When chest pain doesn’t mean a heart attack
Your chest hurts, but the pain lies elsewhere. Here are some reasons why.

Chest pain is one of the most common reasons for an emergency hospital visit.

It’s right to go because doctors can quickly run tests to check your temperature, blood pressure and heart rate. They’ll then decide whether an electrocardiogram is necessary to check electrical activity, or blood tests to check for proteins released during a heart attack.

But chest pain isn’t always serious and it doesn’t always relate to the heart. Here’s Medix’ list of five frequent alternatives.  

1. Heartburn

While it may feel as if your heart’s on fire, it will be your esophagus that’s the problem if you have acid reflux.

Chinese medicine has a wonderful term for it: rebellious qi – vital energy that’s gone absent without leave (AWOL in English). That’s because problems occur when the contents of our last meal flow back through the pipe, which connects our stomach to our throat.

This causes a burning sensation because the esophagus doesn’t have the same protective lining, which the stomach does. And gastric acid is very strong, not much less so than battery acid.

The symptoms of acid reflux, also known as gastroesophageal reflux disease (GERD), mimic heart problems because the two are situated close to each other and share the same nerve network.  

A few distinguishing features of GERD include: a sour or bitter taste, lack of breathlessness and problems soon after eating.

Doctors frequently suggest antacids to neutralise gastric juices, proton pump inhibitors (PPI) to reduce acid production, or lifestyle changes such as cutting back on spicy food.

There are also plenty of folk remedies too. These include baking soda and water, or apple cider vinegar and water to neutralise acid.

In Traditional Chinese Medicine (TCM), practitioners often suggest rhubarb to guide qi back to the stomach, ginger for nausea and ginseng to strengthen digestive organs.

2. Physical exertion

We often think of sharp, sudden chest pain as the classic sign of a heart attack. However, if you’re just been lifting a heavy object, or not warmed up before exercise, then you may well have pulled a muscle instead.

The most common form of this kind of chest pain is called intercostal muscle strain. It affects the muscles that lie between the ribs: helping the latter to expand and contract.

One way to tell if you have pulled such a muscle is to press against the wall of your chest. If it feels more painful, then it’s more likely to be muscle strain. Coughing will also generally make you feel worse.

The classic treatment involves an ice pack to reduce inflammation (for the first day or so), followed by heat therapy such as a hot bath, or a heating pad to increase blood circulation and tissue repair.

Over-the-counter anti-inflammatory pain medication such as ibuprofen can also help. It’s also important to rest for a few days.

3. Pancreatitis

The organ, which releases enzymes to help us digest food, is located just behind the stomach. But if it becomes inflamed, the pain can quickly radiate to the chest and back.

Acute pancreatitis requires an urgent hospital visit since it can result in life-threatening organ failure. Signs to watch out for include pain that erupts shortly after eating and gets worse when lying down, but better when leaning forwards.

Treatments include antibiotics, intravenous fluids and a low fat diet, or fasting, giving the pancreas time to recover.

4. Pericarditis

It may feel like you’re having a heart attack, but it may be the heart’s protective sac-like structure, which has become irritated or inflamed.

One of the most common causes is infection: bacterial, fungal or more usually, viral. Most cases are mild and require rest rather, or anti-inflammatory painkillers such as ibuprofen. 

However, early diagnosis reduces the risk of long-term complications.

5. Panic attacks

One of the worst aspects of suffering from anxiety is experiencing a panic attack, which can come from nowhere and frequently feel like a heart attack.  

One of the differences between the two is that panic attack chest pain is often sharp and stabbing rather than a squeezing sensation. Tingling, sweating, and a furious pounding sensation are also common.

If you hyperventilate, you exhale too much air, which is why some people hold paper bags over their mouths and nose to re-inhale the lost carbon dioxide.

But one of the best ways to get quell a panic attack is to recognise it as such, close your eyes and breathe slowly.  A doctor can also recommend a therapist to help unpick and treat the underlying cause.

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