also tend to amplify the likelihood of a heart problem. Nonetheless, chest pain is indiscriminate and can affect individuals regardless of age and background, depending on its underlying cause.

It is crucial to recognise that chest pain can be life-threatening when it presents alongside conditions such as a heart attack, pulmonary embolism (blood clot in the lungs), aortic dissection (tear in the aorta), or pneumothorax (collapsed lung). Making the choice to seek medical attention when uncertain is a proactive step towards prioritising your health and wellbeing.

Tailoring the approach to treating chest pains

Given the many possible causes for chest pain, the appropriate response varies greatly. From medications and physical therapy to dietary tweaks and stress management, all these treatments are aimed at identifying and addressing the underlying cause.

For individuals experiencing anxiety-induced chest pain, seeking a psychiatric consultation may be beneficial, along with therapy sessions, stress management techniques and medications such as antidepressants or anxiolytics. Those grappling with gastrointestinal issues such as acid reflux or heartburn may find some relief through dietary modifications and medications to reduce stomach acid and alleviate symptoms.

If the underlying cause of the chest pain stems from heart-related issues, these lifestyle adjustments will improve your overall wellbeing:

• Quit smoking
• Maintain a healthy weight
• Follow a balanced diet
• Engage in regular exercise
• Manage stress effectively
• Keep blood pressure and cholesterol levels in check
• Moderate alcohol consumption

  
In consultation with  Dr Sim Hui Wen, Consultant, Division of Cardiology, Department of Medicine, NTFGH and Consultant, Department of Cardiology, NUHCS.