Chest Pain: When to See a Cardiologist

What type of illness corresponds to which medical specialty?

In September, there was gastroesophageal reflux, which improved in October.
After that, I started experiencing intermittent chest tightness and pain.
Initially, it was on the right side, but then it got a bit better.
Later, I began to feel tightness and pain in the left chest, although it didn't feel like heart pain.
Last night at 9:00 PM, my heart started racing, and I experienced severe pain with slightly labored breathing and strong heartbeats.
The pain radiated to my left arm, and I also had nasal congestion.
This lasted for 3 to 4 hours.
Now, I feel a bit better, but I still have a persistent tightness in the left chest, which feels uncomfortable, although my breathing has improved somewhat.
What could this condition be? Which specialist should I see?

Chen Jiayi, 10~19 year old female. Ask Date: 2016/11/06

Dr. He Dongjin reply Cardiology

Hello, it seems you are experiencing nasal congestion, which could be due to a cold or allergies.
You also mentioned intermittent pain on the left and right sides, possibly indicating neuralgia.
Additionally, you feel a persistent pressure in your left chest, which is quite uncomfortable.
However, you are currently able to breathe a bit more normally.
It might be a good idea to check for mitral valve prolapse at the clinic.
Take care, and we are concerned about your well-being at Changhua Hospital.

Reply Date: 2016/11/06

More Info

When it comes to chest pain and related symptoms, it is crucial to understand the potential underlying causes and when to seek medical attention. Your description of experiencing intermittent chest pain, particularly on the left side, along with rapid heartbeats, shortness of breath, and discomfort radiating to your left arm, raises several important considerations.

Firstly, chest pain can stem from various sources, including cardiac, gastrointestinal, musculoskeletal, and even psychological factors. Given your history of gastroesophageal reflux disease (GERD), it is possible that some of your symptoms may be related to acid reflux, which can cause chest discomfort that mimics heart-related pain. However, the acute nature of your symptoms, especially the rapid heartbeat and pain radiating to the left arm, warrants a thorough evaluation to rule out any serious cardiac issues.

The symptoms you described, particularly the sudden onset of severe chest pain, palpitations, and shortness of breath, could indicate a range of cardiovascular conditions, including but not limited to angina, myocardial infarction (heart attack), or other forms of ischemic heart disease. The fact that you experienced pain for several hours and had associated symptoms like nasal congestion and left arm pain is concerning and should not be taken lightly.

Given these factors, it is advisable to see a cardiologist as soon as possible. A cardiologist specializes in diagnosing and treating heart-related conditions and can perform necessary tests such as an electrocardiogram (ECG), echocardiogram, or stress testing to assess your heart's function and rule out any significant issues. If necessary, they may also recommend further imaging studies or even a coronary angiogram to evaluate the blood vessels supplying the heart.

In addition to cardiac evaluation, it may also be beneficial to consult with a gastroenterologist, especially considering your history of GERD. They can help determine if your gastrointestinal issues are contributing to your chest discomfort and provide appropriate management strategies.

In the meantime, it is essential to monitor your symptoms closely. If you experience any worsening of your chest pain, new symptoms such as dizziness, fainting, or severe shortness of breath, or if the pain becomes persistent, you should seek emergency medical care immediately.
Lifestyle modifications can also play a role in managing symptoms. Reducing stress, avoiding known triggers for GERD (such as spicy or fatty foods), and maintaining a healthy diet can be beneficial. If anxiety or stress is a contributing factor, consider discussing this with your healthcare provider, as they may suggest counseling or relaxation techniques.

In summary, your symptoms warrant a thorough evaluation by a cardiologist to rule out any serious heart conditions. Additionally, addressing any gastrointestinal issues with a gastroenterologist may provide further insight into your symptoms. Prompt medical attention is crucial, especially given the nature of your symptoms.

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