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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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