Having chest pain and shortness of breath and wonder if this is an emergency?
Chest pain and shortness of breath can signal an impending heart attack.
Chest pain and shortness of breath can also be symptoms of panic or anxiety attack, or gastroesophageal reflux disease.
Chest pain and shortness of breath may also mean asthma, bronchitis, inflammation of the lining of the lungs, allergies, sleep apnea and more.
So when should you make a trip to the emergency room if you’ve been feeling chest pain and having shortness of breath or labored breathing?
Let me tell you about my mother, who underwent quintuple bypass surgery the day after going to the emergency room with chest pain and shortness of breath.
Obviously, it would be impractical, and a sorry life to live, if every single time you had chest pain or discomfort, you zoomed to the nearest emergency room.
Chest pain can also be caused by damage to rib cartilage, which can also make breathing uncomfortable.
For over a year my mother had periodically been reporting “labored breathing.”
We thought it was either panic attacks (which she definitely had), anxiety attacks (which she definitely had), and perhaps some of this was side effects from narcotic painkillers (difficulty breathing is a well-established possible side effect of these drugs).
After going on Cymbalta, my mother rarely reported bouts of labored breathing; it was no coincidence (it seemed) that once she was on this antidepressant, the panic and anxiety attacks ceased.
Thus, it was no mystery what had happened to the breathing problems.
Fast forward about 12 months. My mother has been free of anxiety and panic issues for all this time, but one morning, out of the blue, is weeping because she’s having trouble breathing.
Because I had seen this behavior so many times before while my mother struggled with clinical depression (secondary to eventually-diagnosed low thyroid) and severe anxiety, I thought it was just a renegade anxiety attack that slipped through the cracks.
(I had been staying with my parents for about a week at this point, to help my father recover from back surgery).
However, my tune changed when my mother began vomiting about 20 minutes later. She had had nothing unusual to eat the day prior. Vomiting was not normal for my mother.
Nevertheless, I still attributed this to a sudden panic attack – panic attacks can cause vomiting.
I knew that she had recently weaned completely off the antidepressant/anti-anxiety drug Effexor, and this reinforced my assessment that she was simply having an anxiety attack.
But then I began thinking: My mother had had multitudes of panic episodes, and not once had ever vomited.
I also knew that an impending heart attack can cause someone to vomit.
I took her to the emergency room where three troponin tests, plus a CAT scan of her heart, were normal. So was her pulse and blood pressure, plus a stethoscope exam.
An EKG was indeterminate. She was sent home with a diagnosis of gastroesophageal reflux disease.
The next morning my mother felt perfectly fine. The next morning I was awakened at 7 am by the sound of my mother’s stressed breathing, and she said since 5 am her chest had been hurting.
I knew something was wrong and told her she was going back to the emergency room. But 30 minutes later, when she felt perfectly fine, she refused to go.
“Finding out what’s really wrong can be frightening, but never knowing can kill you.”
“I feel fine,” she insisted. And she looked fine, too.
But I said, “We have to find out what’s wrong. This isn’t indigestion. Finding out what’s really wrong can be frightening, but never knowing can kill you.”
We went to the emergency room and the new troponin tests were slightly elevated, and because of this, the doctor recommended she be admitted overnight. The next day she had an echocardiogram: abnormal.
Following this was a catheter angiogram: Her coronary arteries were almost completely blocked, and two hours later, she was undergoing quintuple bypass surgery – the cardiothoracic surgeon had informed me that a heart attack could occur at any moment.
I can conclude, then, based on retrospect and logic, that an impending heart attack resulted in the difficulty breathing a few days prior, plus the chest pain, and the vomiting.
Trust your gut instinct, especially if something is different about the picture, a symptom that was never there before.
And remember the following if you’re in the ER:
An EKG, stethoscope, blood pressure reading, a doctor feeling your chest and abdomen, feeling your pulse, and troponin tests cannot rule out severely blocked coronary arteries!
A recent heart attack can be ruled out — but these tests absolutely cannot rule out an imminent heart attack!