Have you ever experienced sudden sharp chest pain that lasts for up to a minute before disappearing and leaving a soreness—or an awareness of pain—that gradually disappears over the next few minutes? Did it appear on the left side of your chest below your left nipple? Was it so intense you didn't want to breathe or move? Did you think you, for a split second, "OMG, I'm too young to have a heart attack?" If so, you are one of many. Not to worry, the pain has nothing to do with your heart despite it's proximity and, while its exact cause remains unknown, it's probably due to a pinched nerve. In fact, the condition is so common, it's medically known as Precordial Catch Syndrome (PCS). It occurs more often in children and teenagers but can persist into adulthood. Some people report the sensation of a bubble popping immediate before the pain recedes. There are no apparent triggers; PCS can occur during exercise or rest and may present multiple times in one day or at irregular times over multiple years.
Another, benign cause for chest pain is Costochondritis, an irritation of the ribs and sternum after strenuous physical activity, heavy lifting, or a blow to the chest. The pain is present—or can be recreated—by movement of the patient's chest, shoulders, or arms, by palpation during a physical exam, or by coughing. Costochondritis is treated with rest and NSAIDs.
Substernal chest pain you should be concerned about is usually different: Think pressure or squeezing. Non-tender. Non-traumatic. Persistent pain, not relieved by movement. This is especially true if the patient has a history of cardiac problems, is on cardiac meds, and the pain is accompanied by sweating, shortness of breath, and unusually pale skin. Pain linked to a heart attack may also mimic indigestion and radiate to the patient's neck, arms, or back. In these cases, give 2-4 baby asprin and begin a Level 1 (urgent) evacuation to to a hospital capable of cardiac surgery. Click to read an article about administering chewable baby aspirin ASAP during a suspected heart attack.
Want more information on this and other wilderness medicine topics? Take one of our wilderness medicine courses. Guides and expedition leaders should consider taking our Wilderness First Responder course.
Looking for a reliable field reference? Consider consider purchasing one of our print or digital handbooks; our digital handbook apps are available in English, Spanish, and Japanese. Updates are free for life. A digital SOAP note app is also available.
Your comment will be posted after it is approved.
Leave a Reply.
Our public YouTube channel has educational and reference videos for many of the skills taught during our courses. Check it out!