Suffering from chest pain? These are 12 myths and facts you must be aware of

Have you ever had a sharp pain in the chest and thought you were having a heart attack?  Did you hear about the gentleman who had gas or heartburn and turned out he was in fact, having a heart attack?  What about the lady who had chest pain and turned out to have a muscular injury only?  

It is often quite difficult to determine what is the cause of your chest pain: is it a serious cardiac issue or just a muscular pull? 

Here are some myths and facts about chest pain which we should all know.

1. Myth: Chest pain always means heart attack

Fact: Chest pain can have many causes.  It can be from a blocked artery in our heart which is called angina.  It can also be from other structures in the chest.   

• • Cardiac causes: Swelling of the covering of the heart (pericarditis), swelling of the heart muscle (myocarditis), mitral valve prolapse, or aortic stenosis.
  • Aortic dissection: A tear in the main artery supplying blood to the body
  • Gastrointestinal disease like acid reflux/heartburn, stomach ulcers, stomach infections/gastritis, gallstones
  • Lung diseases like asthma, pneumonia, irritation of the lining of the lungs called pleurisy, clots in the lung called pulmonary embolism
  • Costochondritis or swelling in the area between your ribs and breastbone/sternum. 
  • Muscular pain like a sprain in the chest muscles
  • Herpes zoster : A skin condition where a painful rash with fluid filled boils appears over the chest; it is also called shingles.
  • Pain attacks

2. Myth: Angina and heart attack refer to the same thing

Fact:  A heart attack occurs when the blood flow to a part of the heart is completely cut off by a blood clot.  Angina or angina pectoris refers to the feeling of chest pressure, tightness or discomfort, which usually worsens with exertion and reduces with rest. Angina usually occurs when the blood flow to the heart is not meeting the demands of the heart and usually occurs due to blockages in the heart.

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• Angina occurs when blood flow to the heart is not meeting the demands of the heart. Heart attack occurs Occurs the blood flow to a part of the heart is completely cut off by a blood clot.
• Angina usually worsens with exertion and reduces with rest. Heart attack occurs all of a sudden and does not reduce with rest
• May reduce with putting a nitrate (eg sorbitrate) under your tongue. Heart attack may or may not reduce with putting a nitrate (eg sorbitrate) under your tongue.
• Angina involves chest discomfort (rarely described as pain), pressure or tightness in the chest, as if someone has put a weight over the chest. Heart attack involves crushing chest pain, severe, associated with sweating and shortness of breath (Some patients may have atypical symptoms and may not have chest pain at all).
• Angina occurs often due to atherosclerotic blockages (build up of fatty plaques) in the heart arteries. Heart attack occurs due to sudden formation of a blood clot in one of the heart arteries, leading to blockage of the blood flow in that territory.
• Angina needs evaluation from a cardiologist. Heart attack needs urgent attention in the emergency department of a tertiary care hospital.

3. Myth: If I don’t feel chest pain, it is not a heart attack

Fact: Chest pain is the main complaint in only about two-thirds of heart attacks.  In the remaining one thirds, patients may not complain of chest pain.  They may have atypical complaints like pain in the shoulder, jaw pain, choking in the throat, sweating, shortness of breath, nausea, lightheadedness or severe fatigue. A small number of people may not experience any symptoms at all.

4. Myth: It is not a heart attack if the chest pain is on the right side, not the left

Fact: Chest pain could be on the left, right or on both sides and could represent heart blockages or heart attacks.  Chest pressure or tightening can be experienced anywhere in the chest, even in the upper abdomen, and commonly spreads to the neck, arm, shoulder and jaw.

5. Myth: Lying down and resting for sometime will stop heart attacks.  Coughing vigorously will stop heart attacks.

Fact: If you suspect you are experiencing a heart attack, you should immediately go to the nearest emergency department and get an ECG done.  Lying down, waiting, resting, coughing and doing any other maneuvers can only lead to unnecessary delays in your treatment and may even aggravate the problem.

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6. Myth: “Does the heart stop beating during a heart attack?”

Fact: In a heart attack, the blood flow to one of the arteries gets blocked, which can cause heart tissue damage. When the heart stops beating it is referred to as ‘cardiac arrest’. A heart attack can lead to cardiac arrest.  So, before a heart attack culminates in a cardiac arrest, no time should be wasted in reaching the nearest hospital. 

7. Myth: I am only 30 years old, I cannot get a heart attack

Fact: Although heart attacks were common in males over the age of 45, recent trends show that heart attacks are more and more common in younger age groups.  One in four heart attacks in India occur in people under 40 years of age.

8. Myth: Women rarely get heart attacks

Fact: The most common cause of death in women is heart disease.  Although women can get heart attacks, they usually occur after menopause.  Younger women can also experience heart blockages and heart attacks, especially if they have risk factors like smoking, diabetes, hypertension, stress, high cholesterol or family history of heart disease. 

Men and women can experience heart attacks very differently. While chest pain could be the dominant symptom, women may feel unusual symptoms like breathlessness, jaw pain, shoulder or back pain, nausea, heartburn or unusual fatigue.

9. Myth: Biggest cause of concern in women is breast cancer

Fact: False. Cardiovascular disease is the biggest cause of death in women.

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10. Myth: If heart disease doesn’t run in my family, it means I am safe

Fact: While a family history of heart disease can increase one’s risk of developing the illnesses, many individuals have heart problems without any family history. Risk factors include high blood pressure, high cholesterol, diabetes, smoking, obesity, physical inactivity and stress.

11. Myth: I am doomed if heart disease runs in my family

Fact: False. Lifestyle changes can lower your risk of developing heart disease, despite a family history.  A healthy diet, which is rich in fruits and vegetables as well as regular exercise, can keep heart disease at bay. 

12. Myth: I have chest pain, since I lifted some weights today, it must be muscular. I will massage it and wait till morning

Fact:  If you experience any chest pain, the best thing to do would be to get an electrocardiogram (ECG) done immediately.  Do not presume it is muscular or heart burn. Get an ECG as soon as possible. It might save your life.