Is it true that if you have only the one symptom of chest tightness, and no other symptoms, that you could still be having a heart attack?

You probably already know at least a few of the symptoms that a heart attack often causes.

One is a sudden feeling of shortness of breath, as though you can’t quite catch your breath.

Your breathing is as though you’ve just run up a flight of stairs even though you’ve been sitting before the TV.

Or, it could be a sudden cold sweat with nausea, accompanied by severe chest pain – or just the cold sweat and nausea by themselves.

But what about tightness? Can tightness in the chest be the only symptom of a heart attack?

“Absolutely, chest tightness can be the only sign of a heart attack,” says Momina Mastoor, MD, a board certified cardiologist with WellSpan Medical Group in Gettysburg, PA.

Dr. Mastoor explains, “It’s hard to say how common it is, because it’s about how the patient is interpreting the pain they’re experiencing.

“Chest tightness is a sign of chest pain, and how patients describe it is different.

“For some it can be a squeezing sensation; others feel a crushing pain; others feel a heavy pressure or like an elephant is sitting on their chest.

“So chest tightness is just chest pain experienced in a different way. And it can be the only symptom.”

Another reason why the prevalence of this solitary symptom is not known is because nobody knows how many people – who never regained consciousness after their heart attack – had only tightness in the chest.

The sensation of tightness, squeezing, pressure or a vice is caused by oxygen being cut off to a portion of the cardiac muscle.

The coronary artery that feeds that deprived section of muscle has been blocked. Blood flow is completely obstructed.

The obstruction may be a blood clot caused by an arrhythmia, or a fragment of soft plaque that has broken off from the inner wall of the artery.

Benign conditions can cause a tight feeling in the chest, including anxiety, muscle strain and acid reflux.

When in doubt, have a cardiologist examine your heart function before you see the gastroenterologist or sports medicine doctor.

Dr. Mastoor formally ran the Structural Heart Clinic at MedStar Union Memorial Hospital in Baltimore, MD.
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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