What does chest pain on the right side mean

Advice: warning signs

Chest pain can indicate an impending heart attack

"Coronary artery disease" (CHD) is characterized by narrowing of the coronary arteries. Symptoms typical for this disease can occur depending on the extent of the constriction and the resulting obstruction of the blood flow. The most common symptom is load-dependent chest pain, especially on the left side. Hence the technical term angina pectoris ("tightness in the chest"). However, complaints can also arise during rest, which are then to be classified as more serious ("unstable angina pectoris").

Location and type of pain

The most common pain occurs behind the breastbone or the left front side of the chest. This pain can then also radiate to the shoulder, back, abdomen, arm, neck, and even lower jaw. The pain is far more often localized on the left side of the body, but often also on the right side.

Often these complaints are not perceived as typical pain, but rather as a dull feeling of pressure, tightness or burning. Often these symptoms are accompanied by a feeling of anxiety or shortness of breath.

Duration of pain

In angina pectoris, a pain sensation in the chest that is characterized by a temporary reduced blood flow to the heart muscle, the pain usually lasts between 5 and 30 minutes. Typically these complaints respond well to "nitro spray", i.e. the pain disappears in a few minutes.

Differences between angina and heart attacks

Angina pectoris corresponds to a temporary inadequate blood flow to the heart, while a heart attack usually leads to the occlusion of a coronary artery, which leads to the death of myocardial tissue. However, new scientific findings suggest that the transition between angina pectoris and myocardial infarction is fluid.

In a heart attack, the pain corresponds to angina pectoris in terms of location and radiation. However, it is usually stronger, lasts longer and does not respond to nitro spray. The pain is then often accompanied by a strong feeling of fear ("annihilation pain"), a feeling of weakness and severe restlessness. Many patients sweat, have difficulty breathing and complain of nausea and vomiting. In the worst case, cardiac arrhythmias, for example, can lead to cardiac arrest and sudden loss of consciousness. Therefore, patients with a suspected heart attack are always brought to the clinic accompanied by a doctor.

Differential diagnosis

A relative inadequate blood flow to the heart muscle can also occur in diseases of the heart valves or the heart muscle without the coronary arteries being constricted. Inflammation of the pericardium or pleura can also cause similar symptoms.

But diseases of other organs can also cause symptoms that can hardly be distinguished from angina pectoris symptoms: heartburn, stomach ulcers, diseases of the spine and joints.

Silent lack of blood circulation in the heart

Almost half of all patients with a heart attack have no previous chest pain, and even 15-20% of all patients have no symptoms during the heart attack.

Risk factors

Classic risk factors for a heart attack are: smoking, high blood pressure, diabetes (diabetes mellitus), obesity, high cholesterol, increased occurrence in families. You can calculate your personal risk of suffering a heart attack in the next few years on the website of the CHD task force.

Basically, the following advice can be given

Exercise-dependent chest pain can indicate narrowing of the coronary arteries. In this case, we recommend that you make an appointment with your general practitioner or an internist / cardiologist. There it can be determined whether there is any evidence of "coronary artery disease" and whether further examinations are necessary.

A strong, persistent (> 20 min) pain in the chest ("annihilation pain"), especially if this is accompanied by "vegetative" symptoms (sweating, nausea, vomiting, dizziness), can be an indication of a heart attack. These complaints should not be taken lightly; the emergency services (fire brigade: 112) should be notified. Under no circumstances should you try to drive your own car to the clinic, as in the event of a sudden loss of consciousness you not only endanger yourself but also other road users.

Diabetics have a particular risk of silent heart attacks. A good adjustment of the blood sugar level, in particular with a normalization of the body weight, as well as close care by the family doctor help against this risk.