Cardiac Imaging and Chest Pain: Questions for Patients

I came across a article and thought it would make a good basis for a blog post about what to ask your doctor if you are experiencing intermittent chest pain. Some questions that came to mind include, “When should I worry about chest pain?” and “How can my doctor use medical tests to come to a final answer about my actual condition?” I thought about these questions a bit, and came up with what I think is some useful information for our readers. Read on for my answers… When should I worry about chest pain? We’ve all seen the common, almost folklore-style idea of a man experiencing a heart attack. We see someone gripping his chest, feeling pressure and severe pain, perhaps falling to the ground. On TV, in movies, in factors. Not uncommonly “heart muscle (myocardial) pain” due to an insufficiency of blood supply, ischemia, or “angina” may affect the arm – left or right – the jaw, throat or even the abdomen. It may be accompanied by nausea and suggest a gastrointestinal condition or may be persistent suggesting a musculoskeletal ache. Angina is, in fact, the great mimic among diagnostic conditions. It is an especially treacherous mimic since this potentially life-threatening symptom is generally unaccompanied by physical signs of illness and can masquerade as a benign condition as diverse as a viral syndrome, a stomachache or a muscle cramp. Additionally, the coronary patient can experience shortness of breath, lightheadedness, fever, or other painless symptom. Too often, angina may be “silent.” Even the most serious coronary event may be painless and the only proof is a simple EKG, or the patient’s own concern of “something wrong” – or perhaps a physician’s clinical suspicion! How can my doctor use medical tests to come to a final answer about my actual condition? Fortunately, the physician can supplement his or her diagnostic skills with a variety of simple, safe, widely available and relatively inexpensive diagnostic methods. Since even with a severe coronary narrowing, the blood supply to the heart remains normal at rest, methods which specifically seek to identify cardiac ischemia do so with the application of increased demands for coronary blood flow, to science, not folklore, to rule out the potential of a serious and life-threatening event.