In brief
Chest pain is a complaint where the cost of a mistake is high in both directions: you can be frightened by a harmless oesophageal spasm, or you can mistake a heart attack for heartburn. The pointers below do not replace a doctor, but they help you make a decision.
Do not wait, do not search online, do not try a stomach tablet, if the pain:
The single ambulance number in the UAE is 998. In a heart attack, delay is measured in the amount of heart muscle lost.
A link with physical exertion or emotional stress; reproducibility (the pain appears at the same level of exertion); easing at rest; and a diffuse character, with the patient showing not a point but the whole palm over the breastbone. The presence of risk factors — age, hypertension, diabetes, smoking, high cholesterol, early cardiac events in relatives — makes it more likely.
Pain that can be brought on by pressing a finger on a specific spot is more likely musculoskeletal. Pain that changes with a deep breath or on turning the body is more often related to the chest wall or the pleura. Burning behind the breastbone after eating, when lying down, with a sour taste, is more likely reflux. Stabbing pain lasting a few seconds at rest is usually not cardiac. A panic attack causes intense chest pain with palpitations and a feeling of not getting enough air. This is a real condition that needs help, just a different one.
An important caveat: none of these signs rules out a cardiac cause on its own. They shift the probability, but do not cancel the need for assessment.
Women more often describe not the classic pressing pain but breathlessness, unusual tiredness, nausea, or discomfort in the back or jaw. Because of this, heart attacks in women are more often recognised late. In addition, the Fifth Universal Definition of Myocardial Infarction established separate troponin thresholds for men and women, since normal values in women are lower, one more reason to recheck a result that was once considered borderline.
Once an emergency has been ruled out, assessment is guided by the probability of coronary heart disease: a detailed history, examination, ECG, echocardiography, and tests — troponin, lipid profile, glucose, and NT-proBNP where indicated. After that, stress tests and imaging as needed. The point is not to order everything, but to work from the clinical picture.
At GMS a cardiologist consultation is AED 750; ECG (AED 400), echocardiography (AED 1,100) and an express troponin test (AED 100) are performed in the clinic; NT-proBNP is AED 400 and the cardiovascular risk profile AED 350. Consultations daily from 9:00 to 21:00, in Russian and English.
Signs pointing to the heart: a link with exertion or emotional stress, pain that recurs at the same level of exertion, easing at rest, and a diffuse character — the patient shows the whole palm rather than a point. Risk factors such as age, hypertension, diabetes, smoking, high cholesterol and early cardiac events in relatives make it more likely.
If the pain is pressing or squeezing behind the breastbone and lasts over 15–20 minutes, spreads to the left arm, neck, jaw or between the shoulder blades, comes with breathlessness, cold sweat, nausea or sudden weakness, or began on exertion and does not settle at rest. The ambulance number in the UAE is 998; do not wait or try a stomach tablet.
Pain brought on by pressing a specific spot is more likely musculoskeletal; pain that changes with a deep breath or turning is usually chest wall or pleura; burning after meals or lying down with a sour taste is more likely reflux; stabbing pain for a few seconds at rest is usually not cardiac. None of these rules out the heart on its own.
This article is for information only and does not replace a consultation. If you have symptoms, see a doctor.
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