Confronting Chest Pain

Q.  I am a 66-year-old man and have been experiencing chest pains for a few weeks now. They go away on their own, and I feel well otherwise. My family keeps telling me to see a doctor. Do I need to?

A. Dr. Zachary Levine: The short answer is yes. Every year, millions of people visit the hospital because of chest pain. While many of these people will have benign problems, a significant number will have serious and potentially life-threatening ones. With heart disease being the biggest killer of adult men and women in North America, chest pain is a symptom that can’t safely be ignored.

There are many causes, including cardiac (heart), vascular (blood vessel), pulmonary (lung), gastrointestinal (stomach and colon), skin, muscle, cartilage and psychological causes. The doctor can distinguish among these by a performing a thorough history and physical examination. Important factors the doctor will consider include your personal and family health history, as
well as factors that increase your risk for certain problems. The doctor will clarify the exact type of pain, what causes it and what relieves it, and related symptoms.

On physical examination, your vital signs will be checked (heart rate, blood pressure, oxygenation). If necessary, further testing is arranged, such as blood tests, an electrocardiogram and imaging studies such as X-rays or ultrasounds. By doing this, your doctor can rule out life-threatening causes of chest pain and the doctor’s visit will reassure you. If not, then the visit can be lifesaving.

Dr. Zachary Levine is a physician at the McGill University Health Centre and medical correspondent for Zoomer Radio (AM 740, ZOOMERRADIO.CA).