respiratory, musculoskeletal, gastrointestinal, psychological or other causes.
“But when it is cardiac, it can be deadly,” Gulati notes.
That’s why getting care is urgent. “We have such good treatment, but time is heart muscle,” she adds. “The sooner we see you, the sooner we can treat you.”
Who is most at risk?
Chest pain accounts for more than 6.5 million emergency department visits annually in the United States, plus nearly 4 million outpatient visits. The guidelines, the first from the AHA and ACC dedicated solely to chest pain, outline standards to help doctors identify who is most at risk and reduce unnecessary testing in those who aren’t.
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The guidance suggests other ways for health care professionals to alter how they talk to patients. For example, doctors should stop using the term “atypical” to describe chest pain. Aside from being confusing, it’s a technical detail with significant implications for women.
While both women and men experiencing heart problems most commonly report “typical” chest pain similarly, women more often report additional “atypical” symptoms such as nausea, fatigue and shortness of breath. This has resulted in women being less likely to receive timely and appropriate care.
“In the past, we have often said that women presented ‘atypically,'” Gulati says. “Nonetheless, this seems to be used to say that the pain isn’t cardiac, rather than meaning a woman is presenting differently than expected.” Instead, doctors should use the term “noncardiac” if heart disease is not suspected.
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What to do if you experience chest pain
“The most important thing people need to know about chest pain is that if they experience it, they should call 911,” Dr. Phillip Levy, a professor of emergency medicine and assistant vice president for research at Wayne State University in Detroit says. “People shouldn’t waste time trying to self-diagnose. They should immediately go to the nearest hospital. And if they’re going to go to the nearest hospital to get evaluated for chest pain, ideally, it should be by an ambulance.”
Even if most cases of sudden chest pain end up not being heart-related, it’s never something to ignore. When people put off going to the emergency department, they’re more likely to suffer complications if they are indeed having a heart attack. “And those complications can be as severe as death.”
Gulati says nobody should be afraid they’re calling for no reason. “I always tell my patients it’s better for us to laugh together once we find some other cause for it versus us not being able to laugh together again.”
Lastly remember that consulting with your doctor should be a shared decision-making process. Research shows “if they’re party to that decision-making, patients are much happier with the care delivered.” So if your doctor is not allowing you to weigh in on your treatment options, consider changing doctors.
