University of Michigan cardiologist explains when chest pains aren’t a heart attack


Every 40 seconds, someone in the United States has a heart attack.

Chest pain can be a key warning sign of heart trouble, but millions of people who suffer chest pain are actually suffering from something else.

Many patients in the ER have chest pain, and in fact, in the majority, doctors ultimately discover a non-cardiac cause.

But that does not mean chest pain should be ignored.

“Chest pain is very common,” said University of Michigan Health Cardiologist Dr. Nicole Bhave. “It accounts for about five percent of ER presentations in the U.S., and most of the time, chest pain is not heart-related.”

One of the most common other causes is heartburn due to gastroesophageal reflux disease, or GERD.

Bhave says the body may not know where to place pain in the esophagus and stomach, which then gets referred to the center of the chest.

“Spasm of the esophagus, for instance, which is something that can be associated with acid reflux disease, can be really, really painful,” Bhave said.

Straining the chest muscles can also lead to pain.

“There are a lot of bones and muscles in the chest wall and particularly if you’ve done a strenuous workout or a lot of heavy lifting that can lead to strain of those muscles,” Bhave said. “Similarly, if you’ve been coughing because of a respiratory illness, that can cause strain on those muscles and cause chest discomfort as well.”

Emotional stress or anxiety can trigger chest pain as well.

“There’s a very powerful connection between the mind and the body,” Bhave said. “Oftentimes, mental stress, anxiety, and depression will manifest as physical symptoms.”

Bhave says if there is any doubt, get checked out.

“If you have chest pain, particularly if it’s new, severe, or associated with other symptoms, like again, that shortness of breath or nausea, those are reasons that you want to go into the emergency room.”

Unless there is a clear other cause for your chest pain, you must take it seriously and seek help.

And if you have risk factors for a heart attack, like diabetes or high blood pressure, that increases the likelihood that chest pain is heart-related.

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