Chest pain is one of the symptoms that causes the most concern. Although it is often not related to a heart attack, that does not mean it should be minimized. In fact, it can have different causes, all of which require a proper evaluation to rule out a heart problem.
The cardiologist Hernán Krimer (MN 121.253) explained that chest pain always deserves medical evaluation, especially in people with cardiovascular risk factors.
The specialist also recalled an intriguing fact: “The last World Cup brought with it a curious silent epidemic: thousands of people consulted for chest pain. While most were not suffering a heart attack, that does not mean the symptom should be minimized”, he noted.
Chest pain from lack of oxygen in the heart’s arteries
According to Krimer, one of the most important causes of chest pain is the lack of oxygen reaching the heart muscle.
“Depending on the severity of the condition, it can be angina or an acute myocardial infarction. It should never be ignored”, he warned.
The doctor detailed that this pain usually presents as a tight pressure in the center of the chest that can radiate to the left arm, both arms, the jaw, the neck, or the back. In addition, it can be accompanied by cold sweat, shortness of breath, nausea or an impending sense of death.
Krimer explained that an intense emotional load increases the release of adrenaline and noradrenaline, elevating blood pressure, heart rate, and the heart’s oxygen consumption.
“In people with coronary disease, that stress can promote the rupture of an atheromatous plaque and trigger a heart attack”, added the specialist.
That is why he was emphatic: “In the face of pain of these characteristics, seeking medical consultation must be immediate. In cardiology there is a maxim that remains valid: time is muscle”.
Muscular pain: a frequent cause that also needs evaluation
Not all chest pains have a cardiac origin. “Los músculos intercostales, el pectoral mayor o las articulaciones entre las costillas y el esternón pueden inflamarse o contracturarse”, explained the doctor. He even noted that it can appear after uncontrolled hugs, jumps, falls during a celebration or simply from staying in uncomfortable positions for many hours.
The specialist indicated that this type of pain generally increases with movement, when pressure is applied to the area or with certain body positions. However, he clarified that although it is usually benign, it must always be differentiated from a cardiac origin. Intense anxiety can also manifest with physical symptoms very similar to those of a cardiac problem.
“Anxiety can cause hyperventilation, palpitations, a sensation of shortness of breath and chest pain or tightness, symptoms that are often confused with a cardiac event“, Krimer explained. The cardiologist clarified that the release of adrenaline is real and causes measurable physiological changes.
However, he emphasized an important warning: “When the pain is new or cardiovascular risk factors exist, it should never be attributed to anxiety automatically without proper medical evaluation”.
Digestive pain: when the problem is not in the heart
Another common cause of chest pain comes from the digestive system. “Las picadas abundantes, las comidas grasas, el alcohol, las bebidas gaseosas y las cenas tardías favorecen el reflujo gastroesofágico y los espasmos del esófago”, determined the cardiologist.
The specialist noted that the burning sensation or pressure behind the sternum can resemble heart pain remarkably.
For that reason, he stated that often it is necessary to perform an electrocardiogram and other studies to differentiate them. Heart attacks in women can present differently from men, which is why they often go unnoticed.
“Although it occurs for the same causes, in women the pain can be more diffuse, feel like a burning sensation or appear in the back, the jaw or even manifest only as shortness of breath or extreme fatigue“, explained the doctor.
The specialist stressed that these symptoms should not be underestimated because they are often mistaken for gastritis, ulcers or digestive spasms. He also warned that these conditions are frequently overlooked even in emergency departments when interpreted as lesser problems.
Finally, he left a clear recommendation. “All chest pains should be evaluated with an electrocardiogram, regardless of whether the symptoms are typical or atypical”, he affirmed.
And he added that this guidance becomes even more important for people with cardiovascular risk factors, such as high blood pressure, diabetes, high cholesterol, sedentary lifestyle, obesity or a history of heart disease.
The final message from the specialist is blunt: in the face of chest pain, especially if it appears suddenly or is accompanied by other symptoms, you should not wait or try to diagnose it at home. Getting timely medical advice can make a difference.
