So how long should you wait after getting chest pain to call for help? It’s immediately. This directive comes from a recent ACC 2012 meeting in Istanbul, Turkey. “Time is heart muscle,” as the saying among cardiologists goes.
Here I am, writing this article, but not having respected this directive with my own mother when she had chest pain over two years ago. I pulled out of her driveway to take her to the ER two and a half hours after I learned she had chest pain.
The chest pain had ceased, but I had insisted on an ER visit. I should have, the moment I learned of the chest pain. She felt fine on the way to the ER, but the next day underwent quintuple bypass surgery.
In cardiac emergencies, such as a heart attack, calling an ambulance immediately ensures the patient gets prompt medical care,” says Professor Tom Quinn, United Kingdom, member of the ACCA Board.
“Most of these treatments are highly time-dependent,” continues Professor Quinn. He notes a “chain of survival” when the heart stops beating, that applies to those not only with severe chest pain, but also sudden severe labored breathing, and who have collapsed unconscious.
Sudden chest pain is very frightening, yet many people let it go, especially if they’re at home, since comfort items are right there, such as a nice bed to settle into or a comfort food to take their mind off the symptom.
Another reason people with chest pain at home are less likely to call an ambulance (or if they do, it’s delayed), is because they don’t want neighbors to see them being loaded into an ambulance.
On average it takes two to four hours for people to get to the ER, says a report in the Wall Street Journal. Some wait days before seeking help. Many are in denial.
The morning of my mother’s chest pain, she said a few times, “I think it’s my heart.” A few days earlier when she had labored breathing while at rest (but no chest pain), she said, “I think there’s something wrong with my heart. I want my heart checked.”
To this day I remember precisely where she was standing in the house when she said this, yet strangely, at the time, I didn’t feel an urgency to get her to the ER for a heart exam, though I did take her to the ER a short while later (she was discharged hours later with a misdiagnosis of acid reflux).
There was also some denial going on with me as well, including when, the next day after I kept pushing for her to give me a detailed description of her sensations, she said, “It sometimes feels like there’s a brick sitting on my chest.”
This inspired me to do an Internet search on angina rather than whisk her into the car to head to the ER. I then diagnosed her with unstable angina, but continued sitting at the computer, not realizing that unstable angina can be immediately life-threatening.
Next day when she had the chest pains and I took her to the ER, she was diagnosed with unstable angina, admitted and had the bypass surgery.
Sudden, severe chest pain doesn’t always mean a heart attack or unstable angina from a severe blockage in an artery. It can also mean a ruptured aortic aneurysm. The symptoms of this, and of a heart attack, can be identical: severe, sudden chest pain radiating to the upper back, between the shoulder blades.
“Stabbing or ripping chest pain always raises the specter of what we call ‘aortic dissection,’ explains Dr. John A. Elefteriades, MD, for an interview of another online article of mine called “Stabbing, Ripping Chest Pain: Get to ER; May Be Torn Aorta.” He is a William W.L. Glenn Professor of Surgery, as well as Director of the Aortic Institute at Yale-New Haven, New Haven, CT.
Mayoclinic.com says that sudden severe chest pain can also mean a pulmonary embolism; you can be dead within minutes from this. However, a pulmonary embolism typically follows very specific circumstances: extended air or ground travel in cramped quarters, and excessive inertia following surgery or injury. In elderly people, dehydration, heart disease and valve malfunction can cause a pulmonary embolism.
So even if there’s no apparent family history of heart disease and you jog every day and don’t smoke, sudden severe chest pain can mean a ruptured aortic aneurysm or a pulmonary embolus. And by the way, the typical aortic aneurysm (prior to dissecting) produces NO symptoms!
Sources:
sciencedaily.com/releases/2012/10/121022080406.htm
online.wsj.com/article/SB10001424052702304432704577347723157872672.html
mayoclinic.com/health/pulmonary-embolism/DS00429/DSECTION=risk-factors
