Chest Pain: When to See a Cardiologist

I have been experiencing chest pain frequently lately?

Hello Doctor: I have been experiencing intermittent chest pain and tightness for the past few days, particularly on the left side, which has been quite severe.
Sometimes it is accompanied by headaches and shoulder blade soreness, and the pain is getting worse.
Should I be concerned that there is a problem with my heart? Should I see a cardiologist?

Miss Chen, 20~29 year old female. Ask Date: 2020/07/30

Dr. He Dongjin reply Cardiology

Hello, the chest pain accompanied by headaches and scapular soreness is likely due to postural issues, possibly myofascial pain syndrome.
It is advisable to observe the symptoms or use some pain relief medication.
Changhua Hospital cares about your well-being.

Reply Date: 2020/07/30

More Info

When it comes to chest pain, especially when it is persistent and accompanied by other symptoms such as headaches and shoulder blade pain, it is crucial to take these signs seriously. Your description of the pain being more severe on the left side, along with the associated symptoms, raises the concern for potential cardiac issues. While not all chest pain is indicative of a heart problem, it is essential to rule out serious conditions, particularly if the pain is worsening.

Chest pain can arise from various causes, including musculoskeletal issues, gastrointestinal problems, anxiety, and, of course, cardiac conditions. Given your symptoms, it is advisable to consult a cardiologist. They can perform a thorough evaluation, which may include a physical examination, an electrocardiogram (ECG), and possibly further imaging studies like a stress test or echocardiogram to assess your heart's function and structure.

The fact that you are experiencing pain that is increasing in intensity is particularly concerning. In the context of cardiac health, this could suggest angina, which is chest pain due to reduced blood flow to the heart muscle. Angina can be stable (occurring with exertion and relieved by rest) or unstable (occurring at rest or with increasing frequency and severity), the latter being a medical emergency.

Additionally, the presence of headaches and shoulder blade pain can sometimes be associated with cardiac issues, particularly if they are part of a broader pattern of symptoms. For instance, referred pain from the heart can manifest in the shoulders, neck, and back. This phenomenon occurs because the nerves that supply the heart also supply these areas, leading to confusion in the brain about the source of the pain.

Moreover, if you have risk factors for heart disease—such as a family history of heart problems, high blood pressure, high cholesterol, diabetes, smoking, or a sedentary lifestyle—these factors further increase the urgency of seeking medical attention. Even in the absence of these risk factors, sudden or severe chest pain should not be ignored.

In summary, given your symptoms of persistent and worsening chest pain, particularly on the left side, along with associated headaches and shoulder discomfort, it is strongly recommended that you see a cardiologist as soon as possible. Early evaluation and intervention can be critical in preventing potential complications. Remember, it is always better to err on the side of caution when it comes to heart health. Your well-being is paramount, and a healthcare professional can provide the necessary guidance and treatment options based on a comprehensive assessment of your condition.

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