Ignored chest pain

In clinical work, we often hear the following:

"When I eat a full meal, my toothache comes back. Take some metronidazole and rest for a while and it will be fine."

"I feel chest tightness whenever I move. I did a CT scan and the doctor said it was caused by emphysema."

Little do people know that these symptoms may be manifestations of angina pectoris. Once the symptoms worsen, they may progress to acute myocardial infarction.

Even now, some patients still think, "Why can't I get through this discomfort today?" They often choose to take medicine on their own and do not seek medical treatment in time. This situation will further develop until they feel like they are dying or even faint, and then they go to the hospital for treatment. It's too late to regret!

So today we are going to talk about this.

What is chest pain?

What is high-risk chest pain?

What is myocardial infarction?

Why do you need an electrocardiogram when you have chest pain, toothache, or even upper abdominal pain?

Chest pain literally means pain in the chest area. According to the survey, acute chest pain is one of the most common reasons for visiting the emergency department, and the number of patients visiting the department ranks second. The causes of chest pain are complex, and untimely diagnosis and treatment may lead to serious adverse prognosis.

Cardiac chest pain : The most common is angina pectoris caused by ischemic heart disease, especially acute coronary syndrome, including unstable angina and acute myocardial infarction. **Acute coronary syndrome accounts for the highest proportion and is the most dangerous among high-risk chest pain. **It requires timely diagnosis and identification and active treatment.

Residents, if you experience chest pain that is oppressive, squeezing, stuffy, unbearable, accompanied by sweating, or even a sense of impending death, you may have an acute myocardial infarction . At this time, you should call 120 ambulance in time and have an electrocardiogram as soon as possible to determine whether it is a myocardial infarction. The 120 ambulance will take you to the nearest chest pain center for diagnosis and treatment.

The earlier you seek medical attention for chest pain caused by acute myocardial infarction, the greater the benefit. The longer you delay seeking medical attention, the more myocardial cell necrosis there is, the higher the risk of heart failure, the worse the prognosis, and the serious impact on the quality of life in the later stages.

Especially for high-risk groups, once obvious pain occurs and lasts for a long time, they should call 120 for medical treatment in time and be sent to the nearest chest pain center for diagnosis and treatment.

High-risk groups refer to people with the following risk factors, including: family history of heart disease, chronic heart disease, diabetes, hypertension, hyperlipidemia, obesity, smoking, etc. The more risk factors they have, the greater the risk, and the greater the risk of acute myocardial infarction.

Some patients have atypical chest pain symptoms, such as toothache, throat tightness, upper abdominal pain, etc. People with multiple risk factors should be alert when they experience the above atypical chest pain symptoms, as they may have acute myocardial infarction. They should call 120 for medical treatment in time and be sent to the nearest emergency department for diagnosis and treatment.

Why should we call 120 to escort to the nearest chest pain center when we have the above chest pain? First, timeliness.

When acute myocardial infarction occurs, "time is myocardium, time is life". Racing against time is the principle of treatment for acute myocardial infarction. The golden time for rescue of acute myocardial infarction is 120 minutes. If the process from onset to opening of infarcted blood vessels can be completed within 120 minutes, the mortality rate and disability rate can be greatly reduced, and good treatment effects can be achieved. Calling 120 can shorten the treatment time to the maximum extent, and the chest pain diagnosis and treatment green channel can be activated in advance to shorten the treatment time.

Second, security.

After 120 arrives, they will promptly provide the most accurate emergency measures. Acute myocardial infarction may lead to fatal complications such as malignant arrhythmia, cardiogenic shock, and acute heart failure. 120 can provide corresponding prevention and rescue measures upon arrival.

In addition to the unstable angina and acute myocardial infarction mentioned above, what other high-risk chest pains are there?

01 Acute pulmonary embolism

Symptoms include pain in the front or side of the chest, which gradually worsens. It is accompanied by stuffiness, shortness of breath, dyspnea, and may also be accompanied by hemoptysis. In severe cases, the patient may become pale, sweat, have a drop in blood pressure, or go into shock.

If the above symptoms occur, rest on the spot immediately, breathe oxygen as soon as possible if available, and call 120 ambulance immediately to go to the hospital for treatment.

02 Aortic Dissection

It manifests as severe chest pain, which patients often describe as a "tearing feeling" that can radiate to the back. The pain reaches its peak when it occurs and is unbearable. The patient may become pale, sweat, have a drop in blood pressure, or go into shock. If the above symptoms occur, call 120 ambulance immediately, stay in bed, avoid exerting force, and avoid emotional agitation, and go to the hospital for treatment as soon as possible.

In recent years, the incidence of aortic dissection seems to be increasing. Aortic dissection patients can be found in young to old people, mostly in men, and most of them suffer from hypertension.

03 Tension pneumothorax

Symptoms include pain in the front or affected side of the chest, extreme chest tightness, severe dyspnea, and breathing while sitting. Severe hypoxia may cause bluish lips, irritability, and coma. If the above symptoms occur, be sure to call 120 ambulance immediately or go to a nearby hospital for diagnosis and treatment.

In recent years, the incidence of cardiovascular diseases has increased year by year, and the mortality rate has remained high. There are more and more incidents of sudden death caused by acute high-risk chest pain. Some people even died before they could wait for the 120 ambulance, and some people passed away on the way to the hospital.

To improve the success rate of high-risk chest pain treatment, joint efforts and trust between doctors and patients are needed. Of course, it is also inseparable from our daily education and popular science. Improving the public's understanding of the disease and seeking medical treatment in time when chest pain occurs are the key factors to improve the success rate of high-risk chest pain treatment. In order to reduce the occurrence of tragedies and improve the public's awareness of the severity and importance of prevention and treatment of high-risk chest pain, this article shares with you the popular science knowledge related to high-risk chest pain.

Author: Wang Hongxia, Department of Cardiology, Chongming Hospital, Shanghai University of Medicine and Health Sciences

Reviewer: Ding Rongjing, chief physician, deputy director of the Cardiovascular Prevention and Rehabilitation Committee of the Chinese Rehabilitation Association

Editor: Jia Jing; Illustration: Li Chuan (Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine)