Chest pain severity not a heart attack indicator

PHOTO: Chest pain severity not a heart attack indicator

NEW YORK - A high degree of pain does not make it any more likely that someone coming into the emergency room with chest pains is having a heart attack, researchers found in a study of more than 3,000 patients.

The most severe chest pain was not a good predictor of which patients were actually having a myocardial infarction, or heart attack, nor of which patients were most prone to having one within the next month.

Conversely, "If chest pain isn't severe, that doesn't mean it's not a heart attack," said Dr. Anna Marie Chang, an author of the study and an emergency physician at the Hospital of the University of Pennsylvania.

Using a scale of zero to 10, with zero representing no pain and 10 being the worst imaginable, researchers gauged the pain levels of about 3,300 patients who arrived at the UPenn hospital emergency department complaining of chest pain. They then followed the patients for 30 days to see who had further heart-related events.

Patients with the most severe chest pain were no more likely to be having a heart attack, or to have one within the next month, than patients with lesser pain. Pain that lasted more than an hour was also not a useful sign of a heart attack versus other conditions.

Chest pain of any severity should be cause for concern, experts caution. Pain is a red flag for other serious health problems, too, such as stomach ulcers or a tear in the aorta, the heart's main artery, like the one that killed actor John Ritter in 2003.

"The cause of chest pain may or may not be a heart attack, but it could definitely be something serious," said Dr. James Feldman, an emergency physician at Boston Medical Center who was not involved in the study.

Classic heart attack symptoms do include chest pain or pressure, but other hallmarks are shortness of breath, nausea, vomiting and faintness.

Moreover, the pain of a heart attack doesn't always settle in the chest area.

"Pain may occur in the chest, arm, jaw, back or abdomen and may be described differently by different people," said Dr. Rajiv Gulati, a cardiologist at the Mayo Clinic in Rochester, Minnesota, who was not involved in the study.

Although in the study pain severity wasn't a good indicator of who was having a heart attack at the hospital, having arrived at the emergency department in an ambulance was.

That may be because people tend to dismiss chest pain until they are having symptoms they deem serious enough to warrant calling emergency services, Feldman explained.

"If you are only waiting for crushing chest pain, you may wait to delay care, and that would be a problem," he said. "Any chest pain is a serious complaint and means you need to seek medical care right away."

"Unexplained chest discomfort should be taken seriously, regardless of the intensity of pain," Gulati agreed. "Early evaluation can save lives."

The current findings, published in the Annals of Emergency Medicine, could also help save doctors money by helping them judge who is and is not having a heart attack.

Failures to diagnose acute myocardial infarction account for 20 per cent of malpractice claims paid out, the authors note, and some two to five percent of patients who are having heart attacks are inappropriately discharged from emergency departments.

SOURCE: Annals of Emergency Medicine, online August 1, 2011.

Purchase this article for republication.

VIDEOS YOU SHOULD WATCH

  • #Joeyjios: We try bubble tea mala hotpot and bubble tea toast

    Full story: http://www.asiaone.com/food/we-try-bubble-tea-mala-hotpot-and-bubble-tea-toast-guess-which-ones-got-us-hooked Mala and bubble milk tea within the same hotpot? What about bubble tea on toast? Who even comes up with these ideas?! This week on #Joeyjios, we give these dubious food creations a taste-test to see if they're worth your time, money and calories. #bubbletea #bbt #boba --- Read more: http://www.asiaone.com/ FOLLOW us on - Facebook: https://www.facebook.com/asiaonecom - Twitter: https://twitter.com/asiaonecom - Instagram: https://www.instagram.com/asiaonecom/ EMAIL: For story leads, business enquiries, contact asiaone@mm2entertainment.com
  • Thirstdays: Where we talk weird dates and wild fantasies

    Full story: https://www.asiaone.com/entertainment/thirstdays-where-we-talk-weird-dates-and-wild-fantasies Ooo, it's been a hot week and the thirst is real at AsiaOne. Join Le En and Bryan as they chat about weird dates, constant 'cravings', and Beyonce's thigh gap! And they are quenching that thirst with a cup of root beer float to celebrate the return of a certain fast food restaurant. Thirstdays is a fortnightly AsiaOne #entertainment series where our hosts Le En and Bryan give you a peek into their personal lives while they satisfy their thirst over a drink, have a no-holds-barred chat, and do fun things. #gossip #confessions #realness --- Read more: http://www.asiaone.com/ FOLLOW us on - Facebook: https://www.facebook.com/asiaonecom - Twitter: https://twitter.com/asiaonecom - Instagram: https://www.instagram.com/asiaonecom/ EMAIL: For story leads, business enquiries, contact asiaone@mm2entertainment.com
  • Don't Say Cannot Ep4: He beats people up, but for the country

    Full story: http://www.asiaone.com/singapore/dont-say-cannot-delinquent-national-wrestler He used to beat people up, simply because he had "too much energy" to expend. Now, he still beats people up - but for the country. Meet 24-year-old #Singapore national wrestler Toh Xin Ran. Seeing the number of medals that he has been awarded and the respectful manner in which he now interacts with his wrestling coach, it is hard to imagine that Xin Ran used to be a troubled kid in his younger days. #wrestling #sportsman --- Read more: http://www.asiaone.com/ FOLLOW us on - Facebook: https://www.facebook.com/asiaonecom - Twitter: https://twitter.com/asiaonecom - Instagram: https://www.instagram.com/asiaonecom/ EMAIL: For story leads, business enquiries, contact asiaone@mm2entertainment.com
  • #Joeyjios: Taste-testing The Alley Luxe and CHICHA San Chen

    Full story: https://www.asiaone.com/food/alley-luxe-and-chicha-san-chen-opens-week-heres-what-try A Michelin-standard bubble tea for $4.70? A drink that looks like the Northern Lights? This week, #Joeyjios her colleague Le En to check out two new bubble tea (BBT) stores that are opening along Orchard Road. Which will they prefer? Watch to find out. #Thedeerishere #TheAlley #Chichasanchen #Boba --- Read more: http://www.asiaone.com/ FOLLOW us on - Facebook: https://www.facebook.com/asiaonecom - Twitter: https://twitter.com/asiaonecom - Instagram: https://www.instagram.com/asiaonecom/ EMAIL: For story leads, business enquiries, contact asiaone@mm2entertainment.com
  • Office Tea Episode 5: Bosses and Things

    It’s been a few weeks - let’s find out if the higher-ups of AsiaOne have any regrets about hiring Le En. Efforts were made to make nice, charity is involved and work is never-ending still. Follow and subscribe so you won't miss a single episode of our new series, Office Tea! To catch more of her antics, follow her @goofy_feline! --- Read more: http://www.asiaone.com/ FOLLOW us on - Facebook: https://www.facebook.com/asiaonecom - Twitter: https://twitter.com/asiaonecom - Instagram: https://www.instagram.com/asiaonecom/ EMAIL: For story leads, business enquiries, contact asiaone@mm2entertainment.com
  • #Joeyjios: DIY your way into mum's heart this Mother's Day

    Full story: https://www.asiaone.com/women/joeyjios-diy-your-way-mums-heart-mothers-day Mother’s Day is this Sunday! Have you gotten mum a gift yet? This week on #Joeyjios, Joey tries her hand at DIY projects that’s thoughtful, useful and inexpensive. #Mothersday #DIY --- Read more: http://www.asiaone.com/ FOLLOW us on - Facebook: https://www.facebook.com/asiaonecom - Twitter: https://twitter.com/asiaonecom - Instagram: https://www.instagram.com/asiaonecom/ EMAIL: For story leads, business enquiries, contact asiaone@mm2entertainment.com
  • Don't Say Cannot Ep3: He 'sees' the world with the help of tech

    Full story: https://www.asiaone.com/singapore/dont-say-cannot-he-may-be-blind-he-can-text-faster-you Edwin Khoo, 43, surprises friends with the speed at which he types on his phone. The reason? He's been blind since birth. But #technology has been the game-changer for Edwin in navigating the world around him despite his #disability, allowing him to #travel and even host his own online #podcast. --- Read more: http://www.asiaone.com/ FOLLOW us on - Facebook: https://www.facebook.com/asiaonecom - Twitter: https://twitter.com/asiaonecom - Instagram: https://www.instagram.com/asiaonecom/ EMAIL: For story leads, business enquiries, contact asiaone@mm2entertainment.com
  • Office Tea Episode 4: The Dress Code

    It’s in the employee handbook - but does ANYONE actually read and follow the dress code? Are calves too scandalous? Le En puts on Athleisure and tries to get away with it! Follow and subscribe so you won't miss a single episode of our new series, Office Tea! To catch more of her antics, follow her @goofy_feline! --- Read more: http://www.asiaone.com/ FOLLOW us on - Facebook: https://www.facebook.com/asiaonecom - Twitter: https://twitter.com/asiaonecom - Instagram: https://www.instagram.com/asiaonecom/ EMAIL: For story leads, business enquiries, contact asiaone@mm2entertainment.com
  • Caryn Cheng finds the best deals at IMM's Greater Savings Home and Furnishing Sale

    Full story: https://www.asiaone.com/singapore/5-couples-share-most-expensive-items-they-have-ever-bought-their-home AsiaOne challenges Caryn Cheng to find the best deals at the upcoming #IMM Greater Savings Home and Furnishing #Sale. IMM's Greater Savings Home & Furnishing Sale will start May 13 to 19. With 20 per cent off storewide at Best Denki and discounts of up to 50 per cent at stores such as INKAGU Outlet by Picket & Rail, Linen Gallery Outlet and Red Apple from May 17 to 19, this epic sale is not to be missed. Address: 2 Jurong East Street 21, Singapore 609601 Opening hours: 10am to 10pm #brandedcontent --- Read more: http://www.asiaone.com/ FOLLOW us on - Facebook: https://www.facebook.com/asiaonecom - Twitter: https://twitter.com/asiaonecom - Instagram: https://www.instagram.com/asiaonecom/ EMAIL: For story leads, business enquiries, contact asiaone@mm2entertainment.com
  • #Joeyjios: I try a ballet-inspired workout despite my two left feet

    Full story: https://www.asiaone.com/singapore/joeyjios-i-try-ballet-inspired-workout-despite-my-two-left-feet Tendu, Arabesque and Grand Pliés? This week on #Joeyjios, I found out that these are in fact, not edible food dishes, but dance moves in ballet.  Watch as former professional ballerinas and co-founders of #BalletBody, Lisha Chin and Alison Carroll, take me through a snippet of their hour-long ballet-inspired workout while I try my best to keep up.  #Ballet #Barre #Fitness --- Read more: http://www.asiaone.com/ FOLLOW us on - Facebook: https://www.facebook.com/asiaonecom - Twitter: https://twitter.com/asiaonecom - Instagram: https://www.instagram.com/asiaonecom/ EMAIL: For story leads, business enquiries, contact asiaone@mm2entertainment.com

SERVICES