Diagnosing chest pain
Angina can refer to several specific sensations that people may experience when their heart muscle is not getting enough oxygen. To determine whether your chest pain is more likely caused by angina or by something else, your doctor may ask you several questions, including:
- What does the chest pain feel like?
- Where exactly do you feel the pain?
- Does the pain spread to other areas of the body? Where does it spread?
- How long does the pain last?
- What made the pain start? What makes it worse?
- What made the pain stop? What makes it better?
- What other symptoms did you experience?
Not everyone experiences angina as chest pain. Many people describe angina as a pressure, tightness, heaviness, or squeezing, or simply as a discomfort.
The table below shows how your doctor interprets your answers to these questions. The table divides your answers into two categories: answers that suggest you have angina (and possibly coronary artery disease) and answers that suggest your chest pain and/or other symptoms are not from coronary artery disease. Following the table is a more detailed discussion of how your doctor interprets your answers.
Interpreting your symptoms Question
Answers that suggest angina
Answers that may suggest another cause
What does the chest pain feel like? Dull heaviness, pressure, tightness, squeezing, crushing, discomfort
Sharp, stabbing, shooting, cramping Where exactly do you feel the pain? Mid-chest or left side of chest, lower jaw, left arm Right side of chest, above jaw, or below diaphragm Does the pain spread? Where does it spread?
Jaw, left arm, left hand Back, abdomen How long does the pain last? At least 5 to 10 minutes, but may last for hours
Seconds, or constant pain lasting for days
What made the pain start? Exertion, emotional or physical stress Rest, change in position, deep breathing, pressing on chest What made the pain stop? Rest, nitroglycerin Change in position, antacids What other symptoms do you have? Shortness of breath, sweating, nausea, feeling of indigestion, palpitations Numbness or tingling in fingers or lips Get help
You should not use this chart to try to diagnose the cause of your own symptoms. Not everyone experiences angina in the same way. You can have symptoms that are not typical of angina and that appear to be from something else but may actually be angina or a heart attack.
Too often people have chest pain or other symptoms but do not seek medical attention because they do not think their symptoms are due to angina or a heart attack, or they simply deny that they could have heart disease. As a result, they do not get the lifesaving treatment that they need. You should always see a doctor to find out what your symptoms mean.
What are "anginal-equivalent" symptoms?
Some people never experience chest pain even when the heart is clearly suffering from a lack of oxygen. However, these people often experience other symptoms instead of chest pain. For example, you may have difficulty breathing or you may feel like you have heartburn or indigestion, but in fact your heart is being deprived of oxygen. When these symptoms are caused by coronary artery disease (CAD), your doctor will interpret them the same as though you have angina. For this reason, these types of symptoms are called "anginal equivalents." Because some symptoms of CAD can be very different from actual chest pain, you must tell your doctor about all the symptoms you have been experiencing.
| Author: | Robin Parks, MS | Last Updated: May 14, 2007 |
| Medical Review: | Caroline S. Rhoads, MD - Internal Medicine Stephen Fort, MD, MRCP, FRCPC - Interventional Cardiology | |
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