Harvard Heart Letter

Ask the doctor: Is this pain from my heart?

Ask the doctor

Is this pain from my heart?

Q. Every now and then I get a sudden, sharp pain on the left side of my chest. It feels like a penknife sticking into me. I get a little dizzy, and then it disappears as quickly as it came on. I have mentioned this to my internist and cardiologist. Even though the results of an electrocardiogram and thallium stress test were fine, it still scares me. Should I be more concerned about this?

A. Different descriptions of chest pain can alert doctors to serious problems. When a narrowed coronary artery restricts blood flow to the heart muscle, people often feel a dull, aching pressure across the chest or in the neck that lasts for minutes. This is what doctors call "typical angina." A heart attack may cause intense chest pain or what feels like severe indigestion that can last for hours. A pulmonary embolism (a blood clot in the lungs) often makes itself known as chest pain that becomes worse with a deep breath. An infection of the pericardium, the outer lining of the heart, can cause chest pain that is made worse by lying down or sitting up.

There are so many variants on chest-pain themes that doctors try to weigh a person's description of his or her pain against their experiences with different diseases. Fleeting, sharp chest pains are so common in healthy people that they generally don't indicate serious heart disease. If you have had a normal electrocardiogram and stress test, it's even more unlikely that the chest pain indicates a blood flow problem. Please keep in mind that no test is perfect. So if there is any change in the type, frequency, or feeling of your chest pain, let your doctors know as soon as possible.

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