
First of all, I think even using the word “pain” to describe a common heart attack symptom may be misleading for many women.
It’s important to remember that up to 40% of women experience no chest symptoms at all during a heart attack. And since my own heart attack, I have met countless women who describe their chest symptoms not as pain, but in one of these ways:
- pressure
- squeezing
- choking
- numbness
- tightness
- heaviness
- fullness
- burning
These symptoms – called angina pectoris - can appear not only in the chest area, but also in the neck, throat, or upper abdomen, and can be associated with discomfort in the jaw, shoulders, head, or both left or right arms.
Cardiologist Dr. Richard Fogoros reminds us that “these symptoms can last from less than a second to days or weeks, can occur frequently or rarely, and can occur sporadically or predictably. With such a broad definition, you can see why the term ‘chest pain’ is in itself of little help to doctors.” 
It’s also important to remember that there are some heart attacks that are accompanied by extremely atypical symptoms. When I was at Mayo Clinic after my own heart attack, I met two women there whose only symptoms in mid-heart attack had been a persistent cough and numbness in the lower lip respectively. For more on the wide variety of actual heart attack symptoms in women, read How Does It Really Feel To Have A Heart Attack? Women Survivors Tell Their Stories
Angina can also occur in the absence of any coronary artery disease. Up to 30% of people with angina with a heart valve problem called aortic stenosis, which can cause decreased blood flow to the coronary arteries from the heart, can have angina. People with severe anemia may have angina because their blood doesn’t carry enough oxygen. People with thickened heart muscles need more oxygen and can have angina when they don’t get enough.
When it comes to chest pain, Dr. Fogoros adds that it’s important to keep in mind that chest pain is merely a symptom, not a diagnosis. And because it can be a symptom of anything from a catastrophic to a trivial medical problem, when a person experiences chest pain it’s important to try to characterize that pain as rapidly as possible as being either completely benign or possibly significant.
He offers the following list of the more common causes of chest pain:
- angina due to coronary artery disease
- angina due to coronary artery spasm (Prinzmetal’s Angina)
- angina due to coronary microvascular disease (sometimes referred to as Coronary Syndrome X)
- heart attack
- heartburn (acid reflux)
- benign chest wall pain
- costochondritis, an inflammation of the cartilage that connects a rib to the breastbone
- anxiety or panic disorder
- asthma, bronchitis, pneumonia, pleuritis
- mitral valve prolapse
- pericarditis
- recent chest trauma
- peptic ulcer
- aortic dissection
- Thoracic Outlet Syndrome *
Let’s look at the condition on this list called benign chest wall pain as an example. In young, healthy people presenting with chest pain, this diagnosis is particularly common according to Dr. Fogoros. He believes that doctors do not understand this condition very well, and consequently neither do their patients.
“Because this condition is completely harmless, the lack of understanding on the part of patients as to what is causing the pain often leads to months or years of needless worry or anxiety.”
Read specific details about each condition that may cause chest pain in the original article from Dr. Richard Fogoros.
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