Ask the doctor: If I am feeling chest pain, should I call 911?

Ask the doctor

If I am feeling chest pain, should I call 911?

Q. I am a 73-year-old male. I've been diabetic for 50 years, and had a quintuple bypass eight years ago. I try to get an hour of exercise on a treadmill each day. While working out a couple of days ago, I developed a sudden sharp pain on my left side at about chest level, toward my back. Naturally I stopped, but I wondered when a person like me should call 911.

A. Pain in the chest always deserves special attention, especially in someone like you who has coronary artery disease (atherosclerosis of the heart's arteries). Pain from coronary artery disease is felt as heaviness, or a squeezing, pressing or burning sensation, in the middle of your chest, under the breastbone. In many cases, the sensation spreads to either or both shoulders, arms, neck, back, or jaw. You may also feel it high in the abdomen, just below the chest.

Angina is a particular type of pain caused by coronary artery disease. It usually lasts 2–10 minutes and is brought on by exercise, exposure to the cold, or psychological stress — particularly anger. Unstable angina is angina that may not have such a clear trigger. It's more serious, usually lasts longer — about 10–20 minutes — and may keep on coming back. Unstable angina can be an indication that the atherosclerosis in the arteries is worsening — waxing and waning in severity and intermittently getting in the way of smooth blood flow to the heart. It can be the prelude to a heart attack.

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