Chest pain has many causes, and one of them is arrhythmia, which means an abnormal rhythm of the heart.

To find out if chest pain can be the only symptom, however, of a heart arrhythmia, I consulted with Peter R. Kowey, MD, FACC, Professor of Medicine and Clinical Pharmacology, Jefferson Medical College; Chief, Division of Cardiovascular Diseases, Main Line Health System; and author of “Lethal Rhythm,” a medical mystery.

Here is what Dr. Kowey explains: “Chest pain is rarely the only symptom of an arrhythmia — much more common are palpitations, shortness of breath and lightheadedness.”

This doesn’t mean that if you’re experiencing chest pain along with some shortness of breath, and maybe also another symptom like what seems like skipped heartbeats . . . that you can safely assume that this is arrhythmia rather than an impending heart attack.

Problem is, the symptoms of an impending heart attack, and that of an arrhythmia, are strikingly similar.

Not only that, but just the two symptoms – chest pain and shortness of breath (or difficulty breathing) – can mean many possible medical conditions, including GERD (gastroesophageal reflux disease) and pulmonary embolism.

You cannot diagnose what chest pain and accompanying symptoms are at home.

If you’re experiencing these symptoms, a trip to the emergency room is warranted for a full evaluation to rule out a pending heart attack. Chest pain and shortness of breath can also mean a problem with a cardiac valve.

Dr. Kowey explains: “Most heart arrhythmias are not life-threatening, but certain arrhythmias can cause life-threatening complications such as stroke.

“The problem is that there are many different types of arrhythmias, some of which need little or no therapy and others more aggressive management, such as with surgery, catheter procedures or drugs. In addition, not all arrhythmias cause symptoms.”

Causes of Arrhythmia

  • Emotional distress
  • Side effects of medications
  • Drug abuse
  • Smoking
  • Diabetes
  • High blood pressure
  • Coronary artery disease
  • Heart attack

The risk factors for a disturbance in cardiac rhythm overlap the possible causes (such as coronary artery disease), and some of the risk factors lead to the causes, such as obstructive sleep apnea, obesity, and drinking too much alcohol, which can damage cardiac tissue.

Other risk factors include thyroid problems, caffeine and electrolyte imbalance. Amphetamines and cocaine can cause a deadly arrhythmia known as ventricular fibrillation.

Here are the symptoms of a heart arrhythmia: fainting or near-fainting episodes; dizziness; lightheadedness; a slow heartbeat; a fast heartbeat; a sensation of fluttering in the chest; and of course, chest pain and shortness of breath.

The perception of arrhythmia symptoms is not indicative of the severity of the problem.

Neither is the absence of symptoms, i.e., a life-threatening arrhythmia can present with minimal or mild symptoms, while less severe rhythm disturbances can interfere significantly with normal function.

Chest pain and difficulty breathing are two symptoms that should never be passed off as “just stress.”

Dr. Kowey explains, “It’s important to consult with a physician trained in the treatment of cardiac rhythm problems and to undergo a thorough evaluation that could include imaging of your heart and other diagnostic tests including electrophysiologic (catheter) studies.”

Dr. Kowey’s principal area of interest is cardiac rhythm disturbances, and his group has participated in a large number of pivotal international clinical trials.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.  

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