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Dr. Andrew Rynne

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What causes worsening severe chest pain?

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Dr. Bonnie Berger-Durnbaugh

General & Family Physician

Practicing since :1991

Answered : 3130 Questions

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Posted on Mon, 19 Oct 2015 in General Health
Question: should I go to the ER. I been having a really bad pain in my chest since yesterday but today got worse.
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Answered by Dr. Bonnie Berger-Durnbaugh 49 minutes later
Brief Answer:
Here is some information:

Detailed Answer:
You are young for heart causes of chest pain, but if the pain is severe, you should go to the ER.

Chest pain can usually be broken down into 4 causes:
1. Heart ischemia, heart attack:
This type of pain usually feels like pressure in the chest (at least in men who usually get more typical symptoms than women) and can go down your left arm or up into your jaw. Evaluation for this is to go to the ER where they will likely give you a baby aspirin as heart protection, if severe will give you morphine, and also nitroglycerin which will open blood vessels. They will monitor your heart rhythm and blood pressure/pulse, and take blood tests of cardiac enzymes and troponin, which if elevated are markers for a heart attack. They will most certainly do an EKG to look for signs of heart strain or heart injury. This will take several hours or overnight to sort out.

2. Pulmonary:
Infections of the lungs or something called a pulmonary embolism can cause pain but there is also shortness of breath, sometimes cough, fever. Imaging studies can be used to help sort this out.

3. Musculoskeletal:
Inflammation of muscles of the chest wall can cause chest pain. This can sometimes be diagnosed by evaluating if the pain increases or decreases with movement of the chest such as twisting or raising the arms. Treatment is rest of those muscles and NSAIDs.

4. Gastrointestinal:
Acid reflux can pretty well mimic cardiac causes of chest pain. One way to help see if the pain is cause by stomach problems is if an antacid lessens the pain.

But regardless, if the pain is bad and not improving, do go in and be seen. It is the only way to know for sure that this pain isn't from heart problems.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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