Harvard Health Letter

By the way, doctor: Emergency care for chest pain

Q. If you have chest pain or discomfort, how do you know if it is serious enough to warrant emergency medical attention?

A. The sad truth is that there's no easy way to tell. There are dozens of mimickers of a heart attack. One of the most common is gastroesophageal reflux disease (GERD), and it is difficult even for physicians to distinguish between the two.

Even after an evaluation in the emergency department, which would typically include an electrocardiogram (ECG) and blood work to look for markers released by damaged heart muscle, we're often not certain whether someone has had a heart attack, an episode of unstable angina, or, as is most common, chest pain that was totally unrelated to the heart. That's why only one in five patients admitted to the hospital in order to rule out a serious heart problem actually has one.

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