Chest pain and vomiting too dangerous combination to ignore, consulting doctor immediately a must
Any adult patient who has chest pain lasting for more than five minutes and is vomiting and looks sick should be evaluated by a doctor at the earliest.
Vomiting is a ubiquitous symptom and nearly every one of us has experienced it. The causes can be many and they may be different when you throw up as an infant to when it happens as an adult. The commonest causes are indigestion, gastritis, liver diseases, Hepatitis, pancreatic diseases, poisoning, food poisoning, renal diseases like kidney failure and kidney stones.
In women of reproductive age, pregnancy is a common cause and as they grow older, gall stones are a very significant cause, especially if they are obese or overweight. Vomiting is also associated with heart diseases, most commonly acute myocardial infarction, also known as a heart attack. It may also be caused by aortic dissection and pericarditis, which are associated with chest pain as well.
When vomiting and chest pain occur together
Being a very common symptom as well as being associated with so many causes may create a dilemma in the individual’s mind as to when to consult a doctor. When vomiting is accompanied by chest pain, it could shorten the list of possible causes and help you understand what is wrong. The commonest cause of the two symptoms occurring together is gastritis or dyspepsia (indigestion) that is commonly passed off as acidity or heartburn. Here the patient may have repeated vomiting and have upper abdominal pain that may feel similar to chest pain. Other causes of a similar kind of pain and vomiting are gallstones, also known as acute cholecystitis, where the patient experiences severe pain along with vomiting and sweating.
However, the most fearsome cause of chest pain with vomiting remains myocardial infarction or a heart attack and it is important to be able to identify it so you can call a doctor. The following factors should be considered for this:
- The patient profile: Generally, an obese sedentary male who has hypertension and diabetes has a higher chance of having a heart attack.
- Type of pain: The cardiac pain is generally retrosternal (behind the breastbone), feels like a dull ache in nature and may radiate to the left arm, the jaw, the epigastrium (solar plexus) or the back. It increases on walking or exerting and is associated with sweating and vomiting.
- Duration of pain: The pain may last for five minutes up to half an hour and may be associated with feelings of giddiness, lightheadedness, palpitations and an impending sense of doom.
When to reach out to a doctor
At times, even muscular pains or muscle-pulls may cause chest pain and a feeling of nausea but not be directly associated with vomiting. So, when is it that we should consult a doctor when someone is experiencing chest pain and vomiting? You can decide based on a few thumb rules.
The first and the foremost part is the profile of the patient -- those who are hypertensive and have sedentary habits should consult a doctor in case the chest pain is severe and checks the criteria mentioned earlier. If the vomiting is persistent and there is a previous history of heart disease, then an immediate consult is imperative. If the patient looks sick, is turning blue, is not able to speak in full sentences or is sweating profusely, then it is necessary that an ambulance is called immediately and the patient is shifted to a hospital. In these cases, it is also important to rule out other causes of this combined symptom, like a history of drug ingestion or overdose.
Finally, any adult patient who has chest pain lasting for more than five minutes and is vomiting and looks sick should be evaluated by a doctor at the earliest. For younger patients, it is the persistence of vomiting that is more worrisome and should be taken seriously.
This article was written by Dr Salil Garg, senior consultant, Interventional Cardiology, Fortis Hospital Shalimar Bagh
For more information, read our article on Chest pain.
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