Chest Pain: What to Expect at the Doctor's Office

If you seek medical treatment for your chest pain, your doctor will likely need to ask you a number of questions and perform a series of exams and tests before he is able to make a chest pain diagnosis and determine the cause of your chest pain.

Here's what you can expect to happen once you are at your doctor's office.

Chest Pain Questions

When you first arrive at your doctor's office, he will take your blood pressure, pulse and temperature and will review your medical history and the medical history of your family. To determine the cause of your chest pain, your doctor will next need to ask you a series of questions. Be prepared to answer the following at your appointment:

• Are there certain activities that seem to make the pain worse?
• Do you experience any other symptoms with your chest pain? If so, what are they?
• Does your chest pain spread or radiate to other areas of your body? If so, where does it spread?
• How does your chest pain feel? Is it crushing, squeezing, etc.?
• How long does your chest pain last?
• When does your chest pain start? What, if anything, makes it stop?
• Where do you feel your chest pain?

Try your best to answer these questions as honestly and as thoroughly as possible. Your answers will help your doctor determine whether or not testing is required to diagnose the cause of your chest pain.

Tests for Diagnosing Chest Pain

In order to determine what is causing your chest pain, you may need to undergo several tests. Some of the tests your doctor may order include:

• Angiogram: An angiogram helps your doctor see narrowed and blocked arteries. During the test, your doctor uses a catheter to inject a liquid dye into the arteries of your heart. He will then use video and X-rays to view the arteries as they become filled with dye.
• Blood Tests: Your doctor can use blood tests to detect increased levels of certain enzymes that are normally found only in the heart muscle. Damaged heart cells could cause these enzymes to leak into the blood.
• Chest X-Rays: Chest X-rays can let doctors see the size and shape of your heart and lungs. They can also let your doctor see if you have a tumor in your chest.
• Echocardiogram: This test uses sound waves to produce a video image of your heart.
• Electrocardiogram (ECG): An electrocardiogram can help your doctor diagnose a heart attack as well as a number of other heart conditions. In an ECG, your doctor will attach electrodes to your chest and limbs to measure the electrical activity of your heart.
• Magnetic Resonance Imaging (MRI): An MRI uses magnetic fields and radio waves to painlessly create a cross-sectional view of your body.
• Nuclear Scan: Nuclear scans use trace amounts of radioactive materials to detect such problems as narrowed arteries. The materials are injected into your bloodstream and special cameras are used to watch them as they move through your heart and lungs.
• Stress Test: A stress test is used to measure how your heart and blood vessels react to physical stress. For the test, you may be asked to walk on a treadmill or pedal an exercise bike while an ECG is performed. If you are incapable of exercising, your doctor may give you a drug that will stimulate your heart in a way that is similar to exercise.

Your doctor might need to perform additional tests to make an accurate chest pain diagnosis. The tests you will need to have performed will depend largely on what your doctor believes to be the cause of your chest pain.

After reviewing your test results, your doctor will be able to tell you whether your chest pain is being caused by a heart condition.

Resources

Havens, Lila; Hess, Christopher, Hess (updated January 12, 2006). Diagnosing chest pain. Retrieved November 8, 2007, from the Sutter Health Web site http://www.sutterhealth.org/health/healthinfo/?A=C