Diagnosis
of Chest Pain
Being
in the outdoors does require physical exertion, whether you
are camping, hiking, hunting or fishing. Whenever there is
physical exertion, problems can arise for which you are unprepared.
It is very, very important for all individuals, especially
upon reaching the 4th and 5th decades of life, to have a complete
screen before going out on an extended trek in the outdoors.
The #1 cause of death amongst deer hunters is heart attacks.
With regard to instituting a personal health regimen, it is
important to visit your primary care provider for wellness
screening, which will include getting your cholesterol checked.
If you are overweight, it is important to start a diet regimen,
with an increase physical activity being very important. Even
thin young males and females have heart attacks in their 30’s
and 40’s, especially if there is a very strong family
history of heart disease.
When
traveling out-of-state, for example to Colorado to hike in
the mountains, it is also recommended that you take a copy
of your most recent EKG with you, which you can reduce in
size to fit in your wallet. In the event you need to see a
medical provider you will have with you pertinent medical
information in the form of a baseline EKG with which to compare
if an EKG is ordered.
Signs
and symptoms of chest pain can vary and mimic many other disorders.
A few differential diagnoses for chest pain include pneumonia,
pulmonary embolism, gastric esophageal reflux disorder or
GERD, gastritis, esophagitis, and even duodenal ulcers and
gall bladder disease, as well as muscle strains and contusions
can mimic heart attack type pain.
Classic
cardiac type pain is not sharp pain, but pressure over the
chest. It can radiate to bilateral shoulders, neck and/or
arms. It can be accompanied with nausea, diaphoresis (sweating)
and shortness of breath. It can increase with exertion. It
is important to note that a heart attack can and does present
with any combination of, or all of the above-mentioned symptoms,
or none of the above, which would be your classic “silent
heart attack.”
Exertional
angina occurs when there is existing coronary artery disease,
and pain is exacerbated with certain types of exertion.
Chest
Pain First Aid and Treatment
So,
what do we do when we are in the outdoors and begin to experience
chest pain? Hopefully you are not alone—a very important
reason for traveling with a companion or group. The person
or persons you are with can offer support, reassurance and
valuable transport aid. Four 81 mg. chewable aspirin is the
first line of treatment and has been shown to reduce your
chances of having a severe heart attack by 53%. Therefore,
when packing your medical bag for your camping, hunting, fishing
or other outdoor excursion, make sure that you have four chewable
81 mg. aspirin with you. Protect them by placing in aluminum
foil wrapped in cellophane so they do not get wet. Obviously
you do not want to take aspirin if you are allergic!!!
For individuals who are allergic to aspirin, there is a medication
called Clopidogrel. If you are allergic to aspirin, ask your
primary care provider to write you a prescription for that
if you are going on a long excursion, or if you have history
of heart attacks or angina. Once you have experienced chest
pain and are concerned you may be having heart attack, you
should take your aspirin as directed and minimize exertion.
If you are quite a distance from your vehicle, it is best
to be transported in a gurney. If not, walk slowly with periodic
resting. MOST IMPORTANTLY, have someone else drive
the vehicle to the ER. If you suspect you are having
a heart attack, do not go to an urgent care center unless
that is the only place available for medical care. You want
to go to the closest facility, preferable an emergency room,
where they can perform labs and further testing.
*
Side note: Please check into rescue insurance. It is nominally
priced, generally $12/weekend. If you are going hiking up
in the mountains or camping, it can save you a lot of money
in the event you need to be transported out by helicopter
or other means.
Thank
you and be safe.
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