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Chest Pain? Don't Wait!

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Why is it that, on a regular basis in the ER, I see very intelligent patients with chest pain that clearly could be a “heart attack” wait at home for hours before they come in to see me? I suppose there must be some degree of denial of their symptoms. “If I ignore the pain and don’t go to the hospital, it can’t be my heart…” On an intellectual level, this clearly doesn’t make sense, but I see it almost every day, and this is too bad, because, with a heart attack or a stroke (a “brain attack” – more on that another day!), “time is tissue”… Every minute wasted before getting to definitive care (either a cardiac catheterization or use of a “clot busting” drug), allows more heart muscle to go starved of oxygen and die. This means a weaker pump and a shorter life expectancy.

So, if you develop chest pain, especially if it feels like a heaviness or pressure sensation, or like an unfamiliar “indigestion” you should seek prompt medical attention. Other worrisome signs that it might be your heart include onset with or shortly after exertion, associated shortness of breath, nausea or sweating, and movement or radiation of the pain into the neck, jaw, back, shoulder or arm (either side).

Steps to take:
  • immediately find a place to rest
  • loosen any constrictive clothing
  • call 911 right away and request an ambulance (they’ll arrive with the equipment needed to begin managing a heart attack, though you still need to get to the hospital for the definitive treatment)
  • take an aspirin (if you’re not allergic to it)… best: chew and swallow 2 baby aspirins
  • try to stay calm… to slow your heart rate and reduce how hard it must pump
I’d be remiss if I didn’t, in closing, throw out those familiar “ounce of prevention” tips – eat healthy, exercise, don’t smoke, keep high blood pressure and/or diabetes under control, and watch your cholesterol.

But, most importantly, if you have worrisome symptoms, don’t wait!... get yourself promptly to the ER!

Stay alert and stay safe.

- Dr. Bob
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About the Author

The Stanford Emergency Room is the center of emergency care at Stanford University.

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