Science Questions with Surprising Answers
Answers provided by
Dr. Christopher S. Baird

Why do heart attacks always cause chest pain?

Category: Health      Published: May 4, 2013

diagram of heart
Public Domain Image, source: NIH.

Heart attacks do not always cause chest pain. This is a dangerous misconception. While chest pain often does accompany a heart attack, sometimes it does not and the symptoms are less severe. The American Heart Association states, "Although it's common to have chest pain or discomfort, a heart attack may cause subtle symptoms." Common symptoms of heart attack include nausea, feeling light-headed, shortness of breath, anxiety, and pain in one or both arms, the back, neck, or jaw. Leading up to the heart attack, the person may have experienced unexpected fatigue, difficulty breathing, and heart palpitations (the feeling that the heart is skipping a beat or beats irregularly). If you experience these symptoms, even without chest pain, you should immediately seek out emergency medical help. While there are many other less-serious medical conditions that can cause these symptoms, it is better to play it safe.

A heart attack occurs when insufficient blood is supplied to the heart's muscle cells. Without the blood-delivered oxygen needed for the heart's muscle cells to operate, they malfunction and may even die. The problem is that the heart pumps life-sustaining blood to the rest of the body, so if it malfunctions, the entire body becomes oxygen-deprived. Such a state quickly leads to death. The decrease in blood supply to the heart is usually caused by blockage in a coronary artery by plaque build-up. The chest pain caused by a heart attack is a direct result of the heart muscle cells not receiving enough blood. This is similar in mechanism to when not getting enough oxygen to your skeletal muscles while exercising can cause them to cramp or spasm.

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Topics: chest pain, heart, heart attack, myocardial infarction