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Is your chest pain a heart attack or something else? The Harvard Heart Letter discusses

That dull burning in your chest doesn’t seem to be going away, and it feels like it's getting worse. Is it a heart attack or something else? That’s a vexing question, one that millions of people and their doctors face each year. It’s a problem because chest pain can stem from dozens of conditions besides heart attack, from pancreatitis to pneumonia to panic attack, reports the May 2010 issue of the Harvard Heart Letter.

Doctors use several pieces of information to determine who is, and who isn’t, having a heart attack. The most accurate are blood tests for markers that show damage to the heart muscle, such as creatine kinase and cardiac troponin. But since it takes awhile for blood levels of these proteins to get measurably high, the best early methods are an ECG (electrocardiogram) plus the story and description of your chest pain and other symptoms.

The Harvard Heart Letter notes that it is more likely to be a heart attack if you experience

  • a sensation of pain, or of pressure, tightness, squeezing, or burning
  • the gradual onset of pain over the course of a few minutes
  • pain in a diffuse area, including the middle of the chest
  • pain that extends to the left arm, neck, jaw, or back
  • pain or pressure accompanied by other signs, such as difficulty breathing, a cold sweat, or sudden nausea
  • pain or pressure that appears during or after physical exertion or emotional stress or while you are at rest.

Symptoms that are less likely to be heart attack include

  • sharp or knifelike pain brought on by breathing or coughing
  • sudden stabbing pain that lasts only a few seconds
  • pain clearly on one side or another
  • pain confined to one small spot
  • pain that lasts for many hours or days without any other symptoms
  • pain reproduced by pressing on the chest or with body movement.

Read the full-length article: "Chest pain: A heart attack or something else?"

Also in this issue of the Harvard Heart Letter

  • May 2010 references and further reading
  • Chest pain: A heart attack or something else?
  • Banishing secondhand smoke
  • A no-surgery fix for atrial fibrillation?
  • Heart Beat: Blood clot prevention lacking in hospitals
  • Heart Beat: Walnuts and arteries
  • Heart Beat: Women and heart disease
  • Heart Beat: Diabetes drug interferes with vitamin B12
  • Heart Beat: Motorized scooters
  • In Brief
  • Follow-up
  • Ask the doctor: What can I do to stop smoking if the "standard" treatments don't work for me?

More Harvard Health News »

About Harvard Health Publications

Harvard Health Publications publishes four monthly newsletters--Harvard Health Letter, Harvard Women's Health Watch, Harvard Men's Health Watch, and Harvard Heart Letter--as well as more than 50 special health reports and books drawing on the expertise of the 8,000 faculty physicians at Harvard Medical School and its world-famous affiliated hospitals.